Adrenal Fatigue

Adrenal fatigue is an undiagnosed epidemic. The adrenal glands are pyramidal shaped organs sitting on top of the kidneys. They are responsible for secreting steroid hormones, such as cortisol, DHEA, aldosterone and adrenaline.

Adrenal fatigue is characterised by fatigue commonly in the afternoons and evenings followed by an increase in energy in the late evening, dizziness, weakness, and a decreased ability to handle stress. It is caused by weak adrenal gland function, which can lead to conditions such as chronic fatigue and under active thyroid if left untreated.

A condition called Addison’s disease occurs when the adrenal glands fail completely. This 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 supplementation 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 better diagnosed by a series of salivary cortisol measurements throughout a day.

There is not an over night cure and someone suffering from adrenal fatigue needs to understand that it can be a long process before the desired results are achieved.

Management of Adrenal Fatigue:

The following steps play an important role in improving adrenal gland function.

  • 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.

  • Reduction in heavy metal burden- mercury in particular can damage the adrenal glands. Mercury levels can be reduced by having all amalgam (silver mixed with mercury) fillings removed by a dentist who follows protocols to minimise mercury exposure and by chelation therapies.

  • Correction of any coexistant hormone imbalances. It is rare to have 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 (fight-flight response) and at times of stress or adrenal fatigue, production of adrenal hormones will favour the survival hormones. This therefore produces a relative deficiency of sex hormones.

  • Salt- salt is often deficient in adrenal fatigue and adding salt frequently improves blood pressure.

  • 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.

  • B vitamins- these are crucial for adrenal gland recovery. Extra pantothenic acid B5 (1 gram twice a day) is often effective.

  • Vitamin C- 2 grams at least twice a day. The adrenal glands have the highest demand for vitamin C of any gland in the body.

  • Magnesium 300mg daily.

  • Adrenal glandular extracts which contain the raw materials from animal adrenal glands for adrenal repair and recovery.

  • Adaptogenic herbs- Rhodiola appears to work best in adrenal fatigue. Alternatives are Ginseng, Ashwagandha and Licorice.
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