Hope-
I am not surprised your friend has not had a lot of support from Drs… I never did and I've seen half the number of "medical professionals" as many people I've come across… Finally, I took my health into my own hands and had to learn—a lot. But this is a great place for that—many knowledgable and generous souls on this forum.
That said, it would really help your friend if she could find a naturopath and if she/he is also lyme-friendly, that would be so helpful. It's an exhausting search but very important for some people to have that kind of support-I know it is for me. There are good professionals out there but they are few and far between.
Also, it really took me a long time to get my cortisol functioning well. I took Cortisol Mgr at night and Isocort in the AM and honestly, I can't say it affected that much. Nor did my ND and I really understand the whole picture and what demands were placed on my immune system and adrenals at that time. And every person is different so there is a bit of trial-and-error involved in discovery. It's complicated to treat and she really needs saliva testing done (tests cortisol levels every 4 hrs) in order to understand what is going on—and that is just the cortisol levels. I would bet her neurotransmitter levels are off as well.
This website originated as a thyroid support resource but also has some good info on adrenals, as they are often either in sync or out of sync:
stopthethyroidmadness.comAnd diet is critical. You probably already know this but she needs to eliminate all processed foods. Period. That is essential. Next, she needs to reduce or eliminate all refined sugars and if she can go organic and reduce grains, all the better. Those foods have chemicals that make it so hard to digest and your GI is working 24 hrs a day… it could be struggling at night when it should be in a different mode to aid sleep. And no caffeine for the weary, sorry. That just creates a worse daytime cycle that the body can't adjust from appropriately for night-time.
Please let us know if you have more questions—keep posting.
-p