• What is Adrenal Insufficiency/Fatigue?
• Anatomy of the Adrenal Glands
• What causes Adrenal Insufficiency/Fatigue?
• Signs and symptoms of Adrenal Insufficiency/Fatigue
• How do our naturopaths treat Adrenal Insufficiency/Fatigue?
• How do we test for Adrenal Insufficiency/Fatigue?

Adrenal insufficiency/fatigue is one of the more frustrating and debilitating stress disorders. It is becoming far more prevalent in our society as we try to take on more and more in our busy lives. Our bodies have a tipping point and when the emotional, physical, and mental exertion out weighs our body’s ability to replenish and repair we step over that tipping point and into a state of Adrenal Insufficiency/Fatigue.

In today’s society we are taught to push harder, go farther and to never give up; but we are forgetting a fundamental detail and that is to honour and listen to our body’s needs (for sleep, whole food nutrition, recovery, balanced exercise, and time with loved ones).  At some point the body reaches this threshold and your adrenals cannot keep up with the demands being put on them and unfortunately that means neither can you. The symptoms of adrenal insufficiency/fatigue are very similar to anemia and hypothyroid such as exhaustion, brain fog, irritability, low tolerance for stress. Despite this blood results report normal levels for thyroid function and iron status.

The most discouraging part is that the medical system is not looking at your adrenal health. Therefore when you go to the doctor hoping to uncover why you are feeling the way you are and you leave being told that your results are normal. In these cases there is usually a misdiagnoses of chronic fatigue syndrome and/or mild depression, with little to no recommendations on how to solve the issue.

For an adrenal patient this is hugely frustrating as your exhaustion and brain fog does not supply you with the energy you need to start searching and fighting for your own alternatives or answers.  Often times patients go home in disbelief and fear because they know they are not feeling anywhere close to what their normal is and now there is an even greater fear knowing the traditional medical system cannot help them.

You will be relieved to know that our naturopathic physicians at our naturopathic clinic are very well versed in testing and treating adrenal insufficiency and fatigue and with the proper treatment it is possible to fully recover and get your self back.

What are the Adrenal Glands?

            The Adrenal glands sit on top of the kidneys and are only a short distance from the aorta (the major artery of the body) and the vena cava (the major vein). This placement is very convenient for rapid adrenal response to hormonal messages that are transported through the blood. Some important hormonal key player’s in the adrenal gland are ACTH (adrenal corticotrophic hormone), cortisol, epinephrine (adrenalin), norepinephrine (noradrenaline), aldosterone, DHEA, pregnenolone, progesterone, estrogens, testosterones, and androestenedione.

            ACTH is a hormone messenger from the pituitary gland that signals to the adrenal glands to secrete cortisol and how much is needed. In a matter of a few seconds after receiving the message the requested level of cortisol is sent from the adrenal glands to the rest of the body. Cortisol is also known as our stress hormone and is a very powerful anti-inflammatory when is being optimally and properly regulated. When we are putting our bodies in a chronic state of fight or flight, either with food, lack of sleep, over-exercise and/or mental stress then we are signaling to our adrenals to release more and more cortisol. This in turn eventually causes our adrenals to become fatigued. There doesn’t have to be a complete failure (Addison’s disease) before you experience symptoms, dysfunction can also present many uncomfortable symptoms.

Signs and Symptoms for Adrenal Fatigue¹ (most common but not exclusively)

Difficulty getting up in the morning	Increased time to recover from illness, injury or trauma
Continuing fatigue not relieved by sleep	Light-headed when standing up quickly
Craving for salt or salty foods	Mild depression
Lethargy, everything feels like a chore even things that were once enjoyable	Less enjoyment or happiness with life
Increased effort to do everyday tasks	Increased PMS
Decreased sex drive	Symptoms increase if meals are skipped or inadequate
Decreased ability to handle stress	Thoughts less focused, more fuzzy (Brain Fog)
Memory less accurate	Decreased tolerance
Don’t really wake up until 10:00 am	Afternoon low between 3:00 and 4:00 pm
Feels better after evening meal	Decreased productivity

Stages of Adrenal Fatigue²

Stage One: ALARM PHASE

This is the body’s immediate reaction to a stressor; it can be an imminent physical threat, a job interview or even a hospital stay. During this stage, the body is capable of making large amounts of the needed hormones to adequately address the threat. Individuals will benefit from a state of increased arousal and alertness during this stage, however sleep patterns may begin to suffer and you may feel periods of tiredness. Individuals rarely report symptoms during this stage and we will go in and out of this stage several times throughout our lives.

Stage Two: Continuing the Alarm Phase

            As stress continues, your body’s response to it does also. During this stage, your body is still well equipped to produce the needed hormones but the levels of DHEA and other sex hormones start to drop. The resources needed to create the sex hormones are being diverted to the production of stress hormones, such as cortisol. Symptoms of over-exertion will start to kick in with a feeling of being “wired but tired”. The ability to maintain alertness is there when needed but then crashing hard in the evenings. Stimulants (coffee and energy drinks) are usually used in this stage to give the body an extra lift.

Stage Three: The “Resistance” Phase

            The endocrine system continues to focus on producing stress hormones at the cost of the sex hormones. There may be substantial drops in hormones such as DHEA and testosterone, as hormone precursors material is sent towards the cortisol production pathway. This diversion is called the “pregnenolone steal” since pregnenolone is a precursor to both the sex hormones and cortisol. The individual is still able to function, manage a job, and continue to live a pretty normal life, except the lowered levels of many important hormones, is making a big impact on the individual’s quality of life. Typical symptoms could include regular tiredness, a lack of enthusiasm, regular infections, and a lower sex drive. The length could be for several months or even years.

Stage Four: The “Burnout” Phase

            After a period of time the body simply runs out of ways to create stress hormones, cortisol levels drop, sex hormones and neurotransmitter levels are low and this is what we call “burnout” (term coined by Dr. Fredenberger). This is the crash after a long period of coping with stress. The symptoms for this stage are extreme tiredness, lack of sex drive, irritability, depression, anxiety, weight loss, apathy and disinterest in the world around. This hormone insufficiency has big implications for almost every part of the body. To have full a recovery from this stage, there is a significant time needed, patience and often a complete change in lifestyle.

Who suffers from Adrenal Fatigue?¹

            Anyone can suffer from adrenal fatigue, we all have different capacities to deal with stress and what one person can handle with ease another person may feel overwhelmed by. That’s why the road to recovery from adrenal fatigue is very specific to the individual’s life, the environment, diet, sleep patterns and stressors. Some more common personality traits of individuals more likely to suffer from AF are individuals who are “type A” personalities, whom are never satisfied and are constantly reaching for MORE, at all costs.

Causes of Adrenal Fatigue¹

Primary components that can lead to AF:

• Lack of sleep
• Poor food choices
• Using food and drinks as stimulants when tired
• Staying up late even though fatigued
• Being constantly in a position of powerlessness
• Constantly driving yourself
• Trying to be perfect
• Staying in double binds (no-win situations) over time
• Lack of enjoyable and rejuvenating activities

Lifestyles that can lead to AF:

• University student
• Mother with two or more children and little support from friends and family
• Single parent
• Unhappy marriage
• Extremely unhappy and stressful work conditions
• Self-employed with a new or struggling business
• Drug or alcohol abuser
• Alternating shift work that requires sleep pattern to be frequently changed
• All work, little play

Life events that can lead to AF:

• Unrelieved pressure or frequent crises at work and/or home
• Any severe or emotional trauma
• Death of close friend or family member
• Major surgery- with incomplete recovery or subsequent persistent fatigue
• Prolonged or repeated respiratory infections
• Serious burns- including severe sunburn
• Head trauma
• Loss of stable job
• Sudden change in financial status
• Relocation without support of friends or family
• Repeated or overwhelming chemical exposure

Tests for Adrenal Fatigue

            There are a few different tests for adrenal fatigue that our practitioners would be more than happy to help with. The tests are able to test specific hormones, during certain times of the day and assess what stage of adrenal fatigue you may be suffering from.

Treatment for Adrenal Fatigue¹

            Treatment from adrenal fatigue can be a bit of a roller coaster ride. A two steps forward, one step backward process, depending on the stage you are starting in. The path to recovery like anything is very specific to your needs and dysfunction. Our Naturopathic physicians can help you find your unique route back to health. Some keys to recovering from adrenal fatigue are to change the lifestyle and habits that got you there in the first place, such as:

•  Little or no exercise
• Energy robbers (people in your life that drain your energy)
• Overwork and no play
• Constant negative thoughts
• Unattended health problems
• Debilitating attitudes and beliefs
• Refined junk food

Lifestyle changes to Restore Function to Adrenal Glands:

It is essential in all stages to do the following:

• Mental reframing
• Mild exercise (aerobic, anaerobic, and flexibility)
• High-quality food and regular meals
• Positive attitudes and beliefs

Supplements to Restore Function to Adrenal Glands:

In the first two stages of Adrenal Dysfunction we use:

• Adaptogenic Herbs: these are supportive of ensuring your adrenal glands are responding to stress correctly and also have a nutritive effect on your adrenals to restore function.
• Therapeutic Vitamin Dosages of B5 and Vitamin C: your adrenal glands use both of these vitamins in high doses as coenzymes to produce your adrenal hormones due to the greater demand for them often times a deficiency occurs.
• Intravenous Vitamin Therapy: it is not always possible to get therapeutic dosing of Vitamins into the body because of impaired digestion common with adrenal issues so Intravenous Vitamin therapy allows for immediate and 100% absorption. At our clinic, located downtown Vancouver, we have and adrenal specific IV (https://www.aiwclinic.com/iv-vitamin-therapy/)
• Nervines and anxiolytic herbs: if sleep is an issue; often times when you have adrenal issues you are exhausted all day and then wired at night and have trouble sleeping we use herbs to bring your cortisol in the pm down so that you can get that restful sleep you need to allow your body to recover.

In the second two stages of Adrenal Dysfunction we use not only all of the above treatments from the first two stages but also:

• Adrenal extracts: concentrated glandular extracts that provide important building blocks for the adrenal and related endocrine glands.
• Medical leave: It may require that you take up to 3 months off of work at this stage to give your body an ability to recover.
• This stage takes a longer period of time to recover, expect to be in treatment for 6 months to 2 years.

            If you feel like you may be suffering from any stage of adrenal fatigue then please make a consultation with one of our naturopathic physicians before it progresses any further. The sooner the adrenal insufficiency/fatigue is caught the easier and quicker it is to bring you and your adrenals back to health.

References:

1.     Wilson, James L. Adrenal Fatigue: The 21st Century Stress Syndrome. Petaluma, CA: Smart Publications, 2001. Print.

2.     “The Four Stages of Adrenal Fatigue.” Adrenal Fatigue Solution. N.p., n.d. Web. 15 June 2015.