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It often starts insidiously.
A full calendar. A mind that won't switch off. Sleep that doesn't refresh.
And eventually the question: Why am I always tired – even though I "function"?

Chronic stress is not a lifestyle phenomenon. It is a persistent neuroendocrine burden – with measurable biochemical consequences.What happens in the body during stress?
Stress activates a complex axis between the brain, pituitary gland, and adrenal gland. Initially, we react lightning-fast via adrenaline and noradrenaline. Minutes later, cortisol follows – our central stress hormone.

Exhaustion is almost part of everyday life today. Many people function — but with the handbrake on. Sleep no longer restores properly. Concentration fades. Small demands suddenly feel large.

Cortisol – Helpful in the Short Term, Problematic in the Long Term

Raised cortisol:

  • blood pressure
  • blood sugar
  • triglycerides
  • mental alertness

In evolutionary terms this made sense — fight or flight.
Today we sit in an office, with the same hormone profile.

If cortisol remains elevated over time, it leads to:

If cortisol stays raised permanently, the following arise:

  • digestive problems (reduced blood flow to the gut)
  • immunosuppression (inhibition of NK and T helper cells)
  • strain on blood sugar and blood pressure
  • increased susceptibility to infection

In the long term the adrenal gland can become exhausted.

The result: fatigue, listlessness, burnout or chronic fatigue.

The Opposing Forces: DHEA and Melatonin

DHEA is involved in immune regulation, in inflammatory processes and in insulin sensitivity.
Melatonin regulates the sleep-wake rhythm and is likewise immunomodulating.

Under chronic stress these counterparts often fall below the target range.

Why this matters for your health – and what you can do

One decisive question is therefore:

Is your cortisol still regulated — or already out of balance? Serotonin — the often overlooked key point. 95 % of serotonin is produced in the gut.
Serotonin:

  • regulates mood
  • controls appetite
  • influences intestinal motility
  • is a precursor of melatonin

Chronic stress activates inflammatory cytokines

Chronic stress activates inflammatory cytokines (e.g. IL-6, TNF-α, IFN-γ), which stimulate the enzyme IDO.

This converts tryptophan into kynurenine — instead of into serotonin.

Up to 95 % of tryptophan can be lost this way.

The result:

  • low mood
  • sleep problems
  • food cravings
  • increased tendency to inflammation

Have you ever wondered if your exhaustion is really "just stress" – or biochemically measurable?

Modern stress diagnostics: what makes sense?

1. Cortisol daily profile (saliva)

• 8:00 • 14:00 • 20:00
Shows: overload or adrenal exhaustion.

2. DHEA in saliva
To assess hormonal balance.

Good practice: Always interpret values ​​in the context of your symptoms, your daily life and your diet – ideally with medical guidance.

Neurotransmitter Test

Neurotransmitters in stabilized urine

  • Epinephrine
  • Norepinephrine
  • Dopamine
  • Serotonin
  • optional GABA and Glutamate

Tryptophan & Kynurenine
For the assessment of inflammation and serotonin metabolism.

Exhausted – but is it really "just stress"?

Many people come with a similar sentence:
“I am simply tired.”

But tiredness is not a clear symptom. It can come from chronic stress — but equally from quite different physical causes. That is exactly why careful differential diagnosis matters so much.

Before we speak of burnout or the consequences of stress, we should clarify:
What is really behind it?

Differential diagnosis, exclusion of other causes such as:

  • Hypothyroidism
  • Anemia
  • Mitochondrial dysfunction
  • Micronutrient deficiencies

Therapeutic approaches – scientifically sound

  • Identify and reduce stressors
  • Relaxation techniques

Amino acid supplementation for deficiencies:

  • Phenylalanine / Tyrosine (Catecholamines)
  • Tryptophan + Vitamin B6 + Magnesium (Serotonin SW)

Adequate intake of:

  • B vitamins
  • Healthy fats
  • Cofactors like iron, copper, folate

Important: Micronutrients do not replace a healthy diet – they complement it. Why prevention is crucial
Chronic stress is not a "mental problem".
It is a measurable biochemical process.

Those who know their levels can act early – before exhaustion manifests itself. How ORY Berlin can help
At ORY Berlin, we combine:

  • hormonal stress diagnostics (cortisol, DHEA)
  • neurotransmitter analysis
  • micronutrient check
  • inflammation-related parameters
  • individual therapy planning

Not generally.
But differentiated – based on your lab values.

Prevention doesn't start with burnout.
It starts where you understand how your body reacts to stress.

Health is no accident.
It is a process.
And it can be measured.

Exhaustion is almost a part of everyday life today. Many people function – but with the handbrake on. Sleep no longer provides adequate rest. Concentration wanes. Small demands suddenly feel overwhelming.

The word "stress" is quickly thrown around. And yes – chronic stress can significantly affect hormone balance, the immune system, and neurotransmitter metabolism. However, not every instance of exhaustion is automatically stress-related.

This is precisely where structured differential diagnostics come in. Because behind fatigue and decreased performance can also lie thyroid dysfunction, iron deficiency, inflammatory processes, mitochondrial burdens, or micronutrient deficiencies. Without targeted laboratory analysis, these causes often remain undetected.

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