If you are suffering from chronic health problems, you may have a problem with your adrenal glands. In most cases, this problem cannot be diagnosed using standard medical tests of adrenal function. Naturopathic doctors and other Complementary and Alternative Medicine (CAM) providers call this condition adrenal fatigue. If are constantly tired, you may have this problem. And treating it may make a huge difference in your life.
RATIONALE
You have two adrenal glands. They are about the size of a grape. They are located just above your kidneys, on both sides of your mid-back. Your adrenal glands produce many different hormones, most of which help your body combat stress. One part of the adrenal gland produces adrenaline and other ‘fight-or-flight’ hormones, which help you overcome immediate life-threatening crises. The other part produces a wide range of different stress hormones. These include cortisol, DHEA, progesterone, pregnenolone, testosterone and estrogen.
Adrenal fatigue occurs for a very logical and simple reason. Humans evolved to overcome major short-term stresses, like trauma and infections. But in the modern world, many of us are exposed to long-term stress that overworks the adrenal glands. This comes from daily exposure to pychological stress, environmental toxins, chronic low-grade infections and persistent or non-healing wounds. Whatever the source of the stress, sometimes the adrenal glands just cannot keep up with the body’s demand for stress hormones. Adrenal fatigue is the result.
The main symptom of adrenal dysfunction is fatigue. But there are other clues. These include feeling dizzy if you stand up too quickly, having low blood pressure, feeling brain fog and other symptoms of ‘hypoglycaemia’ that improve with sugar intake, salt or sugar cravings. Fatigue is usually worse in the mornings, and some people feel a major dip in energy between 3-5pm. Some people lie awake from 2-4 in the mornings.
DIAGNOSIS
Medical textbooks deal with adrenal problems in a very limited way. The name that is used by endocrinologists to describe low-functioning adrenal glands is Addison’s disease. It is diagnosed by measuring cortisol levels in the blood before and after a small dose of ACTH. This hormone is produced by the pituitary gland, and it should trigger a surge in cortisol levels. While a positive diagnosis of Addison’s disease is quite rare, our experience has been that adrenal dysfunction is actually very common among people with chronic pain and other disorders.
In most cases, adrenal fatigue are quite obvious and the diagnosis can be suspected based on symptoms alone. Sometimes it is helpful to perform additional testing to confirm this problem. The usual approach is to measure cortisol levels in saliva. While this is not a standard laboratory test, it can be done through private labs that do specialized testing. The usual approach is to measure cortisol in saliva samples taken at 8am, 12pm, 4pm and at bedtime. Low levels of salivary cortisol can confirm adrenal fatigue.
TREATMENT
There are several different methods that have typically been used to treat adrenal fatigue. Vitamin C, zinc and B vitamins are helpful. A family of herbs called adaptogens is also often prescribed, including rhodiola, ashwagandha and ginseng. Extracts of animal-sourced adrenal glands have been used for decades with positive results. We have prescribed low doses of hydrocortisone, which helps support the body by providing the hormones that the adrenals cannot produce. Oral treatment can often be effective, but IV infusions are sometimes necessary. None of these approaches has ever been studied in clinical trials, primarily because the condition itself is not yet recognized by medicine.
The most critical aspect of long-term treatment is to address the cause of the adrenal dysfunction. Sometimes avoiding a major food allergy is the key solution. Eliminating heavy metals and other environmental toxins can be helpful. Healing emotional trauma and eliminating ongoing psychological stressors can be critically important. If there are blockages or infections affecting the meridian system, these need to be addressed.