I am a believer in adrenal fatigue being a strong element of PFS, whether it be a root issue or not. Certainly some of the saliva tests for cortisol and dhea have suggested many on this forum have varying stages of adrenal fatigue. I’ve been searching for correlations between T, DHT and blowing out the adrenals - but haven’t found anything substantial.
Unexpectedly I found a correlation between high estrogen and adrenal fatigue. I was listening to a podcast with Ray Peat (raypeat.com/ - who is a respected biochemist). At about 29:40 minutes he suggests that high estrogen directly destroys the adrenals.
blogtalkradio.com/eastwesthealing/2011/08/25/ray-peat-serotonin-and-endotoxin
It seems the best citations for this assertion can be found in Dr. Peat’s below article
raypeat.com/articles/articles/estrogen-age-stress.shtml
I found the following citation the most interesting, given many have complained of increasing sensitivity to stress.
“Short-term estradiol treatment enhances pituitary-adrenal axis and sympathetic responses to psychosocial stress in healthy young men.”
Given that we know some PFS suffers have high estrogen from the blood work and reports of gynecomastia, it seems like this may support adrenal fatigue as a root issue.