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In addition to Phase A symptoms of Adrenal Fatigue such as salt craving, insomnia, and low blood pressure at rest, and Phase B symptoms of Adrenal Fatigue such as feeling cold, sluggish, irregular periods, PMS, low libido, acne and hypoglycemia, the typical Phase C Adrenal Exhaustion patient will also complain of one or more of the following: sudden onset of anxiety attacks, impending doom at rest, sudden onset of heart palpitations despite a normal cardiac function, sudden onset of dizziness and lightheadedness at rest, waking up in the middle of the night for no reasons and the inability to go back to sleep, sudden onset of fragile emotional states such as crying for no apparent reason, fragile reactive fluid state with edema and sodium imbalance, a sudden onset of fluctuating blood pressure, orthostatic hypotension, POTS, cardiac arrhythmia and orthostatic intolerance

Particularly, they found a positive relation between serum D-lactate (a marker of increased intestinal permeability) and markers of hepatocytes necrosis, cholestasis, and triglycerides metabolism [47]