I was expecting just desiccated adrenal not both adrenal and adrenal cortex. Nonetheless, this supplement really helped me. Day 1, like others said, it’s like a freight train or long term espresso rush (I had a hard time sleeping). Day 2, I felt wired but not like the day before (I still had a hard time sleeping). Day 3, it settled down even more (and I was able to sleep some). Day 4, it seemed to even out and was not noticeable – but I was more alert and had energy, and was calmer. Day 5, I was very even and some of my more bothersome side effects had completely subsided (sweating, oily skin). I am only taking it in the morning, I haven't increased my dosage yet.I have Hashimoto’s Thyroiditis and I am on prescription medication for it. Despite the medication, I still didn’t feel my best. I still just have no energy and still had symptoms that are as indicative of adrenal fatigue as well as Thyroiditis. Many physicians are loathed to treat “adrenal fatigue” with prednisone because it’s not a recognized illness. Back in the olden days they used to treat any adrenal disease with desiccated animal adrenals.A NIH article THE INFLUENCE OF THE THYROID ON ADRENAL CORTICAL FUNCTION by Ralph E. Peterson (1953) states that “The thyrotoxic (hyperthyroid) individual is capable of manufacturing each day a quantity of cortisol that in a normal subject would quickly induce a state of hypercorticism. It might be postulated that if the hyperthyroid state were severe enough, as in a thyroid crisis, the rate of transformation of secreted cortisol might exceed the capacity of the adrenal to synthesize cortisol, and thus adrenal insufficiency might develop in the presence of an overproduction of cortisol.” (And, conversely, a hypothyroid individual does not manufacture enough cortisol.)Dr. Lam on his website states that “Adrenal weakness progresses through stages as the body de-compensates. It is the body's strategy to return to a state of simplicity from a life that is too complex for the body to handle. Despite rising ACTH, the adrenals cannot keep up with the body's demand for cortisol. This may happen over a few years. Total cortisol output is reduced, and DHEA falls far below average. The nighttime cortisol level is usually reduced as the HPA axis "crash". The body is unable to maintain homeostasis. Early in this stage, mild symptoms characteristic of the first and second stages of Adrenal Fatigue become persistent or chronic (Phase A). As the condition gets worse, multiple endocrine axis imbalances tend to occur (Phase B). This manifests in the form of ovarian-adrenal-thyroid (OAT) axis imbalance in females and adrenal-thyroid axis imbalance in males. The body is in a constant state of mild to moderate fatigue in phase A and B.“As the body continues its downward path of impaired function, it gathers steam. The body becomes compromised in trying to maintain the fine controls of homeostasis. Normal equilibrium is lost. The body enters a state of reactive disequilibrium (Phase C). Severe fatigue is the norm for those with Phase C.“Your body will try to maintain equilibrium with the activation of the autonomic nervous system (ANS). However, the body is too fatigued. Other pathways of the NEM stress response are damaged as well. impaired metabolic, clearance, and detoxification pathways give rise to paradoxical, unpredictable, and exaggerated outcomes. Reactive sugar imbalances, fragile blood pressure, postural hypotension, heart palpitations, POTS, dizziness, anxiety reactions, being "wired and tired," periodic adrenaline rushes, fragile fluid state; such as hypersensitive dilutional hyponatremia, sudden onset of anxiety, and a sensation of impending doom are common.”My hope is that I can figure out how to use all of this information to fix myself, since the doctors don’t seem to care.