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Adrenal Fatigue 25 July 2009

Adrenal fatigue is an undiagnosed epidemic. It is caused by weak adrenal gland function. The adrenal glands are pyramidal shaped organs sitting on top of the kidneys. They secrete steroid hormones, the main ones being cortisol, DHEA, aldosterone and adrenaline. Addison’s disease occurs when the adrenal glands fail completely. It is usually diagnosed by finding low early morning cortisol levels, a high ACTH level and a poor response to an ACTH stimulation test. ACTH is secreted by the brain to stimulate the adrenal glands. In Addison’s disease, the adrenal glands have failed and the administration of ACTH does not result in the expected rise in cortisol. Occasionally, the adrenal glands fail because of disease of the pituitary gland in the brain which secretes ACTH. In this case early morning cortisol levels and ACTH levels are low but there is a rise in cortisol with the ACTH stimulation test.

Unfortunately none of these tests show the more subclinical but much more common disorder of adrenal fatigue. This disorder is characterised by fatigue (particularly in the afternoons and evenings, often with a characteristic reprieve in the late evenings), dizziness, weakness, sugar cravings and a decreased ability to handle stress. This disorder is better diagnosed by a series of salivary cortisol measurements throughout a day. Adrenal fatigue is caused by progressive damage to the adrenal glands by metabolic acids resulting from stress, negaitve emotions, what we eat and what we drink.

The features of this disorder were documented over 70 years ago by Dr Hans Selye. He proposed that there were 3 stages to the bodys reaction to stress:

  • Fight of flight (stress)
  • Adaptation (stress managed)
  • Exhaustion (worn out)

His experiments with rats showed that the initial reaction to stress was for the adrenals to enlarge as it manufactured more adrenal hormones. As the stress was managed, the adrenals returned to normal size but if the stress continued, the adrenals shrunk and the release of adrenal hormones was significantly decreased.

Selye recognised that there was bad stress called distress and good stress called eustress. We all need good stress to function best but bad stress hould be minimised.

Treatment is long and arduous but always worth the effort. Management revolves around the following steps:

  1. Stress reduction. Stress causes the adrenal glands to overwork and produce high levels of cortisol. Eventually however they become tired and cortisol levels drop. Stress must be reduced to allow the adrenals to heal. Loss of the normal diurnal cortisol excretion by doing shift work can also stress the adrenal glands. Stress produces 3 times as much metabolic acid than eating so stress reduction is an absolutely essential component of recovery.
  1. Reduction in heavy metal burden- mercury in particular can damage the adrenal glands.
  1. Correction of any coexistant hormone imbalances. It is rare for there to be an adrenal problem without coexistant imbalances with thyroid hormones and sex hormones. The adrenal gland requires normal levels of thyroid hormone to function properly and vice versa. The adrenal hormones are involved with survival. The adrenal sex hormones are icing on the cake. At times of stress or adrenal fatigue, production of hormones will favour the survival hormones, therefore producing a relative deficiency of sex hormones.
  1. Salt- salt is often deficient in adrenal fatigue and adding salt frequently improves blood pressure. It is esential to use the correct form of salt.
  1. Temporary replacement of hormones. Cortisol, DHEA and aldosterone can be supplemented in physiological doses without side effects. This is best done short term to give the adrenal glands a rest and allow them to recover. If cortisol levels are low, DHEA should not be administered without cortisol as well because DHEA further decreases cortisol levels.
  1. B vitamins- these are crucial for adrenal gland recovery. Extra pantothenic acid (1 gram twice a day) is often effective.
  1. Vitamin C- 2 grams at least twice a day (not calcium ascorbate) short term. The adrenal glands have the highest demand for vitamin C of any gland in the body.
  1. Magnesium 300mg daily. In my experience the best and most effecient way to restore cellular magnesium levels is by the use of alkaline water (which contains magnesium bicarbonate) and unrefined salt.
  1. Adrenal glandular extracts which contain the raw materials from animal adrenal glands for adrenal repair and recovery.
  1. Adaptogenic herbs- rhodiola appears to work best in adrenal fatigue. Alternatives are ginseng, ashwagandha, maca and licorice.

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