** Thanks for contacting HCM with your health concern and you should see an Endocrinologist regarding the symptoms experienced by your daughter since attending physician will be in better position about the outcome of management, however some possibilities which can be furnished from my side is/are: 1. Since adrenal insufficiency causes low cortisol level,and under active thyroid thus causing fatigue thus one has to take into account HRT [hormone replacement therapy], since there is no replacement of hormone in any -pathy PS. since low cortisol level are associated with low blood pressure,reduce immune system function and excess tiredness. 2. HRT is the treatment of choice along with steroids since STRESS is the main cause of acute de compensation in these patients. PS. check regularly with cortisol level 3. In Ayurveda Yashtimadhu increases cortisol level due to the presence of glycyrrhetinic acid by blocking an enzyme that converts cortisol to its less active form. PS. but make sure not to take/give it for prolonged use, otherwise there will be reversal of symptoms [high blood pressure, heart disease, weight gain] 4. stress management techniques like journal writing, yoga/meditation produce cortisol regularly and maintain healthy levels. . Eat plenty of whole grains, fruits and vegetables, high in sugar and starch such as bread, pasta, and sweets to help raise cortisol levels . Grapefruit and citrus can help your adrenal glands boost cortisol production [ Grapefruit has properties that triggers the deactivation of enzyme responsible for breaking down the cortisol hormones.] . Ask her to maintain a regular sleep schedule since body naturally produces cortisol during the hours when you re sleeping [sleep in total darkness and if possible without the use of an alarm clock is recommended]