We're an acupuncture and functional medicine clinic in downtown Seattle. We've been around since 2008. Our work blends traditional Chinese medicine with modern functional medicine, and we treat everything from chronic pain and digestive issues to hormonal patterns, fertility, autoimmune conditions, and the long tail of 'something is off and no one can figure out what.' We specialize in the complex, chronic, and 'mystery' cases that other clinics often punt on.

What makes you different from other acupuncture clinics?

Three things. First, we treat the whole person, not just the symptom — every plan is customized, no cookie-cutter protocols. Second, we blend Chinese medicine with functional medicine, lab work, modern technology, and clinical reasoning that most acupuncture clinics don't do. Third, we say what we mean. We'll tell you straight up if we think we can help, if we think you'd be better served somewhere else, or if a particular intervention isn't right for you yet. We're not here to upsell you — we're here to actually fix what's going on.

Where is GoodMedizen located?

We're at 509 Olive Way, Suite 1401, in downtown Seattle, WA 98101. The Medical Dental Building, on the corner of Olive Way and 6th Ave. The primary entrance is on Olive Way next to Go Fitness and Cherry Street Coffee. Take the elevator to the 14th floor.

Yes. Every provider at GoodMedizen is a Licensed Acupuncturist (L.Ac.) with a Master's degree in Acupuncture and Chinese Medicine, plus extensive continuing education. We're nationally board certified and licensed by the State of Washington.

What conditions do you treat?

A lot. Pain (chronic and acute), digestive issues, hormonal imbalances, fertility, anxiety and depression, sleep problems, allergies, autoimmune conditions, fatigue, post-surgical recovery, headaches and migraines, neurological conditions, skin conditions, and the long tail of 'something is off and no one can figure out what.' Acupuncture and TCM are whole systems of medicine — we're always looking at the whole body, working on restoration of function to help your body perform the duties it's supposed to.

Do you take my insurance?

We're in-network with most major Seattle-area carriers including Premera, Regence, Aetna, Cigna, First Choice Health, Kaiser PPO, Molina, and several others. We can verify your specific benefits before your first visit so there are no surprises — text us your insurance info or fill out the form on our website and we'll run a benefits check for you.

What if you don't take my insurance?

We're preferred providers for most insurance plans in Washington State. We can still see you on a self-pay basis at our standard or member rates. If you have an FSA or HSA, you can typically use those. We can also provide a superbill that you can submit to your insurance for potential out-of-network reimbursement, depending on your plan.

How much will it cost me?

It depends on your insurance plan, your deductible status, and what services you receive. We'll always run a benefits check before your first visit and tell you what to expect — copay, deductible, coinsurance, the whole picture. No surprise bills.

How do GoodMedizen memberships work?

Standard ($99/mo) is for fairly straightforward cases — member-rate acupuncture, 10% tier discount, office-visit access to your practitioner, 60-minute appointment times that include a few modalities. Premium ($179/mo) adds weekly group Q&A access for people who want more clinical guidance between visits, with a 15% discount on everything. Functional ($397/mo) is the full toolkit — monthly functional medicine visits, quarterly lab review including specialty labs, dedicated messaging access with 24-hour return, 80-minute appointments for more modality work, and 20% off acupuncture, services, and supplements. Memberships are month-to-month and you can cancel anytime.

What's the difference between a la carte and a membership?

A la carte is pay-as-you-go — you pay full rate for each visit and service. Memberships give you a monthly rate that includes longer visits, member pricing on every service and supplement, modalities included in your appointment time, and varying levels of provider access depending on tier. Memberships are designed for people who plan to use them — if you'll be in regularly, they save you significant money over a la carte.

Does acupuncture hurt?

The needles we use are very small — about the width of a strand of hair — and most people do very well with them. They are still needles, so there might be a spot here or there that's a little sharp. If something feels sharp, it should go away within a moment or two. Some points, especially in the hands, can have a deep, dull, achy quality. That ache is actually a good thing, so long as you can rest comfortably with it. Our number one goal is that you are comfortable with our treatments.

How many acupuncture sessions will I need?

What we're trying to do in the beginning is get the attention of your immune system, so we front-load treatments 2–3 times a week for typically the first 2–3 weeks. If you aren't seeing significant change by visit 3, then we dig deeper. The ultimate goal is quarterly maintenance visits — 4 times a year at season change. The goal is to limit the amount of intervention you'll ever need.

How long until I feel better from acupuncture?

Most patients notice benefit from acupuncture at their very first visit, although the first benefits noticed can be nebulous — feeling more relaxed, sleeping better, having more energy. We want to start seeing explicit change around visit 3, and significant improvement around visits 4–6. We front-load treatments to get the attention of your immune system, then slow down.

Is acupuncture safe during pregnancy?

Yes — and incredibly helpful. Acupuncture is safe throughout pregnancy when performed by a trained practitioner, and it can help with morning sickness, back pain, sleep, anxiety, breech presentation, labor preparation, and postpartum recovery. It's often one of the only things a pregnant person can do for stubborn aches and pains, as many standard treatments and medications are contraindicated.

Can children get acupuncture?

Yes. We treat kids of all ages, including infants for things like reflux and sleep disturbances. For younger children we often use non-needle techniques (shonishin, gentle bodywork, magnets, ear seeds) that get the same effect without the needles. By age 8–10, most kids are curious about the needles and actually lead us to start using them.

Is dry needling the same as acupuncture?

Dry needling is a form of acupuncture — so all dry needling is acupuncture, but not all acupuncture is dry needling. Acupuncture is a complete medical system with upwards of 5,000 years of clinical refinement. Acupuncturists train for 3–4 years at master's or doctorate level and complete national board exams. An acupuncturist needs 2,000–4,000 hours of training to insert needles. A physical therapist can be certified to do dry needling after 50–100 hours. That's the practical difference.

What is functional medicine and how is it different from going to my regular doctor?

Conventional medicine is excellent at acute care, surgery, and managing established disease. It's less designed for the chronic, complex, multi-system stuff — the gut/hormone/inflammation/fatigue tangles where every specialist sends you to a different specialist. Functional medicine zooms out, looks at how your systems interact, and uses targeted labs and interventions to address the upstream causes. We work alongside your conventional providers, not in place of them.

How long does functional medicine take to work?

Most people start feeling shifts within 4–6 weeks of starting a personalized protocol. Bigger structural changes — restoring gut function, rebalancing hormones, healing chronic inflammation — usually take 3–6 months of consistent work. Functional medicine is iterative: we run labs, build a protocol, retest, refine. It's not a quick fix; it's a rebuild.

How do I know if I need detox?

Common signs include chronic fatigue, brain fog, unexplained inflammation, hormonal disruption, chemical sensitivity, mold exposure history, dental amalgam history, occupational exposures, autoimmune patterns that aren't responding to other care, and a long history of 'doing everything right' without feeling right. We start with a thorough intake and (when indicated) testing to figure out whether toxic burden is actually the issue.

Why doesn't GoodMedizen sell a 30-day detox kit?

Because they don't work, and some of them are dangerous. Pre-packaged detox kits don't account for your specific exposure history, your drainage capacity, your genetic detox pathways, your medication situation, or your nutrient status. They mobilize toxins without first making sure your exits are open — which is exactly how detox protocols cause harm. Real detox is individual. We don't shortcut it because we've seen what happens when people do.

How much does microneedling cost at GoodMedizen?

Microneedling at GoodMedizen is a flat $619 per session and is never discounted. Exosomes are expensive — really expensive — and they're the difference between 'okay' results and exceptional ones. Cheap microneedling without quality exosomes is a fundamentally different treatment. We don't compromise on the materials.

How many microneedling sessions will I need?

Most people see significant results from a series of 3 sessions spaced 4–6 weeks apart, with maintenance every 6–12 months after. Severe scarring or significant sun damage may benefit from a series of 4–6 sessions.

What should I expect at my first acupuncture visit?

Your first visit is longer than a typical follow-up — usually 75–90 minutes — because we're doing a thorough intake. We'll go through your health history, current medications and supplements, lifestyle, and what brought you in. Then we'll do a TCM diagnostic exam (pulse, tongue, palpation) and build your initial treatment plan. The treatment itself is included in this first visit.

How do I book an appointment at GoodMedizen?

Online at goodmedizen.com/schedule-now — it's the fastest way and shows real-time availability. You can also text 206-402-3813 if you'd rather book that way or have a specific timing question.

What's the fastest way to reach GoodMedizen?

Text 206-402-3813. We're a busy clinic and during clinic hours we're with patients, hands-on, often literally holding needles. We can't pick up the phone in real time — but we can absolutely respond to a text between patients. Texting is by far the fastest way to get a response from us.

Adrenal Fatigue: What's Real, What Isn't, and What to Test

Sep 8

9 min read

Search the term and you land in a fight.

One side tells you adrenal fatigue explains the exhaustion you cannot sleep off, the 3pm collapse, the wired-and-tired evenings, and that a protocol will fix it. The other side tells you the condition does not exist, that endocrinology has looked and found nothing, and that anyone selling you a supplement for it is selling you a story.

Both positions contain something true. Neither is much use to a person who feels terrible.

What follows is the middle, which is less satisfying than either camp and considerably more accurate: the label is not a diagnosis, the physiology it gestures at is real and measurable, and the distinction between those two things determines whether you get help or get sold something.

The system in question

Your stress response runs on a three-part relay called the hypothalamic-pituitary-adrenal axis, or HPA axis.

The hypothalamus, sitting deep in the brain, notices a demand — a threat, a deadline, low blood sugar, an infection, a hard workout, an argument. It releases corticotropin-releasing hormone. That signals the pituitary to release adrenocorticotropic hormone, ACTH, into the bloodstream. ACTH travels to the adrenal glands, two small triangular organs perched on top of the kidneys, and instructs them to produce cortisol.

Cortisol then does a great deal. It raises blood sugar so muscles and brain have fuel. It modulates immune activity. It influences blood pressure, mood, memory consolidation, thyroid hormone conversion, and the timing of sleep. When enough cortisol is circulating, it signals back up to the hypothalamus and pituitary to ease off — a thermostat, switching the furnace down when the room is warm.

That rhythm has a shape. Cortisol should rise sharply in the thirty to forty-five minutes after you wake, a surge called the cortisol awakening response, then decline across the day to a low point around midnight so melatonin can rise and sleep can begin. The shape matters as much as the total. A person can produce a perfectly normal amount of cortisol across twenty-four hours and still feel dreadful if it arrives at the wrong times.

What the evidence says

The most rigorous examination of the term is unambiguous, and it is worth reading carefully rather than quoting selectively.

Researchers at the Federal University of São Paulo screened 3,470 papers and analysed the 58 that met inclusion criteria, looking specifically at cortisol profiles in fatigued and healthy people. Their conclusion was flat: there is no substantiation for adrenal fatigue as a medical condition, and the term remains a myth (Cadegiani & Kater, BMC Endocrine Disorders, 2016 — PMID 27557747). An editorial in the South African Medical Journal reached the same verdict two years later, adding that the methods used to assess the HPA axis in this literature have frequently been inappropriate (Ross, Jones & Blockman, 2018 — PMID 30182895).

Take that seriously. The adrenal glands of a chronically stressed person are not exhausted, depleted or failing. They are perfectly capable of making cortisol. Adrenal insufficiency proper — Addison's disease — is a serious, diagnosable, potentially life-threatening condition with specific testing and specific treatment, and it is a different thing entirely. Anyone who tells you your adrenals are worn out is describing a mechanism that does not happen.

Now read the same paper's own list of limitations, which is where the argument gets interesting. The authors flag heterogeneity of study design, the descriptive nature of most studies, and the poor quality of fatigue assessment across the literature. Translated: the studies disagreed with each other, many were not designed to answer the question, and hardly anyone measured fatigue well. That is a finding about the state of the research as much as about the state of the patients.

What is measurable

Set the disputed label aside and look at what has been documented in people with clinical burnout, and the picture sharpens considerably.

A systematic review of the medical literature on burnout found consistent HPA-axis changes: a lower or more blunted cortisol awakening response, higher DHEA-sulphate, a lower cortisol-to-DHEAS ratio, and stronger suppression on dexamethasone testing. The same review argued that HPA-axis evaluation deserves a place in primary care, and that burnout is regularly misfiled as depression or anxiety and treated accordingly (Kakiashvili, Leszek & Rutkowski, International Journal of Occupational Medicine and Environmental Health, 2013 — PMID 24018996).

Notice what changed. The adrenal glands are not tired. The signalling has shifted — the rhythm, the sensitivity of the feedback loop, the ratio between cortisol and its counterweight hormones. Regulation is the thing under strain, and regulation is measurable.

This is why the framing matters so much. A broken system needs replacing. An overloaded one needs relief, resources, and the right sequence of support. Nothing about your stress response is broken.

How you got here

Cortisol responds to load, and load is not only psychological. The list that reaches us in clinic usually includes several of the following at once.

Sleep that is short, fragmented, or badly timed. Blood sugar that swings — long gaps without eating, then a carbohydrate-heavy meal, each dip pulling on the stress response to bring glucose back up. Chronic inflammation from an unresolved gut issue, a lingering infection, or an autoimmune process. Overtraining, or training hard on inadequate fuel. Perimenopause, where falling progesterone removes a calming influence on the nervous system while the demands stay identical. Caffeine used to paper over the first two problems. Circumstance also counts, and often weighs most — caregiving, grief, financial pressure, a job that does not stop.

None of these is a character flaw. Each is a demand the system is answering, and the answer costs something.

What to test, and what a test can tell you

A one-off morning blood cortisol answers one question well: is this Addison's disease. That question is worth ruling out and your physician can order it.

For the rhythm question, we use a four-point salivary or dried urine collection across a day, most often the DUTCH panel, which measures free cortisol and cortisone at waking, mid-morning, afternoon and night, alongside DHEA and the metabolites that show how much cortisol is being produced overall versus how much is being cleared.

Be clear-eyed about what that gives you. It is a picture of one day. It is not a diagnosis, and the endocrinology societies do not accept it as one. What it does give is a shape to compare against your symptoms — whether your morning rise is flat, whether your evening value is high when it should be falling, whether total output is low or simply mistimed. Combined with what you report, that shape frequently changes what we do first. On its own it is a number without a story.

We look at thyroid function alongside it, since cortisol influences the conversion of T4 to active T3, and the two problems produce overlapping symptoms. Ferritin, B12, vitamin D and a fasting insulin fill in the fuel and mineral picture.

The older map

Chinese medicine has described this territory for a very long time, and its language survives because it is useful, not because it is mystical.

The pattern we most often see here is Kidney depletion — which in this system refers to a functional network governing deep reserves, will, reproductive capacity and the body's baseline warmth, rather than to the organ a nephrologist treats. Kidney yang depletion presents as cold, heaviness, low morning drive, a person who cannot get going. Kidney yin depletion presents as heat that rises at night, restlessness, night sweats, a person who is exhausted and cannot fall asleep. Both describe reserves drawn down faster than they are replaced.

The map earns its place because it insists on sequence. Chinese medicine does not tonify a depleted person immediately; it settles the system first, clears whatever is obstructing, then builds. Give a rich building formula to someone whose system is agitated and inflamed and they feel worse. That instinct is why our own approach calms before it replenishes, and why we resist the impulse to hand someone a stimulating adaptogen in week one.

What we do about it

The sequence matters more than any single item in it.

Calm the signal first. Acupuncture is where we start, and the mechanism is autonomic rather than mysterious — needling shifts the balance between sympathetic and parasympathetic activity, which is the tone the whole axis is reading. Sleep timing gets corrected in the same phase, since a disordered cortisol curve rarely repairs while the sleep-wake schedule is still moving.

Fill the coffers. Minerals go first because the stress response spends them. We use Quicksilver Scientific's Catalyzed Mineral Complex, a liquid blend of macro and trace minerals in a form that absorbs without needing robust stomach acid — useful in people whose digestion is already compromised. Magnesium runs alongside it, and the form is chosen for the job: Magtein, magnesium L-threonate, when the target is cognitive and sleep-related, since it is the form with meaningful evidence for crossing into the central nervous system. Protein intake gets audited, because amino acids are the substrate for the neurotransmitters the whole system runs on.

Then adaptogens, and not before. Adaptogens modulate rather than stimulate — they blunt an excessive stress response and support a flattened one, which is why they suit a dysregulated curve better than a stimulant does. Two of the herbs involved have direct human evidence. A sixty-day randomized, double-blind, placebo-controlled trial of standardized ashwagandha extract in stressed adults produced significant reductions in anxiety scores and in morning cortisol against placebo (Lopresti et al., Medicine, 2019 — PMID 31517876). A phase III randomized, double-blind trial of standardized Rhodiola rosea in people meeting diagnostic criteria for stress-related fatigue improved burnout scores and attention, and altered the cortisol response to awakening compared with placebo (Olsson, von Schéele & Panossian, Planta Medica, 2008 — PMID 19016404).

We use the Sun Horse adaptogenic formulas, which pair those herbs with a broader base. Thrivagen is the female-oriented blend — chaste tree berry, shatavari and Angelica archangelica layered over gynostemma, maca, American ginseng, schisandra, rhodiola, astragalus, reishi and ashwagandha. It was formulated by master herbalist Dan Moriarty of Sun Horse Energy, originally for his wife. NanoMojo is the nineteen-herb male-oriented counterpart, adding stinging nettle, saw palmetto and tribulus. Ultra Energy is the thirteen-herb universal blend when neither hormonal emphasis is wanted. All three are liposomal, taken as two pumps twice daily, held in the mouth for thirty seconds before swallowing, on an empty stomach about ten minutes before eating.

Expect the first change in sleep quality and evening calm, usually inside two to three weeks. Daytime energy tends to follow the sleep, not lead it.

Reassess. We retest the curve rather than assuming the plan worked.

Four things you can do this week

Each of these has a mechanism, and the mechanism is the reason it works.

Get up with the first alarm. Snoozing fragments the final sleep cycle and blunts the cortisol awakening response — the surge that is meant to launch your day. Rising at a consistent time trains the rhythm back into shape. It sounds unappealing when you are this tired, and it becomes easy faster than you would think.

Eat protein within an hour of waking. A protein-containing breakfast stabilizes morning blood sugar so the stress response is not conscripted into glucose management before you have left the house.

Move screens out of the last hour. Blue-weighted light suppresses melatonin release, and melatonin cannot rise while cortisol is still elevated. The two hormones share a see-saw. Dimming the evening lets the top of the curve come down on schedule.

Take a hot shower ninety minutes before bed. Heating the skin drives peripheral vasodilation, and the rebound drop in core body temperature afterwards is one of the strongest physiological cues for sleep onset. The signal is the cooling, not the warmth.

One more, harder than the rest: take a standing commitment off the calendar. Not the most important one — an optional one you keep out of habit. Load is the variable driving all of this, and every plan that adds supplements while leaving the load untouched is doing half the work.

Where this leaves you

Adrenal fatigue is not a diagnosis, and your adrenal glands are not failing. The exhaustion is real, the rhythm disturbance behind it is measurable, and it responds to a sequence that calms first, replenishes second, and modulates third.

If you would like this in a form you can keep, the complete adrenal and HPA-axis guide is in our free resources library with the full testing comparison and the self-care protocol.

If you have been exhausted long enough that you have stopped expecting to feel different, that is the point at which testing the curve is worth doing rather than guessing at it. You can book a visit online, and it is worth reading about hormone imbalance and adrenal health alongside this.

Persistent fatigue also deserves a conventional workup. Anaemia, thyroid disease, sleep apnoea, diabetes, cardiac and autoimmune conditions all present this way, and none of them should be missed while a cortisol curve is being interpreted.

We maintain a professional dispensary through Fullscript, which lets us specify forms and verify sourcing. Links to it are affiliate links.

This article is educational and is not medical advice. It is not intended to diagnose, treat, cure, or prevent any condition. Adrenal insufficiency is a serious medical diagnosis requiring physician evaluation. Speak with your physician or a qualified practitioner before starting, stopping, or changing any supplement, particularly if you take prescription medication, have a thyroid or adrenal condition, or are pregnant.

Sources

Cadegiani FA, Kater CE. Adrenal fatigue does not exist: a systematic review. BMC Endocr Disord. 2016. PMID 27557747
Ross IL, Jones J, Blockman M. We are tired of 'adrenal fatigue'. S Afr Med J. 2018. PMID 30182895
Kakiashvili T, Leszek J, Rutkowski K. The medical perspective on burnout. Int J Occup Med Environ Health. 2013. PMID 24018996
Lopresti AL, Smith SJ, Malvi H, Kodgule R. An investigation into the stress-relieving and pharmacological actions of an ashwagandha (Withania somnifera) extract: a randomized, double-blind, placebo-controlled study. Medicine (Baltimore). 2019. PMID 31517876
Olsson EM, von Schéele B, Panossian AG. A randomised, double-blind, placebo-controlled, parallel-group study of the standardised extract SHR-5 of the roots of Rhodiola rosea in the treatment of subjects with stress-related fatigue. Planta Med. 2008. PMID 19016404

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