Archive for June, 2010

Jun 22 2010

Adrenal Fatigue – What is adrenal fatigue

The adrenal glands, two crescent-shaped glands that sit on top of each kidney, are responsible for regulating the body’s response to stress by controlling the hormones released during stress. Adrenaline, noradrenaline, cortisol, DHEA, estrogen, progesterone and testosterone are all produced in the adrenal glands. These are the hormones that regulate energy production, immune function, heart rate, muscle tone, and other processes necessary to cope with stress. Excessive stress can impair the functioning of the adrenal glands causing a decrease in the output adrenal of hormones, especially cortisol. When this occurs, it leads to adrenal fatigue.

Adrenal fatigue has been known by many other names throughout the past century, including non-Addison’s hypoadrenia, sub-clinical hypoadrenia, neurasthenia, adrenal apathy, and adrenal exhaustion. Although it affects millions of people in the U.S. and around the world, conventional medicine does not yet recognize it as a distinct syndrome. Chronic, severe fatigue is the major complaint of patients with adrenal fatigue. However, adrenal fatigue is often associated with broad spectrum non-specific symptoms making it difficult to diagnose.

What Causes Adrenal Fatigue?

The major insult to the adrenals is caused by either a very intense single stress, or by chronic, repeated stresses that have a cumulative effect. Many times the cause of adrenal fatigue is not obvious because it can be due to a combination of factors. The stress can be physical, emotional, psychological, environmental, infectious, or a combination of these. The adrenals respond to every kind of stress the same, whatever the source. Some examples of stress that can lead to improperly functioning adrenal glands include, poor diets, lack of exercise, use of stimulants (caffeine, nicotine, amphetamines), lack of sleep, lack of relaxation, illness, overwork, major surgery, financial pressures, negative altitudes and beliefs, fears, marital stress, smoking, death of a loved one, stressful job, and recurring bouts of respiratory infections.

Signs and Symptoms
Continuing fatigue not relieved by sleep
Lethargy (lack of energy)
Feeling rundown or overwhelmed
Increased effort to perform daily tasks
Decreased ability to handle stress
Gaining weight, especially around the waist
High frequency of getting the flu and other respiratory diseases
Increased time to recover from illness, injury or trauma
Less enjoyment or happiness with life
Reduced sex drive
Lightheaded when rising from a horizontal position
Thoughts less focused, more fuzzy and memory less accurate
Afternoon low between 3 to 5 pm
Feel better suddenly for a brief period after a meal
Feel more awake, alert and energetic after 6 pm than during the day
Often feel tired from 9 – 10 pm, but resist going to bed
Need coffee or stimulants to get going in the morning
Cravings for salty, fatty, and high protein food such as meat and cheese
Increased symptoms of PMS for women
Pain in the upper back or neck with no apparent reason
Difficulties in getting up in the morning
Mild depression
Food and or inhalant allergies
Dry and thin skin
Hypoglycemia
Low body temperature
Nervousness
Palpitation
Unexplained hair loss
Alternating constipation and diarrhea
Diagnosis

None of the standard laboratory tests currently in use are designed to detect adrenal fatigue. However, there are tests that may contribute to an assessment. One such test, known as postural hypotension, occurs if blood pressure drops when a person stands up from a lying position. Postural hypotension almost always indicates low adrenal function. Another test involves checking cortisol levels either in blood, saliva or urine. Cortisol levels vary throughout the day and are highest between 6-8am. A low 8:00am plasma cortisol level can indicate poorly functioning adrenal glands. Some clinicians prefer testing cortisol levels in saliva because cortisol levels fluctuate during the day. Checking salivary cortisol can easily be done 4 or more times in a day and may detect an abnormality missed by a single blood test. The ACTH (adrenocorticotropic hormone) stimulation test can also used to diagnose poor adrenal function. ACTH is a pituitary hormone that stimulates the adrenal glands to secrete cortisol. When ACTH is injected, there should be an increase in cortisol production. If this does not happen, adrenal fatigue is probable.

Treatment

Treatment begins with an attempt to relieve stressful situations as much as possible. Initiate lifestyle changes, including diet modification and exercise. Limit the consumption of processed foods, alcohol and tobacco because these substances put extra stress on the adrenal glands. Take small breaks to lie down during the day, increase relaxation, eat regular meals, exercise regularly, get to bed early and sleep until at least 9:00 a.m. whenever possible. Try laughing because it increases parasympathetic output which reduces stress and blunts the release of excessive cortisol. Remove negative people from your life and do something fun each day

Below is a list of nutritional supplements that may also offer additional benefits to patients experiencing adrenal fatigue.

Vitamin C 2,000-4,000 mg/day
DHEA 50 mg a day
L-theanine 100-400 mg a day
Vitamin E w/mixed tocopherols 800 IU/day
Vitamin B complex
Melatonin 300 mcg-6 mg (at bedtime)
Niacin (125-150 mg/day) – as inositol hexaniacinate
B-6 150 mg/day
Phosphatidylserine capsules 300 mg a day
Pantothenic acid 1200-1500 mg/day
Magnesium citrate 400-1200 mg
Liquid trace minerals (zinc, manganese, selenium, chromium, molybdenum, copper, iodine)– calming effect

If depression is present – Add SAM.e 200 mg bid; DL-Phenylalanine (DLPA) 500 mg bid
Licorice (Glycyrrhiza glabra) no more than 1000 mg of glycyrrhizin
A diet that would be conducive to treating adrenal fatigue includes one that combines unrefined carbohydrates (whole grains) with protein and oils at most meals—olive, walnut, fiber, flax and high-quality fish oil. It is also important for patients to eat regular meals, avoid junk food and eat a diet with emphasis on vegetables. It may be of additional benefit that patients add sea salt to their diet.
Some herbal remedies that have been noted as possible therapies include Licorice, Ashwagandha, Maca, Siberian Ginseng, and Korean Ginseng. There are several glandular extracts on the market that contain adrenal, hypothalamus, pituitary, thyroid, and gonads that are also often recommended. Physiologic replacement of oral cortisone, DHEA, Pregnenolone, and Progesterone under the supervision of a physician may also be very helpful.

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