What to expect as you age: 45-55

Fat levels continue to fall, but as you approach and then pass menopause it’s the drop in hormone levels that cause the majority of changes. The skin becomes considerably drier, and this alone makes it more likely to crease and wrinkle. As collagen loss speeds up, this accentuates the laxity that begins in your early 40s and jowls can appear as the face starts to sag. You could also notice your skin start to look a little more sallow as circulation becomes less effective.

What to expect as you age: 35-45

The face starts to lose shape now as you start to lose fat that lies under the skin. Lines and wrinkles become more pronounced, particularly the marionette lines that run from the sides of the mouth to the chin, and nasolabial folds that run from the side of the nose to the mouth. Falling collagen levels also lead to a slight hooding of the eyelids and laxity on the face and neck. Your skin tone might lose some brightness as cell turnover slows down, but the skin texture should still be smooth. You will notice the skin start to feel drier and tighter. Annoyingly this can also be a prime trigger point for adult acne as hormone levels start to become imbalanced in the run up to menopause.

What to expect as you age: 25-35

It’s normal for some lines to appear by now- particularly under the eyes, off to the sides as so-called crow’s feet, and the side of the mouth. The reason is the 10:10 rule- you lose about 10 percent of your collagen every ten years, so every decade you’ll start to notice a greater increase in wrinkles, lines and sagging skin. The good news is your skin tones should still be even, but you might start to notice that t looks a little duller and your skin might feel dryer.

What to expect as you age: 25 or under

At this age, the skin should look plump and youthful, your skin tone should be even and bright, and lines and wrinkles should be virtually non-existent- unless you have a very expressive face, in which case they might faintly appear around your smile lines, between the brows or across your forehead. One change you might notice is that your pores get a little larger, which is one of the first signs of lowering collagen levels.

Adrenal Fatigue Stage 4: Burnout

The cortisol levels continue to drop, flatlining throughout the day, This is a sign that the body is in real trouble. Your body can no longer manufacture stress hormones- all the symptoms of pre-burnout occur but they’re magnified. In some patients it gets so bad they can’t even get out of bed or do the things they love. At this point, they often visit their doctor and are prescribed antidepressants, which don’t treat the cause at all. If you stay in this burnout phase for more than a year, I’ve found it can take years to restore optimal adrenal function. It’s really important to seek help before this point.

Adrenal Fatigue Stage 3: Pre-Burnout

Both cortisol and DHEA levels have now plunged because the body is using up the DHEA levels to deal with the ongoing stress and the adrenals can no longer secrete high levels of cortisol to compensate. Normally cortisol must be high in the morning to wake us; the fact that it’s not means that at this stage most of my patients really have a hard time getting out of bed and continually reset the alarm to snooze. Your enthusiasm for life and your libido might fall. Your immunity is also likely to suffer, so you could find that you’re picking up more minor bugs. Insomnia is likely as are other mental symptoms, such as anxiety and even depression. This can go on for a long period- and many of us still just think we’re living a normal busy life and power through with the help of coffee, sugar and, probably, by now, the odd energy drink. But remember: every time you feel anxious or tired, this is a cry for help from the adrenal glands. They don’t want more coffee or something sweet in a can; they need TLC. Otherwise you will progress to stage 4.

Adrenal Fatigue- Stage 2: Tired but Wired

If stress continues in this state, your endocrine system starts to tire. It diverts energy into making cortisol and, as such, your production of DHEA can drop. This is the point when I most commonly see patients. They know something is not right because that combination of high cortisol but low DHEA makes them feel anxious, and some even develop panic attacks. Libido can also lower. If you’re affected you’ll find it difficult to wake up in the morning, and have trouble getting to sleep or staying asleep at night, even though you’re tired because your mind is whirring. You may also wake up hungry at about 3-5am, as your blood-sugar level drops. You’re probably easily irritated, feeling more cold as the thyroid gland becomes affected and possibly gaining weight around the middle, despite exercising. Oh, and the local barista knows you by name as you need so many cups of coffee to get through the entire day.