Adrenal Fatigue: How Stress Affects Your Life

Are you tired despite getting lots of sleep?  Do you rely on coffee, pop, or sweets to get you through the day yet these stimulants don't give you the lift they once did?  Have you talked to your medical doctor about your fatigue and been told "all the tests are normal"?  If you answered yes to any of the above questions you may be suffering from hypoadrenalism or low adrenal function.   This condition is largely ignored by conventional medical doctors, yet it is an extremely common condition which brings many patients into our office initially feeling exhausted, overwhelmed and frustrated at the lack of answers.  Fortunately, hypoadrenalism is very treatable with Naturopathic Medicine.

The adrenals are two walnut sized glands that sit on top of your kidneys.  Their prime role in the body is to help you withstand stress.  They secrete hormones such as epinephrine, cortisol and DHEA that are involved in the stress response.  Your adrenal glands can become overworked and essentially depleted if you are under prolonged or chronic stress.  Chronic stress can be caused by issues at work, with family, or health problems.  Even people who are very happy with their lives can be under chronic stress by simply trying to cram too much into their days.  The demands of our modern lifestyles have definitely contributed to the rise of hypoadrenalism.  Unless 80-90% of the adrenal organ function is gone (as in Addison's disease), it is not recognized by conventional medicine.  A lesser degree of adrenal function loss can still cause very significant symptoms.  Some of the major complaints and symptoms associated with hypoadrenalism include: fatigue, premenstrual syndrome, depression, poor concentration, craving for sweets, allergies, headaches, alcohol intolerance, pain in the neck and trapezius muscles, and lightheadedness upon standing.<> 

<>There are three stages in the stress response.  The Alarm Stage is the immediate reaction to the stressor.  The stressor can be your child misbehaving, a conflict at work or a traffic jam.  There is a physical response to the stressor which includes increased blood pressure, higher breathing rate, and an increase in blood sugar.  Through repeated exposure to stressors you reach the second stage.  This is the resistance stage.  In this stage the adrenal gland has compensated by increasing in size and function.  At this point you may be in what is considered hyperadrenalism.  Your adrenal gland is actually over functioning.  The third stage of the stress response is the exhaustion stage.  Although the adrenal glands are still enlarged they can no longer respond to further stress.  The glands are burnt out, depleted and exhausted.  This adrenal exhaustion is what is referred to as hypoadrenalism and it causes the symptoms listed above.    <>

How do you know if your symptoms are due to hypoadrenalism?  A licensed Naturopathic Doctor is trained to make this diagnosis.  After taking a through medical history and review of symptoms the doctor will conduct various tests.  There are certain aspects of a physical exam that point to hypoadrenalism.  Specifically, a drop in blood pressure upon standing will usually be measured in patients with low adrenals.  We conduct an in office urine test that gives a good baseline for the activity of some of the adrenal hormones.  In order to measure the adrenal hormone levels directly a conventional medical doctor may offer a blood cortisol test.  The problem with this approach is that cortisol levels naturally fluctuate throughout the day.  Depending on when the test is done the result may or may not pick up hypoadrenalism.  I prefer to conduct salivary hormone testing at four separate times throughout the day.  This approach is not only more likely to reveal a problem with the adrenal hormones but it is also useful in determining the appropriate treatment. 
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There are many effective treatment options for supporting the adrenal glands and eliminating the symptoms associated with hypoadrenalism.  We find that using a combination of modalities works best for treatment.  Good nutrition is an important foundation for treatment.  A diet rich in whole foods and lean protein sources is ideal.  "Whole foods"  refers to foods in their natural form such as fresh fruits and vegetables, whole grains, nuts and seeds.  Protein can be in the form of beans and legumes, soy products, fish, or chicken and beef (preferably organic).  Protein is very important for healthy adrenals and should be consumed with all meals and snacks.  It does not have to be high amounts of protein.  A handful of protein rich almonds with a piece of fruit would be an ideal snack.  The other aspect of nutrition is nutritional supplements or vitamins.  The prescription of supplements is highly individualized but some of the supplements that we commonly prescribe for adrenal support include magnesium, pantothenic acid (vitamin B5), vitamin C, A and E, and zinc.  Herbal medicines are excellent for supporting the adrenal glands and dealing with the associated symptoms.  Borage, licorice, schisandra and certain ginseng species can be most helpful.  Adrenal glandulars and homeopathic remedies are also important to consider in a treatment plan.  Last but not least, it is vital to address the root cause of an individual's hypoadrenalism.  As it is often stress related, measures need to be taken to reduce the individual's exposure to, or their perception of stress.   <>

The effects of the adrenal glands and hormones are far reaching in the body.  Adrenal hormone levels influence many other aspects of health including bone density, cholesterol levels, blood pressure, estrogen/progesterone balance, blood sugar and more.  The adrenals should not be ignored.  It is important to see a Naturopathic Doctor or other licensed health practitioner who understands hypoadrenalism and can provide appropriate, individualized treatment.