Adrenal Exhaustion or Adrenal Fatigue
Adrenal exhaustion or adrenal fatigue is one of the most under diagnosed illnesses in western society. It has been estimated that 80% of adults suffer some sort of adrenal fatigue. Adrenal fatigue, also known as hypoadrenia, is a dysfunction of the adrenal glands ultimately resulting in diminished production of adrenal hormones which adversely affects your physiology.
The most common signs of adrenal fatigue include: continued fatigue, exhaustion, trouble sleeping, trouble getting out of bed, depression, anxiety, sugar and/or salt cravings, weight gain and inability to lose weight, increased effort to do everyday tasks, decreased sex drive, decreased ability to handle stress, light headed when standing up, low body temperature, more prone to colds and flu, palpitations, nervousness, poor memory and less tolerance to stress. As a result of decreased adrenal function people with adrenal fatigue frequently also suffer from hypoglycemia (low blood sugar levels), allergies, arthritic pain and low immune response. Women with it also have increased menstral problems, PMS and menopausal symptoms.
When under stress the stress/ fear-signaling impulses activate both the sympathetic nervous system and the modulating systems of the HPA axis in the hypothalamus. Stress neurons in the hypothalamus secrete corticotropin-releasing hormone (CRH) which causes the release of adrenocorticotropic hormone (ACTH) from the pituitary gland into the general bloodstream, which stimulates the secretion of cortisol and other glucocorticoids from the adrenal glands. This is cascade of events is known as the HPA axis and is a major part of the neuroendocrine system.
The stress impulse also activates the autonomic nervous system from the hypothalamus which provides a more rapid response to stress. This engages the sympathetic nervous system and a withdrawing the parasympathetic nervous system. This is known as the fight-or-flight response.
If you are under constant chronic stress the adrenal glands become exhausted and the sympathetic nervous system is over stimulated. At this stage anxiety gets worse, insomnia, inability to relax, nervousness and a racy mind may also occur and in more severe cases breathlessness, palpitations and even tremors may manifest. A stimulated sympathetic nervous system also results with a decrease in production of digestive juices and gut motility which cause digestive and gut problems which are very common in these patients. Click here for more information on an overstimulated nervous system.
Adrenal fatigue is caused by stress weather it be emotional, mental or physical stress. Energetically it is due to giving your power away to others or to ideals and/or beliefs which creates stress in your life. If you say yes to anyone even though you really do not want to is giving your power away to others. Whenever you do anything you feel that is not right or true for you, but do it anyway, is giving your power away. There may be many areas in your life that you may be doing this however it takes a great deal of self honesty to recognise and accept in what areas you are doing it. Every time you give your power away you leak kidney energy which is needed to fuel your adrenals. A couple of common examples of giving your power away to an ideal or belief could include men working too long and too hard to be a “good” provider at their own, and ultimately their families, expense is an ideal they often try to live up to, while women tend to sacrifice themselves for their children in order to be seen as a “good” mother which eventually harms them and their children eventually anyway.
Doing things that you know are not good for you also contributes towards adrenal issues as you are not honoring your body and in complete disregard of yourself. This could include eating foods you know are not good for you, drinking too much, taking drugs, smoking, going to bed late, not getting adequate rest and relaxation, etc, etc. This kind of disregard of oneself will physically manifest as “poisons” in your physiology that will physically affect your adrenal glands contributing further towards adrenal problems. These could include: heavy metals, pathogens such as viral, bacterial or fungal infections, parasites, allergens, toxins, etc. It is a good idea to test for these and if found to be present need to be eradicated in order to allow your adrenals to repair.
Unfortunately modern medicine does not recognise adrenal exhaustion as a distinct syndrome, only recognising its most severe form being Addison’s disease. Unfortunately this attitude contributes towards many unnecessary health problems for many adrenal sufferers whom are unable to access the necessary treatment. Adrenal fatigue syndrome is a fully recognisable condition which can be healed. The first step is to find a sympathetic practitioner who will order the necessary hormone tests in order to properly diagnose this condition. The reason testing is so important is that other conditions such as hypothyoid, sex hormone imbalances, etc, etc all share very similar symptoms so an accurate diagnosis will ensure the appropriate treatment. In addition adrenal issues can cause thyroid and sex hormone imbalances which may also need to be addressed for a more complete treatment program.
The two main hormones of interest with adrenal exhaustion are DHEA and cortisol as these two hormones are continuously secreted in response to long term chronic stress. Aldosterone, another hormone produced by the adrenals, is also affected in many patients.
Cortisol
A normal functioning adrenal gland produces a whole array of hormones but of particular interest is cortisol. The adrenal glands of a healthy person produces about 20mg of cortisol each day which can increase to 200mg a day during periods of stress in order to help the body cope with the stress. Cortisol is responsible for maintaining normal blood sugar levels, it imobilises fat and protein stores for more energy, it is an anti-inflammatory, controls and modifies most blood cells that participate in immune and/or inflammatory reactions, effects blood vessels and therefore blood pressure, and electrolyte levels in the heart tissue, heart beat, as well as influencing the central nervous system controlling mood and behavior.
During early stages of adrenal stress cortisol levels are usually high which can increase obesity, cholesterol, blood pressure, alters brain chemistry causing depression and anxiety, causes insulin resistance and osteoporosis, to name a few.
During late stage adrenal exhaustion cortisol eventually falls to levels which are insufficient to adequately maintain normal physiological function. Therefore it is very important that cortisol levels are maintained at a optimal level for normal physiological function because if levels are too high or too low can both cause problems.
DHEA
The second adrenal hormone of importance that declines during periods of stress is DHEA. An average healthy man produces about 30mg of DHEA a day, while women produce abound 20mg a day however during adrenal stress may fall to very low levels. DHEA’s main actions are through conversion into other more potent hormones such as the estrogens and testosterone. It also appears to have its own action on the immune system and endothelial cells helpsing boost the immune system and preventing atherosclerosis. If production of DHEA decreases under stress and is not rectified a hormonal cascade effect could occur resulting with a deficiency of other sex hormones such as estrogen, progesterone and testosterone. If these hormones get too low then a whole range of other systems and problems can also occur such as PMS, Menopause, andropause and hypothyroidism.
The adrenal and thyroid glands work together producing their coresponding hormones which are responsible for maintaining and controlling your metabolism and thus energy levels. During periods of stress when adrenal function decreases the thyroid responds by producing more thyroid hormones in order to overcompensate for underactive adrenals. This is where you get the tired but wired symptoms. As time progresses the thyroid gland eventually burns out producing less thyroid hormones and thus causes hypothyroidism which further exacerbates your adrenal symptoms.
It is obvious that adrenal exhaustion can be devastating to your overall health. It causes diminished cortisol and DHEA levels which adversely effects thyroid and sex hormone levels. Without appropriate treatment the adverse hormonal cascade effect will be amplified resulting in very poor health.
Stages of Adrenal Exhaustion
There are three stages of adrenal exhaustion which include:
Stage 1
The first stage, which is called hyper-adrenalism, is characterised by abnormally high cortisol levels and low DHEA levels. High cortisol may cause poor sleep, sugar cravings, confusion, weight gain, hot flushes, water retention, glucose intollerance and muscle wasting. Cortisol also decreases serotonin and melatonin levels which may cause depression and insomnia, respectively. It is also an immunosuppressive which may result in a compromised immune system resulting with frequent infections and illness.
HIgh cortisol also can inhibit the metabolism of T4, a thyroid prohormone produced by the thyroid gland, into its active T3 form. This can create a thyroid hormone imbalance known as reverse T3 dominance which can further exacerabate your adrenal symptoms.
Stage 2
During stage two DHEA remains low while cortisol supplies will hover in the low-normal range leaving you feeling tired and stressed, but functional.
Stage 3
During stage 3 cortisol finally falls to low levels throughout most of the day just like DHEA leaving you with low adrenal function.
Testing for Adrenal Fatigue
In order to determine which stage adrenal fatigue you are in and therefore what is the most appropriate treatment you will need some testing. We recommend either a saliva test measuring DHEA and cortisol levels four times throughout the day or alternatively a serum DHEA-S blood test in conjunction with a 24hr urine cortisol test. Thyroid testing (T3, T4, reverse T3) is also highly recommended as previously mentioned adrenal fatigue may result with certain thyroid imbalances which further complicate fatigue symptoms.
The correct interpretation of your results is essential for appropriate treatment. Click here for details.
Treatments
Treatment of this condition may include:
Treating Adrenal Exhaustion
(1) Learn to say No!
Learn to say no! In order to completely heal from this condition you must stop giving your power away to others and to your ideals and beliefs in order to prevent further kidney energy leaking. You need to learn to act according to your inner truth and by how you feel and not by what you are conditioned into believing what is expected of you. You also need to stop being in disregard of yourself. Be more self loving and stop doing what you know is bad for you click here for more details. Techniques such as esoteric healing can help facilitate this process.
This step is most important because if you seek treatment in the form of a pill or supplement without addressing this you will only improve your bodily function but will not truely heal and restore harmony back into your body. Restoring function without addressing the underlying energy will only bury the ill energy deeper in your body as the ill pattern which lead to your condition in the first place has not been addressed and thus will only arise again in the future with a greater force and thus more severe symptoms.
(2) Lifestyle Changes
You need to remove stress from your life and/or learn to manage it more effectively. Remove energy robbers in your life, change your situation or change yourself so you adapt to the situation, change the stress inside yourself, light exercise, relaxation techniques such as meditation.
Getting adequate sleep is also essential for the healing process. Get to bed early and if you cannot sleep certain supplements such as 5-hydroxytryptophan, GABA and melatonin can help restore good sleep patterns.
Generally your body will require plenty of rest, relaxation, adequate nutrition and good quality sleep in order for it to heal and repair any damage done. This is a time of self nurturing to aid the healing process.
(2) Diet
The problem with recommending a generalised diet is that it will not suit everybody due to individual allergies/intollerances, etc. I recommend testing for food allergies and intollerances in order to identify specific foods that are a problem so an indiviualised diet can be determined. We recommned ALCAT blood testing which can test for 50, 100 or 150 different foods. If you cannot afford this test then as a minimum we recommend removing all gluten, diary and yeast from your diet.
A high protein, low carbohydrate diet works best as fluctuating sugar levels stress the adrenals further.
As a generalisation remove alcohol, caffeine, sugar and carbohydrates, gluten, dairy, fried foods and junk foods. In addition plenty of fresh foods high in nutritional content and clean water are essential. The topic of adrenal diet is too great to cover adequately here so an adrenal diet is usually provided during a consultaton which can be tailored based on test results.
(3) Remove The Cause
Apart from stress there are a whole range of factors that may contribute to the cause of adrenal exhaustion. Apart from removing possible allergens (mentioned above) from your diet you should also reduce excessive copper levels, reduce excessive mercury or toxin levels, eradicate any pathogens that may be present such as candida, parasites, virus’, repair digestive function and bowls, treat sleep apnoea, etc. Tests are available to determine if any of these may be an issue.
(4) Supplements
Mild to moderate cases of adrenal fatigue will benefit from a range of supplements. We recommned those required as cofactors for adrenal hormone production. These include: Vit C, Zinc, Magnesium, Iodine, Vit D, VIt B5, and Vit E. Our laboratory produces these in a combination capsule for convenience – click here to order. If higher doses of VIt C and magnesium are required then the use of Magnesium oil and Vit C powder can help.
Other supplements that are beneficial include: Coenzyme Q10, glutathione, alpha-ketoglutaric acid, MSM, Lipoic Acid, Vitamin B12 and ribose. They are used to stimulate aerobic metabolism by increasing oxygen transport and promoting the Citric acid cycle and respiratory chain metabolic pathways thus increasing metabolism and thus energy production.
We caution patients with the use of certain adaptagen herbs such as all the Ginsengs which are commonly used in many adrenal products. These herbs tend to over stimulate the adrenals when in fact they need to rest. This results in short term benefits of increased adrenal output however in the long term can be devistating for the adrenals. We have seen many test results for adrenal patients on these herbs whose cortisol levels crash after prolonged use. In addition energetically these herbs increase ill energy (prana) in the body which only bury your issues even deeper and allow you to continue in the ill pattern which is responsible for the depletion in the first place. Our lab produces a herbal combination capsule used to fire up your kidney energy and thus support your adrenals – click here to order.
Dimethylglycine capsules which are reported to increase the oxygenation of your blood used by athletes for increased energy/endurance may also provide some benefit.
(5) Bioidentical Adrenal Hormones – DHEA/Cortisol/Pregnenolone
Those who suffer more moderate to severe adrenal fatigue tend to respond better on bioidentical adrenal hormone replacement at physiological doses. The hormones used will depend on what stage of adrenal exhaustion you are in:
Stage 1- Low DHEA and High Cortsiol
If DHEA levels are too low when compared to optimal levels they will need to be supplemented wih DHEA. The doses of DHEA required usually range from 10 to 25mg for women and 20 to 50mg DHEA for men. Slow release capsules are the preferred method. Cortsiol levels usually self correct while on DHEA however in some cases it may continue to remain high. For these cases we recommend cortisol care capsules made by our laboratory which contain beta sitosterol in combination with a vitamin B complex used to reduce elevated cortisol.
Stage 2 or 3 – Low DHEA Low-normal Cortisol
If tests reveal both DHEA and cortisol are low when compared to optimal levels then they will both need to be increased. In these cases DHEA is used in conjunction with either cortisol or Pregnenolone.
Pregnenolone is a pro-hormone which is converted into cortisol in the body and is thus used to increase cortisol levels. In the past it was generally considered more desirable to use pregnenolone to increase cortisol levels rather than using cortisol itself as pregeneolone does not create a negative feedback mechanism which shuts down the bodies own production of cortisol. However in many cases pregnenolone is unable to effectively raise cortisol levels even at very high doses.
Therefore low dose cortisol has become a more favorable treatment. Generally 10 to 20 mg of cortisol is required daily and at these doses should not shut down the bodies own production of cortisol. These medications may be incorporated into a single slow release capsule which is taken each morning.
| Men | |
| Dose | Resistant Cases |
| DHEA 25 – 50mg | DHEA 25 – 50mg |
| Pregnenolone 50 – 100mg | Cortisol 10 – 20mg |
| Women | |
| Dose | Resistant Cases |
| DHEA 10 – 25mg | DHEA 10 – 25mg |
| Pregnenolone 25 – 100mg | Cortisol 10 – 20mg |
Again, after a month on these hormones both DHEA and cortisol levels should be re-tested and doses readjusted if your levels do not lie within the upper one third of the normal physiological range. If cortisol levels do not increase on the pregenolone after two to three months then you should switch to cortisol as previously mentioned. After 6 months on adrenal replacement therapy try to gradually reduce the doses. If the adrenals have recovered sufficiently they will “pick up the slack”. If not you will need to be on it for longer but generally it is not necessary to go beyond two years if the underlying cause has been addressed.
Related Conditions
There are a number of conditions that stand out as having an adrenal component which include: chronic fatigue, fibromyalgia, hypoglycemia, ischemic heart disease, chronic and recurrent infections, rheumatoid arthritis.
