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Adrenal Fatigue

adrenal-fatigue_300

In my previous article I discussed Susan, a 38-year-old woman with insomnia that gradually increased over the past two years. Her sleeplessness came from adrenal fatigue. Disruption of the adrenal hormones can result in adrenal fatigue, which frequently interferes with sleep. This article about adrenal fatigue explores the hormones involved and the symptoms of this condition so you can recognize it.

Adrenal Gland Hormones And Stress

Each of your adrenal glands sits on top of a kidney. They each have a middle (medulla) and outer (cortex) portion that performs separate functions.

In moments of stress, the adrenal medulla produces epinephrine (adrenaline), a necessary contributor to your fight-or-flight mode. Adrenaline does some amazing things really fast in your body: It increases the heart rate and the force of each contraction, constricts your blood vessels, opens your small lung airways, converts fat and glycogen into glucose for energy use, increases your metabolic rate (momentarily), and dilates your pupils.

Your adrenal cortex produces your sex hormones, fluid-balance hormones and cortisol.

I would like to focus on cortisol, especially on what happens when cortisol is low. Cortisol is your anti-stress hormone. It is secreted by the adrenal gland as a response to physical or mental stress in order to quickly free up your energy reserves. It stimulates appetite, improves digestion and acts as an anti-inflammatory (i.e. hydrocortisone).

Incidentally, you may already know a little about the anti-inflammatory effects of cortisol because of a similar molecule administered by doctors called prednisone. When prednisone is used at the usual doses of 10 to 60 mg daily doses for short durations, it dramatically stops the allergic reactions and inflammation that lead to rashes, asthma, joint pain and almost any autoimmune disease. Cortisol is similar to this substance. However, the physiological replacement dose is equal to only 1 to 3 mg of prednisone and is much safer for long-term use (unlike prednisone).

Cortisol is secreted from your adrenal gland into your bloodstream in highest amounts in the morning when you need it to get going with your day. There is a normal drop to a low level in the evening so your body can prepare for sleep.

Effects Of Cortisol Insufficiency

First, cortisol is mood calming. It lowers the excessive output of adrenaline a stimulating neurotransmitter.

Insufficient cortisol is a known major cause of emotional outbursts in the face of mental or physical stress. [1] Insufficient cortisol may also cause you to react to stress with a variety of inappropriate or excessive emotions. Depression, extreme moodiness, memory loss, confusion, absentmindedness, excessive anxiety and panic attacks have been seen to resolve with cortisol supplementation.

What happens when you stress yourself mentally or physically for many years? The natural effect for a large percentage of people is simply that the adrenal gland cannot keep up the demand for cortisol.

There are some typical life conditions that predispose a person for getting adrenal fatigue and cortisol insufficiency. These can include one or more major stressful events or long periods of stress. It may stem from being overworked with little play or relaxation for long periods of time.

Chronic physical illness or post-traumatic stress syndrome can also be a set-up for adrenal fatigue. Alcoholism or drug abuse, prolonged use of steroid therapy (i.e., prednisone, etc.) are other predisposing conditions.

Physical Effects

The physical effects of insufficient cortisol are many. When your cortisol levels are low, you suffer a few or many of the following:

  • Your ability to handle stress is decreased; you are less productive at work.
  • You don’t think as clearly as you used to, especially when hurried or under pressure.
  • You tend to shake or get nervous stomach indigestion when under pressure.
  • Your sex drive is noticeably less than it used to be.
  • You feel lightheaded when rising quickly from a sitting or lying position.
  • You may experience difficulty waking up in the morning, much more energy after the noon meal and an afternoon energy lull from 3 p.m. to 6 p.m.
  • You suffer from being chronically fatigued and cannot relieve tiredness by sleeping.
  • You need to lie down after mental or emotional stress.
  • Your muscles are weaker than they should be.
  • You have an increased frequency or severity of allergic reactions.
  • A white line remains for a minute or more when you scratch your skin.
  • Your blood pressure is low.
  • You get low energy or moody if you do not eat regularly.
  • Feelings of hopelessness or despair increase.
  • You have decreased tolerance; you get more easily irritated by people than you used to.
  • Sweet and salty food cravings strike you.
  • Stress headaches interrupt your day.
  • You break out with skin rashes, eczema, psoriasis, vitiligo (white spots), keloids (thick scars) or irregular brown spots.
  • You experience heavy sweating in armpits.

I have characterized the person with adrenal fatigue. It is a real physical condition. Unfortunately, few doctors know much about because it is not taught in the mainstream medical schools. (When it comes to the adrenals, medical schools teach only about Addison’s disease, or complete adrenal failure).

The treatment is not complicated, but it does require some real lifestyle intervention, some natural supplements and tests. I’ll cover this in my next article for Easy Health Options.

To feeling good for life,

Michael Cutler, M.D.
Easy Health Options


[1] Hertoghe, Thierry: The Hormone Handbook, International Medical Publications, U.K., 2006

Filed Under: Alternative MedicineEasy Health Digest™General Health

About the Author: Dr. Michael Cutler is a graduate of Brigham Young University, Tulane Medical School and Natividad Medical Center Family Practice Residency in Salinas, Calif. Dr. Cutler is a board-certified family physician with more than 19 years experience. He serves as a medical liaison to alternative and traditional practicing physicians. His practice focuses on an integrative solution to health problems. Dr. Cutler is a sought-after speaker and lecturer on experiencing optimum health through natural medicines and founder and editor of Easy Health Options newsletter — a leading health advisory service on natural healing therapies and nutrients.

  1. Craig James says:

    I read the article and except for having a white line appear after a minute or so, and having to lie down after mental or emotional stress, I have experienced all of the above mentioned physical effects of insufficient cortisol. Everything came to a climax about ten years ago, and I had to be hospitalized as I rapidly lost almost all functions of my limbs, complete with major Edema in those limbs around the joint areas. Diagnosis was suggested as Adult onset stills disease, I had the light salmon pink upper body rash, and a few other symtoms/ lack of symtoms. for the diagnosis. treatment was Prednisone which helped miraculously for the pain, and methotrexate, which really fatigued me especially in sunlight. vitamin D, folic acid, and calcium supplements were also recomended by the attending physician. My recovery changed my lifestyle, from a very physical one to becoming more sedentary, but its hard to stop me, except when Fatiuge sets in. Having learned my limits, and knowing my limits it took about Seven years to get some balance through trial and error of what I could do. I have had no more severe episodes and the attending physician has said to me that the disease is in remission. I still get a lot of the symtoms mentioned in the Physical list posted in this article, but I can deal with them more effectively now that I have changed my lifestyle accordingly. thanks for posting the article……good read for high energy lifestyle people

  2. isBubba says:

    Definitely my symptoms to a T … almost every single one in the list.

    Seem to be improving recently with supplementation of the following
    (mostly) adaptogenic herbs:

    -Eleutherococcus Senticosus
    -Schizandra Chinensis
    -Panax Ginseng (or Quinque Folium Ginseng)
    -Rhodiola Rosea
    -Withania Somnifera
    -Bacopa Monnieri

  3. Juan Almendrades says:

    Congratulations to Dr. Michael Cutler for such an interest and almost unpublished article.
    Shouldn´t it be more released so we can fight againt this severe condition that almost turn us down by 60% or more and it¨s not even tought in medicine schools ??

  4. Ze'ev Ben-Dror, C.C.N., Anti-Aging Agora says:

    I really enjoyed Dr. Cutler’s article as I was diagnosed with Addison’s disease two and a half years ago. Eight of the physical effects match me to a tee. I can’t trace the source of the disease although I’ve suffered from severe exhaustion for 10 years. The only possibility is from the time that a former “doctor” gave me too many steroid (celestone) injections for back pain as well as osteoarthritis of the hips and the knees (I had 6 back
    problems, but this was about 20 years ago. (Since then with the help of melatonin 21 mg. a night I was cured. In any case my endocrinologist prescribed prednisone 5 mg. a day, but in all this time it hasn’t helped. As a clinical nutritionist in consultation with an integrative doctor I decided on the treatment of sublingual DHEA 125 mg. and sublingual pregnenolone 50 mg., but while I have the DHEA, I haven’t been able to obtain the sublingual pregnenolone. Hopefully when I obtain the pregnenolone, the treatment will cure the AD. Ze’ev Ben-Dror, C.C.N.

  5. There must be millions of people struggling through their day in the belief that they have a case of fibromyalgia or ME who in fact are adrenally insufficient. In our locale only the naturopaths have any interest or expertise in this area. Everyone who has been told they have fibro should read this!

  6. Margaret Yannarella says:

    For years. I had panic attacks. In malls while shopping shaky & almost surreal super awareness & would have to. Fly out of the store

  7. Ze'ev Ben-Dror, C.C.N. says:

    Fortunately endocrinologist is brilliant and she administered the appropriate tests before she diagnosed Addison’s disease.
    Ze’ev Ben-Dror, C.C.N.
    Anti-Aging Agora
    member, Life Extension Foundation
    member, British Longevity Society

  8. Lynne Phelps says:

    Where can you go to get tested for low adrenal hormone levels and also treated for it? I live in ann arbor, mi.

    • Ze'ev Ben-Dror, C.C.N. says:

      Lynne, I no longer live in the states and so, I can only suggest that you ask your doctor for a referral to an endocrinologist. Good luck. Ze’ev Ben-Dror, C.C.N.

  9. Judy says:

    WHEN? When will you continue the “adrenal fatigue” topic? I have shared this article with several people and we are all eager for “the other shoe” on this subject. You are doing GREAT work and it is very much appreciated.

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