Adrenal Fatigue

This s a very controversial subject and is poorly understood by patients and physicians. Fatigue and lethargy are a very common complaint of adults, specially in the cities and on industrialized nations. Usually when patients have these problems they seek help and increase their intake of coffee, take energy boosting drinks ( full of caffeine, guarana, etc ). If they seek help, most doctors will check blood and thyroid levels as well as some other values that usually turn up to be normal ( and the doctor might tell you you just need to relax or take it easy ).

Since the 1800, the following unrelated symptoms: tiredness, fearfulness, allegies, anxiety, depression, reduced memory, insomnia, difficulty concentrating, inability to lose weight have been put into a syndrome called Adrenal Fatigue or Hypoadrenia. This syndrome, although not lethal can certainly be debilitating. It starts when your system fails to deal with stress.

Signs and symptoms of Adrenal Fatigue

Fatigue

Reduced Sex Drive

Decreased memory

Lack of energy in the mornings, better after meals for a brief period

Lightheaded when standing up

Need for stimulants or coffee in the morning

Craving salty and fatty foods

PMS symptoms for women

Upper back and neck pain

Difficulty in getting up in the morning

Mild depression

Lack or energy

Dry skin

Anxiety

Hair loss

Palpitations

Function of the Adrenals

The adrenals are 2 glands each located on top of the kidneys in the abdomen. these glands manufacture several key hormones for the body, most of them related to fluid and stress management.

The adrenals have got 2 parts to them: A central part ( medulla ) that makes epinephrine and norepinephrine and regulates the autonomic nervous system ( responsible for the fight or flight response ). The outer part or Cortex, is responsible of the production of about 80% of the hormones of the adrenals ( about 50 hormones ), these are the glucocorticoids, mineralocorticoids and androgens.

Of these hormones, cortisol is the most important hormone. When cortisol is low ( and the adrenals are exhausted ), the body cannot deal effectively with stress. Cortisol has the following effects: Normalizes blood sugars, Antiinflammation, regulates immune activity, blood pressure control and stress regulation.

Mineralocorticoids, such as Aldosterone, deal with the sodium and potassium balance of the body, thus regulating blood pressure. Increased stress levels trigger a release of aldosterone, producing water retention and also a loss of potassium and magnesium, which in turn can cause muscle cramps, arrhythmias, etc.

Androgens ( most sex hormones ) are also made on the adrenals such as DHEA and pregnenolone.

Causes of Adrenal fatigue

Stress is a major player. Chronic stress is very common in the western society. The most common causes of stress are work pressure, death of a love one, moving house, changing jobs, illness and marital disruptions.

Adrenal fatigue occurs when the amount of stress overextends the capacity of the body to compensate and recover from stress. Stressors that can lead to adrenal fatigue include Anger, chronic fatigue, chronic illness, chronic infection, chronic pain, depression, fear, guilt, gluten intolerance, low blood sugar , malabsorption and indigestion, toxic exposure, Severe or chronic stress surgery, late hours, sleep deprivation and excessive caffeine intake from coffee or tea.

What happens to Cortisol and DHEA with Stress?

At first Cortisol will increase, and DHEA will decrease. Hormones such as Epinephrine and Norepinephrine will increase. This will have consequences such as increased insulin resistance and increased blood glucose that will lead in time to diabetes, reduced immune response ( increased chance of herpes outbreaks, yeast overgrowth and viral infections ), incresed loss of calcium, increased fat accumulation, hypertension and PMS.

Later in time, once the adrenals are exhausted, very little cortisol and DHEA will be produced. Sex hormones will also decrease.

Allopathic Medicine and Adrenal Exhaustion

Most MD doctors are unfamiliar with this condition, even despite subclinical hypoadrenia being recognized as a syndrome since 1920's, for the simple reason that it is difficult to diagnose effectively by traditional blood test. Normal blood tests are designed to detect severe absolute deficiency of adrenal hormones known as Addison's disease. This disease afflicts only 4 out of 100,000 and is often the result of auto-immune disease or infectious origin. Blood tests are also useful to detect extreme excessive levels of adrenal hormones in a condition known as Cushing's disease.

Adrenal hormones are low in the case of Adrenal fatigue, but still within the "normal" range ( normal ranges are way too large and do not reflect individual needs or patient change in hormones due to age ) and not low enough to warrant the diagnosis of Addison's disease by regular blood tests. In fact, your adrenal hormones can be half of the optimum level and still be labeled "normal". A patient's cortisol level might even be relatively high and it will not mean the patient is normal , but just that the patient has got the beggining of adrenal fatigue.

Another issue that is very important is that for an accurate estimate of what your cortisol levels are is to measure them 4 times a day because of its daily variation ( 8am, noon, 5pm and before bedtime ). DHEA is tested anytime in the day.

Usually Saliva testing is used to test for cortisol, due to its ability to measure free and circulating hormones.

Treatment

The first idea I need to convey is that Adrenal Fatigue is treatable and is reversible, but do not expect to have it solved quickly. You will need at least 6 months to 1-2 years to resolve the problem.

The first step is to measure your hormone levels. You will need to go to a doctor and get him to write an order for saliva testing. ZRT ( Hormone Profile III ) labs and Metametrix ( Adrenal Test Plus ) are labs that usually offer saliva tests ( so do others ).

Then, you will need to remove the factors that contribute to your stress: Do deal with ( get to a counselor, face the problem, engage in Emotional Freedom Technique ) marital, work, relationship, financial problems. Get some good quality sleep from 10 to 7 or 8 if possible. Supplements for insomnia include melatonin, 5-HTP, magnesium, valerian, etc.

Avoid caffeine, tea, sodas, TV, computers, action books, etc. Avoid excercise just before bed, do it 1 or 2 hours before going to sleep or early in the morning.

A. Nutrition and Alternative Medicine

With respect to diet, you can start by taking a good breakfast and not skipping it, even though you may not be hungry. When cortisol levels are at its peak from 6 a.m. to 8 a.m., we may have no appetite. Even a small snack ( nutritious, with good protein, fats and carbs ) is better than nothing at all and will provide the needed energy even though there is no urge to eat. Skipping breakfast is not a good idea. It is therefore important to have a healthy breakfast soon after waking and not later than 10 a.m. Do eat lunch, again try making it nutritious. Sometimes, a nutritious snack ( think protein bar or a good protein shake ) between 2:00 to 3:00 p.m. will be needed to sustain our bodies through the dip in cortisol levels that occurs between 3:00 to 4:00 p.m. Evening meals should be around 5:00 to 6:00 p.m. Supper, if needed, should be in small quantities and low carbs to avoid the steep rise in blood sugar.

If you eat a heavy carbohydrate meal ( think pasta, pizza, breads, etc ), you could have symptoms such as nightmares, anxiety, and night sweats. When this occurs, the body will have to activate the adrenals to put out more cortisol in order to raise the blood sugar back to its normal level. This will eventually put an excessive burden onto the already fatigued adrenal gland if carried on year after year.

A. Diet

Needs to be optimized. Please take into consideration the following key nutritional elements:

1. Sugar :Glucose is a simple sugar found in food. It is an essential nutrient that provides energy for the proper functioning of the body cells. After meals, food is digested in the stomach and is broken down into glucose and other nutrients. The glucose is absorbed by the intestinal cells, carried by the bloodstream to cells throughout the body. However, glucose cannot enter the cells alone. It needs assistance from insulin in order to penetrate the cell walls. Insulin therefore acts as a regulator of glucose transport and metabolism in the body.

Insulin is called the "hunger hormone". As the blood sugar level increases after a meal, the corresponding insulin level rises with the eventual lowering of the blood sugar level and glucose is transported from the blood into the cell for energy. As energy is produced by the cell, blood glucose level slowly is lowered, the insulin release from the pancreas is turned off. As energy continue to be generated, the blood sugar level continues to drop. When it drops below a certain level, hunger is felt. This often occurs a few hours after the meal. This drop in blood sugar triggers the adrenals to make more cortisol. The cortisol increases the blood sugar by converting protein and fat into its component parts. With this, the blood sugar rises to provide a continuous supply of energy for our use between meals. Cortisol therefore works hand in hand with insulin to provide a steady blood sugar level 24 hours a day and keep blood glucose levels in a tightly controlled range.

When the adrenal gland is in a state, the amount of cortisol production drops below the normal level, and the amount of sugar available to the cells is reduced. With less sugar, less energy is available to the body, and fatigue is experienced. As the sugar level drops below a critical point, dizziness and lightheadedness can be experienced. These are common symptoms of low blood sugar (also called hypoglycemia). Low blood sugar is most likely experienced between meals at 10am-12pm, as well as 3-4pm. For diabetics, bear in mind that hypoglycemia hunger might be felt with rather "hugh" glucose numbers.

The body’s automatic response when more sugar is needed during a stress response is to make more insulin in an attempt to move the sugar into the cell from the blood stream to create more energy. Insulin opens up the cell membrane to push the glucose in, resulting in further reduction in blood glucose. This worsens the already existing hypoglycemic state. Not only that, but insulin in icreased amounts will make your body resistant to its action . This means that every time you eat a rich carbohydrate diet you will need to release more and more insulin to get the glucose inside the cells.

A quick fix solution is to take food that is high in refined sugar such as donut or sweets, or drinks that is stimulatory to get the adrenal to put out more cortisol, such as coffee, energy or cola drinks. This gives the person a boost of energy. However, this hypoglycemic symptom relief only lasts for about 1-2 hours. Inevitably, it is followed by a crash to an even lower blood level. The sugar level tends to increase after each quick fix, but drops after a few hours. By the end of the day, the body is totally exhausted.

A diet that maintains a constant sugar level in the blood is a critical consideration in adrenal fatigue recovery. This can be done by taking a variety of low-glycemic index food that releases sugar slowly to sustain the body during and between meals. Starchy carbohydrates that are converted quickly into glucose (such as pasta and bread) should be limited. Soda drinks should be totally avoided. Diets for patients with Adrenal deficiency need to balance the amount of protein, fat, and well as carbohydrates. As compared to a normal person, the adrenal fatigue person has an immediate need for sugar when hunger strikes. At the same time, they also need good protein as well as good fat to have sustained energy ( and more important, feel full ) until the next meal comes.

The primary diet should be high in raw food and that is low in glycemic index ( please search http://www.glycemicindex.com/ ) . Fruit juices should be avoided, fruits like the melons should be avoided too . Good quality protein from meat, fish, and eggs are recommended. These provide a steady source of energy to carry the body through between meals.

Vegetarians have a much higher challenge to keep up with Adrenal Fatigue . Legumes (beans) must be eaten with whole grains, seeds, or nuts to make a complete protein. It is important for vegetarians to add eggs, miso, as well as combining beans, seeds, and nuts with a small amount of whole grain. About 50-60% of the diet should consist of raw food. 6-8 servings of a wide variety of vegetables should be included.

Seeds and nuts ( think Flax seed ) are critical elements and sources of fatty acids that the adrenal glands need in order to manufacture cholesterol, a precursor to all adrenal steroid hormones. You can also take Omega 3 fatty acids form fish ( visit http://www.nordicnaturals.com/ )The key is to take nuts and seeds that are raw and free of rancid oils. Oils that are rancid make the symptoms of adrenal fatigue worse and should be avoided at all cost. Raw nuts should be taken on a liberal basis and should be soaked overnight in water. Nuts such as cashews, almonds, brazils, pecans, walnuts, and chestnuts are excellent. Peanuts should be avoided. Olive oil should be used for salad dressings. If heated it will NOT GIVE YOU its excellent antiinflammatory and nutrition properties. Use coconut oil and butter for any high heat or deep-frying.

Vegetables high in sodium include kelp, black olives, red hot peppers, spinach, zucchini, celery. Fruits should only be taken in moderation ( berries and pears are good ). You will need to learn to feel your body as a bad feeling after food consumption, will tell you that you are on the wrong track and that part of the food you ate is NOT good for you. Organic fruits such as papaya mango, apples, grapes, and cherry are recommended.

On other issues, I will recommend you eat all your meals, or even better, try to have 4 or 5 smaller meals and NOT 2 or 3. When eating whole grain carbohydrates, add protein ( it will make you feel fuller ) and also some fat to slow down the absorbtion of glucose. Ny eating whole carbohydrates you are at least making sure you are taking some fiber too.

2. Salt . As with advanced adrenal fatigue reports a low blood pressure as well as a salt craving. The low blood pressure is due to the reduced fluid in the body. Salt craving is because the body is in a absolute deficiency of sodium. Both are due to the lack of aldosterone. While lost fluids should be replaced, it has to be done carefully. When the fluid is replaced without adequate sodium, the amount of sodium in the body actually gets diluted, therefore resulting in an even lower sodium level. This is called dilutional hyponatremia, a dangerous condition that can be deadly. It is therefore important to add salt liberally to fluids ( if your blood pressure is not high! ) that are taken in by anybody suffering form adrenal fatigue.

Commercially available electrolyte replacement drinks such as Gatorade or Powerade are designed for people who have normal adrenal and excessive loss of potassium during exercise. These drinks are designed to be high in potassium and low in sodium. Sufferers of advanced adrenal fatigue usually have a low cortisol and sodium level. They should take filtered drinking water with ½-1 teaspoon of salt on a regular basis, especially in the morning.

Only a small number of people with adrenal fatigue have concurrent high blood pressure. Those that fall into this category should check their blood pressure carefully during fluid replacement.
Sea salt is better than table salt in that it contains additional trace minerals as well. A good fluid cocktail for adrenal fatigue suffers is vegetable juice diluted with water and sprinkled with sea salt and kelp powder.

Hydration of a person in adrenal fatigue should take about 24-48 hrs. The drink should be administered frequently, about 2-4 times a day in intermittent dosages. Coffee, alcohol, and tea (with the exception of herbal tea) should be avoided.

B. BIO IDENTICAL HORMONES

I would advise you to go to a doctor who knows and manages bio identical hormones to evaluate you and treat you. Treatment for Adrenal Exhaustion should be individualized for each individual patient and adjusted according to symptoms and hormonal levels.

Hormonally ( these are all prescription ), you can supplement hydrocortisone or cortisone acetate in doses of 2.5 to 5 mg two to four times a day. this can replenish depleted adrenals. Also, you could replace DHEA with 15-50 mg a day and pregnenolone 25-50 mg.

C. Supplements

With respect to herbals and supplements, you can use several.

First Think about adding a super green shake in the morning. Replace Coffee with Green tea. Then, think about adding Omega 3 fatty acids ( http://www.nordicnaturals.com/ ) at about 2 to 4 grams daily.

Other herbals and supplements you need to consider are vitamin C, magnesium, siberian gingseng and rhodiola rosea.

I hope this review has been useful for you. Please view this video on the topic