Adrenal Fatigue Questionnaire
©
Dr. James L. Wilson*
*International © March 1981, March 1985, March 2001, April 2008, April 2011, July 25, 2014, March 30,
2016 by Dr. James L. Wilson. All rights reserved. Copies of this questionnaire may be reproduced by
healthcare professionals only for use with individual patients, but no commercial use or application
of any
part of this questionnaire is allowed without prior written consent by the author.
are a total of 87 questions for men and 89 questions for women in the questionnaire. If you
responded with a number above “0” 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 have responded affirmatively to,
the greater your adrenal fatigue. If you responded affirmatively to less than 20 of the questions,
it is unlikely
adrenal f
atigue 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
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, a
nd
2.4 on
up being severe. This number is especially useful for those who suffer from only a few of these
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 recovering from hypoadrenia. It is a good sign you are recovering, 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,