## Too much or not enough The thyroid gland is the first thing to check if you suspect a hormonal imbalance. [Hypothyroidism](https://ul.orna.me/KOge/librarydisease?id=45) occurs when it does not produce enough hormones, hyperthyroidism occurs when it produces too many hormones. Fatigue is a frequent symptom of both conditions. [Hyperthyroidism](https://ul.orna.me/KOge/librarydisease?id=13) is characterized by muscle fatigue: it becomes harder to lift the usual weight when exercising, riding a bicycle, and climbing stairs. It is typical to feel weakness in the legs and arms. An additional symptom may be a decrease in body weight for no apparent reason. Hypothyroidism is often first characterized by cognitive disorders: there is confusion and forgetfulness, it is difficult to concentrate, there is exhaustion and desire to sleep, and muscles "shake" even when not under tension. Other symptoms include weight gain, a constant feeling of cold, and chills. > To assess the function of the thyroid gland, it is necessary to first check the level of the thyroid hormone. Its normal range in adults is 0.3-4.2 mMU/l. If the test reveals abnormalities, the doctor may prescribe additional studies. ## Check the adrenal glands The adrenal glands are next in line for examination: ===they secrete adrenaline, cortisol, and some other hormones. Excessive or insufficient production of these hormones also leads to fatigue. If the failure occurs due to an overabundance of cortisol, characteristic signs are a decrease in libido and a sense of meaninglessness and apathy about life. The condition is similar to depression, but it can be equalized very quickly with hormonal correction. Lack of cortisol slows down reactions, causes "slow-witted" feelings, and makes it difficult to drive a car or perform work that requires precise movements and high coordination. There may be dizziness (due to low blood pressure), fainting (especially against the background of stress), weight loss, darkening of the skin, and craving for salty foods. Adrenaline deficiency has the same symptoms as cortisol deficiency, but in excess, there is insomnia, "fractional" sleep, anxiety, and restlessness. > Normal blood cortisol levels are 64-536 nmol/l and normal adrenaline levels are 0-110 pg/ml. ## Hard to diagnose, easy to fix If you experience the above symptoms in addition to fatigue and weakness, it is necessary to take a blood test for hormones and work with an endocrinologist to correct the condition medically. In the majority of cases, properly selected therapy brings a quick and tangible effect.