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Adrenal Fatigue

--adrenal glands not functioning at optimal level
--when at rest, under stress, or in response to consistent, intermittent, or sporadic demands
--adrenals secrete 50+ hormones incl: epinephrine, cortisol, progesterone, DHEA, estrogen, and testosterone
--adrenal fatigue aka Non-Addison’s hypoadrenia, subclinical hypoadrenia, neurasthenia, adrenal neurasthenia, and adrenal apathy

--financial pressures, infections, emotional stress, smoking, drugs, poor eating habits, sugar and white flour products, unemployment and several other stressors-->adrenals produce less cortisol
--onset after major stress: illness, job, death, children, after which you can't get yourself back together
--"After ____ I was never the same."

--salt cravings
--increased blood sugar under stress
--increased PMS
--perimenopausal or menopausal symptoms under stress
--mild depression
--lack of energy
--decreased ability to handle stress
--muscle weakness
--absent mindedness
--decreased sex drive
--mild constipation alternating with diarrhea, more.
--distinct energy pattern: fatigued in the morning, not really waking up until 10 AM, and not fully awake until after lunch. Diurnal lull in their cortisol so low energy in afternoon, 2-4pm. Feel betteer after 6pm, usu tired by 9 and in bed by 11. Work best late at night or early in morning.
--tired when waking up but too "wired" to fall asleep in the evening
--hard to relax
--not getting enough exercise
--get sick more often, don't get well fast enough

--nothing that says "adrenal fatigue" alone
--elevated plasma ACTH with low plasma cortisol is diagnostic
--postural hypotension test
--AM cortisol test, or all day, spit test
--ACTH stimulation test
--customary for a physician to assess the adrenals with thyroid
--longterm low thyroid lowers adrenal fx
--test serum potassium and sodium
--if pituitary gland is cause of adrenal failure electrolyte levels are usu normal
--extremely low cortisol levels = Addison’s disease = medical emergency

TREATMENT is mainly lifestyle modifications
--lying down during the day
--increased relaxation
--regular meals
--chew food well
--eat by 10am and again for lunch
--exercise (no competition)
--early bedtimes
--sleeping until 9am whenever possible
--diet: general: get lots of protein and reduce carbs, eat veggies, whole grains, protein
--good quality oils: nut & seed oils, olive, walnut, fiber, flax and high-quality fish oil
--avoid hydrogenated fats, caffeine, chocolate, white carbohydrates, and junk foods
--salt esp at breakfast and 30 minutes before lowest energy part of day
--Vitamin C 2,000-4,000 mg/day Sustained Release
--Vitamin E w/mixed tocopherols 800 IU/day
--Vitamin B complex
--Niacin (125-150 mg/day) – as inositol hexaniacinate
--B-6 (150 mg/day)
--Pantothenic acid (1200-1500 mg/day)
--Magnesium citrate (400-1200 mg)
--Liquid trace minerals (zinc, manganese, selenium, chromium, molybdenum, copper, iodine)– calming effect
--If depression is present – Add SAM.e 200 mg bid; DL-Phenylalanine (DLPA) 500 mg bid
--herbal remedies: Licorice, Ashwagandha, Maca, Siberian Ginseng, Korean Ginseng.
--Note: Licorice taken longterm elevates BP. CI's: Hx of hypertension, renal failure, or with digitalis/digoxin
--DOC may advise hormone supplementation with DHEA, Pregnenolone, and Progesterone
--last resort: hydrocortisone (Cortef®) may be necessary, may have dramatic results but can weaken adrenals
--Tx may continue 6 months to 2 years.

Vicki Wade, Pharm. D
January 2005

more notes from elsewhere:
--Avoid all stimulants incl: ephedra, guarana, kola, alcohol, sugar, nicotine (does yerba mate count? it is a xanthine so probably so....)
--avoid allergens (histamine is stimulant)


Jul. 19th, 2008 06:40 pm (UTC)
I believe I have this, though with too much cortisol isntead of too little (is that the same thing?). I can't seem to get a concrete diagnosis of it, however. I did take a cortisol test a couple years ago, and it showed my cortisol levels were through the roof at the certain times of the day, especially late at night and early in the morning. I've tried to follow these tips and suggestions as much as possible, but my condition hasn't improved very much. Needless to say, the last few years have been a nightmare for me. It's interesting info, though. Thanks for posting.
Jul. 19th, 2008 11:02 pm (UTC)
Sorry to hear you're in this condition....high cortisol levels can suppress your immune response, cause you to deposit fat around your organs in your abdomen and chest, and contribute to anxiety and other trouble.

If you have too much cortisol for a long time it's probably because you're under too much stress (both physical and mental).... Fatigue is when your glands just give up, can't keep up the pace anymore. That happens after you've been stressed for a long time and then something even more stressful happens. So if your cortisol is too high you definitely need to fix something. At least retest it a few times to know if the elevated level was due to a temporary stress or something longterm...

FYI: the cortisol level is SUPPOSED to peak just before you waken, and then taper all day being lowest around dinnertime. So it is normal and good for you to have high levels in late night/early morning.



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