Updated: Mar 6
Sometimes also called adrenal fatigue or hypoadrenia, this condition is becoming all too common in today's modern society. Your adrenal glands are your "stress glands", they're about the size of your thumbs and sit on top of your kidneys (also called the suprarenal glands) and are responsible for producing several hormones:
Neurohormones: Such as adrenaline
Mineralocorticoids: Such as aldosterone
Glucocorticoids: Such as cortisol
Sex Hormones: Such as estrogen, progesterone and testosterone.
These hormones work together to regulate your metabolism, immune system, blood pressure and response to stress.
Adrenal fatigue or dysfunction at its extreme form is referred to as Addison's disease, which is complete failure of the adrenal glands. This is an autoimmune condition where the immune system has destroyed the glands to the point they can no longer function. This can be life threatening and requires immediate hospitalization and treatment (1).
So what are the symptoms of adrenal fatigue/dysfunction? Fatigue and weakness, especially in the afternoon (when cortisol levels are naturally lower), poor sleep, depression and anxiety are the most common symptoms I see, but frequently I also see low blood pressure, poor reactions to stressors (even small ones), lower blood sugars, getting lightheaded when moving from sitting to standing, poor memory, low sex drive and weight gain. Craving foods high in sugar, salt and fat is also common. These patients tend to rely on caffeine to get them through the day (1,3).
What causes the adrenal glands to fatigue? Stress is the largest cause. As these glands are responsible for the hormone production that allows us to survive stressful events, they're the ones under fire when we have significant stressful events (i.e. surgery, death in the family, car accidents, etc.) as well as chronic, lower level stressors. These can include: daily traffic stress, financial stressors, family stress, work stress, etc. At some point, the body can't keep up with these demands and something has to give (2).
Today's modern society is nothing but stress - we're rushing to work, have to deal with deadlines and expectations there then need to get home, sit in traffic again, make a meal for the family before it's too late, deal with relationship issues, balance the checkbook and deal with debts, make sure we get some exercise and sleep in at some point - and do it all while looking great and making it look easy. This isn't realistic and isn't what our bodies were designed for. As a result, we see changes in our metabolism, immune system, blood pressure, hormone balance and our response to these stressors, which often includes increased anxiety and/or panic attacks.
How do we fix it? The first step is to get an accurate diagnosis. While the patient history can be very telling, especially if a stressful event preceded the current symptoms, we often recommend a salivary or blood test of the hormone cortisol.
Morning (8 am) blood cortisol levels should be at least 15-20 ng/dL, but this test only gives us one data point during the day. Cortisol levels are naturally highest in the early morning, then decrease throughout the day and are at their lowest at night before we fall asleep. A salivary cortisol test allows us to take 4 measurements so we can use that information to chart the cortisol rhythm.
We often use Quest Diagnostics (often covered by insurance) or Doctor's Data to assess salivary cortisol levels. Common alterations in this rhythm can be seen here:
Depending on the pattern that is seen, the treatment can very.
As always, we start with the basics, as there's no way you can heal your adrenal glands with the continued stressors and by burning the candle at both ends. The first step is to usually take a break - maybe a vacation, maybe just giving some tasks to a coworker or reminding others that you need to take time for your own self-care and decreasing your obligations.
The second step is to decrease the caffeine and leave more time for rest and sleep. If that means scheduling a mid-day nap or sleeping in, then do it. Proper sleep hygiene and support through nutrients and herbs can also help as well as gentle, restorative exercise.
Nutrients: The adrenal glands need several nutrients to properly repair and produce needed hormones;
Vitamin C: 100 mg 3x/day
Vitamin B5: 500 mg 3x/day, include a b-complex or other source of B vitamins.
Magnesium: 200 mg 3x/day
Zinc: 15-30 mg/day, with meals.
Copper: 1-5 mg/day, with meals.
Salt: I recommend sea salt, salt food to taste and consider drinking sea salted water.
Herbs; Certain herbs are known as "adaptogens", because they are helpful at adapting the stress response and supporting healing and repair of the adrenal glands, a few of my favorites include rhodiola, ashwaganda, eletherococcus, glycyrrhiza, oplopanax or panax ginseng.
If the condition is severe enough, we often recommend adrenal glandular support. It provides all the appropriate building blocks to support adrenal function as well as provides some needed rest to the glands by actually containing small amounts of the adrenal hormones. These are generally only taken in the morning and early afternoon as they can be too stimulating when taken in the evening. Additional hormonal support can include DHEA, a precursor steroid hormone that is often low in those with adrenal dysfunction.
Healing from adrenal dysfunction and fatigue can take time, anywhere from 3 months to 2 years, depending on the severity.
Once the adrenal glands start to heal, you'll begin to see relief from the fatigue, improved sleep and easier weight loss.
Should you have questions or would like to discuss your condition in more detail, schedule a consultation with one of our physicians, who are all highly trained and successful in treating adrenal disorders. (503) 894-8977
1) Wilson, James. "Adrenal Fatigue: The 21st Century Stress Syndrome." Smart Publications, p. 7, 2002.
2) Understanding Adrenal Function August 27, 2000, Mercola.com https://articles.mercola.com/sites/articles/archive/2000/08/27/adrenals.aspx(Accessed June 11, 2009)
3) Veracity, Dani. "Recovering From Adrenal Fatigue: How Your Body Can Overcome Chronic Stress and Feel Energized Again." Natural News, April 6, 2006 http://www.naturalnews.com/019339.html (Accessed June 11, 2009)
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