Adrenal fatigue – how to diagnose and get on the road to recovery. Adrenal fatigue is now more usually recognised as a dysfunction of the HPA (Hypothalamic-Pituitary-Adrenal Axis) because of the complex influences and feedback between these three endocrine glands. The Hypothalamus sends messages from the brain to the Adrenal glands, the Pituitary gland and other organs and is responsible for energy levels, body temperature and Circadian Rhythms. The Pituitary Gland is a pea sized gland that produces hormones essential for growth, fluid balance and reproduction. The Adrenal glands sit just above each kidney and produce steroid hormones such as Cortisol, DHEA and sex hormones plus stress hormones like adrenaline and dopamine.

Anyone who has been ill for a long time, suffered prolonged levels of high stress, has an autoimmune disease or diseases (having one predisposes you to getting others) or has Chronic fatigue syndrome always has a degree of Adrenal Fatigue and HPA Dysfunction. The Adrenal Glands make our natural anti-inflammatory, Cortisol, so when they are under-performing the body is likely to be suffering from severe inflammation and potentially degenerative disease,as well as poor blood sugar control and stress control. NB. If you have already been prescribed NSAIDS (non-steroidal anti-inflammatory drugs) for your joint pain or inflammation then please read all this information and decrease the drug use asap. These drugs and the gastric protector drugs that are given with them, have many unwanted and even dangerous side effects especially to the digestive lining. They can also affect your absorption of vital nutrients and so lead to more disruption of body symptoms. It is always much better to treat the source of the problems and not just treat the symptoms.

The symptoms of Adrenal Fatigue will vary with the degree of malfunction of these glands and also may involve some dysfunction of the Thyroid gland as well. (more on that later). You may have some symptoms but still be able to function on a daily basis or have extreme, bed ridden, Chronic Fatigue Syndrome.

Symptoms:-

• low Blood pressure and frequently Postural Hypo-tension – where blood pressure falls on standing up.
• decreased tolerance to cold
• Cold hands and feet – often turning white with bluish nail bases.
• shakiness
• dizzy spells, feeling faint
• increased allergies
• general feeling of exhaustion
• weakness of ligaments and muscle fatigue
• low mood/depression/mood swings
• cravings for salty or sweet food
• problems controlling blood sugar
• lower immunity to infections
• poor sleep quality
• over-active brain late evening or at night
• Adrenaline up/ sex hormones down – irritability, depression, anxiety and menstrual problems in women.
• sensitivity to loud noises
• palpitations
• thin, easily broken nails, sometimes with vertical ridges

If you have a good few of these symptoms and you go to your General Practitioner they may test you and tell you that you don’t have Cushing’s syndrome or Addison’s disease and so therefore there isn’t anything wrong. Most of us know when there is and you can do plenty to fix it either by yourself or with the help of a Functional Medicine Doctor or Nutritionist. It may be possible to obtain an ASI (saliva test) that will be an indicator of the degree of Adrenal exhaustion but saliva tests only tests for free cortisol which is about 3-5% and the amount within the tissues could high and therefore urine tests can be much more accurate. It is important to treat all aspects of this complex system

• by stress reduction
• blood sugar regulation
• Gut dysfunction
• nutritional supplementation.

Treatment

It is essential to get enough Vitamin C on a daily basis as a water soluble vitamin that is not stored in the body or made in the human body (but is in other animals). You need a good source of vitamin C that is easily absorbed and that comes with Bioflavinoids and you have to take a supplement of 2-3,000 mgs to reach a therapeutic dose and cannot initially rely on diet alone. Some people can tolerate the more acidic versions but others may need the buffered versions (sodium ascorbate) and the most neutral for acidity is Sodium Citrate. With some acidic Vitamin C you can reach a intolerance level where you get loose bowel movements and then you have to reduce the dose to your own tolerance level.

Licorice Root an adaptogenic herb that increases the level of circulating cortisol by reducing its breakdown. We are dealing with people who generally have Low Blood pressure with Adrenal Fatigue so in this case it is OK to take the normal Licorice Root. If you have other underlying health problems that cause you to have High Blood pressure then you need to take the Deglycyrrhized (DGL) type which does not raise blood pressure. It is a good idea to monitor your blood pressure while taking Licorice Root, especially lying and standing B/P so that you can vary the dose according to your results. When your blood pressure is consistently at about 120/90 then you can reduce the dose and monitor the effect. If you have an infection or a relapse in your condition it is often wise to increase the dose for a period of time to help your body cope.

Celtic Ocean sea salt and drinking enough water will help normalise Blood pressure and provide essential minerals for good glandular function. Or Sizzling Minerals from Simply Naturals that are 75 Plant based minerals.

Vitamin B Complex 50 mgs which has already been included in supplements recommended but especially B5 (Pantothenic Acid) as a deficiency results in adrenal atrophy. This vitamin is also found in cauliflower, broccoli, salmon, liver and sweet potatoes that are encouraged on the detox diet. Latest research shows that people with certain genetic make-up or problems utilising artificial vitamins may be better taking natural, plant source B Vitamins.

Probiotics are extremely beneficial for improving gut function and boosting the Immune System. I recommend a six day course of Elixa Probiotic that is much stronger and with more beneficial strains than other makes.

Zinc and Magnesium may also be needed in doses higher than can be obtained in your diet. Magnesium is well absorbed through a spray onto the skin which is a good way to take it if you hate swallowing too many pills or are having trouble sleeping and it will act as a relaxant prior to bed.

Some Siberian Ginseng or even Panax Ginseng(which is considered stronger) may help some people as these are adaptogenic herbs but they may not suit everyone and I would not introduce them until you have established the other treatments for a while and are showing improvement. Equally I wouldn’t recommend Ashwaganda or Rhodiola or Astragalus for people who have autoimmune disease because they are very stimulating to the immune system as a whole.

Rest and relaxation are vital to lowering stress levels, reducing inflammation and improving Adrenal Function. Try some guided Meditation tapes or Apps and find one that suits you. Gentle yoga, Tai Chi or stretching or having a massage could be beneficial. Avoid bright lights or electronic devices in the evening to promote the hormones that aid sleep. Spending time with pets or in Nature and getting some sun exposure is extremely beneficial. Avoid anything that causes anxiety or stress like watching the News, taking on other peoples problems etc. and aim for extreme self care and calm.

Controlling your blood sugar by eating frequently and including some protein with each meal plus eating more vegetables and less processed carbohydrates and less fruit and sugar is essential for helping your relaxation and sleep. Cortisol is one of the ways our bodies control blood sugar. When blood sugar drops because cortisol can no longer maintain it effectively the Adrenals produce more adrenaline which also activates the nervous system that makes us alert. Waking at regular times in the night (typically about 4am!) is frequently a sign of these rises in adrenaline. This should stabilise with the detox diet and supplements listed above and can be helped by eating some protein before bed and just a couple of Brazil nuts or a piece of cold meat might help.

Also see the Post on The Thymus gland and the immune system where Licorice root and similar nutrients also help.