Dr. Wilson’s Adrenal Fatigue Questionnaire
From Adrenal Fatigue: The 21st Century Stress Syndrome
by Dr. James L. Wilson
This questionnaire covers many of the common fatigue causes and stress symptoms associated with fatigued adrenals. Although not meant to be a stand-alone diagnostic tool, this stress quiz can be helpful in indicating the presence and degree of adrenal fatigue.
Instructions: Please enter the appropriate response number to each statement in the columns below. Use the values in the rating scale below. Once you have answered all of the questions, scroll to the bottom of the page and click the “Calculate” button. Your score and assessment will be tabulated and displayed.
Note: One column in the questionnaire is titled “Past” and another “Now.” The past refers to the last time you felt well. If you cannot determine a specific date, then pick a relative time after which your symptoms seemed to noticeably worsen. It is helpful to write this date down so 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 generally feel now, in this present time frame or since the date you entered for the “Past” column.
|0||Never / rarely|
|1||Occasionally / Slightly|
|2||Moderate in intensity or frequency|
|3||Intense / severe or frequent|