Chapter 8
Completing the Questionnaire
The following questionnaire is the most important tool in this book for determining if you have hypoadrenia (adrenal fatigue). In conjunction with other doctors over the past 2 decades, I have compiled the indications of adrenal fatigue covered by this questionnaire. Although it has not been standardized, I have found it to be extremely valuable clinically and it has consistently proved its worth time after time. It covers most of the signs and symptoms that are indicators of adrenal fatigue. Your answers to the questions will create a picture of how functional or dysfunctional your adrenal glands are and will help you to determine possible sources of this problem in your life.
Often adrenal fatigue becomes more extreme after a significant event such as an accident, surgery, illness or emotional trauma. Therefore, it is helpful when answering the questionnaire to think about the last time you felt well and the circumstances surrounding it. It is not critical that you have an exact date in mind, but a relative period after which your health began to deteriorate. If there is no particular time after which you noticed a change, do not worry about it. Adrenal fatigue frequently comes on gradually with no identifiable date of onset.
Instructions
The questionnaire is easy to take. Simply read each statement, decide its degree of severity, and then place the appropriate number beside each statement. Note that 0 stands for never or rarely, 1 is occasionally or slightly, 2 is moderate in frequency and intensity, and 3 is severe, constant and/or interferes with your daily living. There may be some statements you feel like putting a 5 beside. However, resist this temptation and only put 3 as the maximum value. Otherwise it confuses the final scoring. Try to be as objective as possible; mark a symptom how it really is rather than worse or better than it is. The more objective you can be about yourself, the more realistic will be your outcome. Do not labor over any one statement as the cumulative score is what is most important.
One column in the questionnaire is titled “Past” and one “Now.” The past refers to your life before the date you entered under “The last time I felt well.” If you cannot determine a specific date, then pick a relative time after which your symptoms seemed to noticeably worsen. Write this date at the top of the “Past” column so that you do not forget it. All your responses in the “Past” column will be about how you felt before that date. The “Now” column is not necessarily about today, but about how you feel generally now, in this present time frame or since the date you entered at the top of the “Past” column.
After you have completed the questionnaire, you will add the numbers in each column, as directed, to find your total scores. Then you will go on to the “Interpreting the Questionnaire” section to determine the state of your adrenal health.
You might find that you have some symptoms not mentioned in this questionnaire. It is not meant to be exhaustive but it adequately covers enough symptoms and signs to accurately determine the presence and the degree of adrenal fatigue. This questionnaire has proven itself extremely useful clinically over the past 20 years. Remember that this questionnaire is for your benefit. The more accurate and objective you can be, the more valuable will be your results. If you answer the questionnaire honestly, your answers will not only help you to determine your degree of adrenal fatigue, but will also give you useful information and insight into your present condition.
Adrenal Questionnaire
Scoring and Interpretation of the Questionnaire
A lot of information can be obtained from this questionnaire. Follow the instructions below carefully to score your questionnaire correctly. Then proceed to the interpretation section.
Total Number of Questions Answered
1. First count the total number of questions in each section that you answered with any number other than zero. Enter the “Past” and “Now” totals separately, entering each in the appropriate boxes for each section of the “Total number of questions answered” scoring chart on the next page. For example, if you answered a total of 21 questions in the “Past” column and 27 questions in the “Now” column of the “Key Signs and Symptoms” with a 1,2 or 3, your total number of questions answered score for the “Past” column in that section would be “21” and for the “Now” column would be “27.” Note that there are no entries for the first section of the questionnaire entitled “Predisposing Factors.” This section is dealt with separately and is not included in the summary below. Therefore, your first entry into the summary boxes will be for the “Key Sign and Symptoms” section.
2. After you have finished entering the number of questions answered in both columns for each section, sum all the numbers for each column and the total in the “Grand Total - Total Responses” boxes on the bottom row of the scoring chart.
3. All the boxes in the “Total Number of Questions Answered” chart should now be filled.
Then go on to the next part of the scoring.
Total Number of Questions Answered
Total Points:
This part of the scoring adds up the actual numbers (0,1,2 or 3) you put beside the questions when you were answering the questionnaire. Add these numbers for each column in each section and enter them into the appropriate boxes in the chart below. Then, sum each column to get the Total-Points-Past and Total-Points-Now scores. Enter these totals in the bottom 2 boxes to complete this part of the scoring.
Interpreting the Questionnaire
The questionnaire is a valuable tool for determining if you have adrenal fatigue and, if you do, the severity of your syndrome. Of course, the accuracy of its interpretation depends upon you completing every section as accurately and honestly as possible. Because there is such diversity in how individuals experience adrenal fatigue, a wide variety of signs and symptoms have been included. Some people have only the minimal number of symptoms, but the symptoms they do have are severe. Others experience a great number of symptoms, but most of their symptoms are relatively mild. That is why there are two kinds of scores to indicate adrenal fatigue.
Total Number of Questions Answered: This gives you a general “Yes or No” answer to the question, “Do I have adrenal fatigue?” Look at your “Grand Total – Total Responses” scores in the first scoring chart (Total Number of Questions Answered). The purpose of this score is to see the total number of signs and symptoms of adrenal fatigue you have. There are a total of 87 questions for men and 89 questions for women in the questionnaire. If you responded to more than 26 (men) or 32 (women) of the questions, (regardless of which severity response number you gave the question), you have some degree of adrenal fatigue. The greater the number of questions that you responded to, the greater your adrenal fatigue. If you responded affirmatively to less than 20 of the questions, it is unlikely adrenal fatigue is your problem. People who do not have adrenal fatigue may still experience a few of these indicators in their lives, but not many of them. If your symptoms do not include fatigue or decreased ability to handle stress, then you are probably not suffering from adrenal fatigue.
Total Points: The total points are used to determine the degree of severity of your adrenal fatigue. If you ranked every question as 3 (the worst) your total points would be 261 for men and 267 for women. If you scored under 40, you either have only slight adrenal fatigue or none at all. If you scored between 44-87 for men or 45-88 for women, then overall you have a mild degree of adrenal fatigue. This does not mean that some individual symptoms are not severe, but overall your symptom picture reflects mildly fatigued adrenals. If you scored between 88-130 for men or 89-132 for women, your adrenal fatigue is moderate. If you scored above 130 for men or 132 for women, then consider yourself to be suffering from severe adrenal fatigue. Now compare the total points of the different sections with each other. This allows you to see if 1 or 2 sections stand out as having more signs and symptoms than the others. If you have a predominating group of symptoms, they will be the most useful ones for you to watch as indicators as you improve. Seeing which sections stand out will also be helpful in developing your own recovery program.
Severity Index: The Severity Index is calculated by simply dividing the total points by the total number of questions you answered in the affirmative. It gives an indication of how severely you experience the signs and symptoms, with 1.0 – 1.6 being mild, 1.7 – 2.3 being moderate, and 2.4 on up being severe. This number is especially useful for those who suffer from only a few of these signs and symptoms, but yet are considerably debilitated by them.
Past vs. Now: Now compare the total points in the “Past” column to the total points in the “Now” column. The difference indicates the direction your adrenal health is taking. If the number in the “Past” column is greater than the number in the “Now” column, then you are slowly healing from hypoadrenia. It is a good sign you are healing, but you will still want to read the following chapters to accelerate your improvement. If the number in the “Now” column is greater than the number in the “Past” column, your adrenal glands are on a downhill course and you need to take immediate action to prevent further decline and to recover. Now complete the section below before you finish reading the rest of the book.
Asterisk Total: Finally, add the actual numbers you put beside the questions marked by asterisks (*) for the “Now” column. If this total is more than 9, you are likely suffering from a relatively severe form of adrenal fatigue. If this total is more than 12, and you answer yes to more than 2 of the questions below, you have many of the indications of true Addison’s disease and should consult a physician in addition to doing the things in this book. Be sure to read the section below, “Approaching Your Doctor,” as well as other appropriate sections in this book before consulting a physician.
Answer the following questions only if you scored more than 12 on the questions marked with an asterisk (*).
Interpretation of the “Predisposing Factors” Section: This section helps determine which factors led to the development of your adrenal fatigue. There may have been only one factor or there may have been several, but the number does not matter. One severely stressful incident can be all it takes for someone to develop adrenal fatigue, although typically it is more. This list is not exhaustive, but the items listed in this section are the most common factors that lead to adrenal fatigue. Use this section to better understand how your adrenal fatigue developed. Seeing how it started often makes clearer what actions you can take to successfully recover from it. This section also leads into a following section that explores in more depth how your adrenal fatigue developed.
Approaching Your Doctor
Now that you have decided that you have some form of adrenal fatigue, it is only natural for you to want to run and tell your doctor. Or you may want to have your doctor do further tests. If you skipped over the last chapter, a word of caution before you share your newfound revelations with him or her. First, your doctor may not believe that adrenal fatigue exists. Second, if he vaguely recognizes the term, he may want to run the test for Addison’s disease. Since only 4 in a 100,000 have Addison’s disease, chances are you will pass the test and he will conclude that there is nothing wrong with you. He may give you some tranquilizers, send you to a psychiatrist, tell you to quit reading the self-help books, or offer other unhelpful advice. Even many alternative physicians are not yet aware of the problems of adrenal fatigue. Believe it or not, the fact that adrenal fatigue is so common and so pervasive makes it more difficult to recognize. But regardless of what your doctor says, adrenal fatigue is real and the questionnaire in this book is a valuable tool in identifying its presence and severity. Although this book is written for people who have no medical background, it is based on a solid foundation of more than 2,400 scientific and clinical references relating to adrenal fatigue. However, the truly important questions are not how many studies relate to adrenal fatigue or whether or not your doctor recognizes it. The important questions are do you suffer from adrenal fatigue and if so, what can you do about it. To help you answer these questions, read on. The next chapter will help you determine how you came to have adrenal fatigue.