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Stress. Everyone suffers from some amount of stress. But for those of us who experience it day in and day out, for years at a time, it takes a terrible physical toll, often in the form of adrenal fatigue.
Last week I mentioned how you won’t get much help from your conventional medical doctor if you suspect adrenal fatigue is the reason you are tired, depressed and hurting. He’ll likely attempt to cover up your symptoms with anxiety or depression medications.
That’s why what I’m about to explain is very important. There are a few ways for you to get the core and correct what’s happening to your adrenal gland—namely an imbalance of the hormone cortisol.
There are legitimate tests of blood, urine or saliva for cortisol levels. But first, your symptoms can help you determine whether you are over-secreting cortisol from too much stress — or under-secreting because of adrenal fatigue.
Consider my patient, “Jane.” Jane is a classic example of adrenal excess leading to adrenal fatigue. At age 44, she is a married mother of six children who owns and runs her own business to support family finances. Therefore, she works diligently to keep up with life’s apparent demands and worries excessively about them. Because she is very intelligent, she thinks her way through stresses, thus often leaving peaceful feelings behind and exposing herself unnecessarily to the ravaging effects of stress on her body. You’ll be interested to learn about my treatment plan for Jane in my next article.
So for starters, I encourage my patients who are at risk for this kind of behavior to take a little questionnaire which reflects the most predominate cortisol excess symptoms, including:
- Mid-day fatigue (with late night energy surges).
- Abdominal obesity.
- Craving unhealthy foods (more than years past)
- Gastrointestinal symptoms (nausea, heartburn, diarrhea, constipation).
- Sex hormone imbalances.
- Depressed mood.
- Accelerated aging of the skin.
The predominate symptoms of adrenal burn-out are:
- Morning fatigue.
- Difficulty concentrating during stress or afternoon brain fog.
- Anxiety (jitters, nervous stomach, panic or paranoia).
- Losing patience easily.
- Headaches or backaches more frequently.
- Easy infections.
- Orthostatic blood pressure (drop in blood pressure when moving from laying down to standing up).
If there is any doubt, I really encourage you to take this a step further. Go online and take a 15-30 minute self-questionnaire taken from Dr. James Wilson’s book, Adrenal Fatigue: The 21st Century Stress Syndrome.  It will instantly calculate your score and show you how likely you are to have adrenal fatigue.
Get your morning serum cortisol level tested. Since there are other tests to consider when searching for causes of fatigue, irritability, and other adrenal dysfunction symptoms you now know about, ask your doctor to have this done along with other routine lab tests. I’ve included here the tests to ask for:
- CBC (complete blood cell)
- CMP (comprehensive metabolic panel)
- TSH (thyroid stimulating hormone, free-T3 and free-T4 hormone levels)
- 25-OH Vitamin D level
- Vitamin B12/Folate levels (see my previous article about MTHFR gene SNP)
- Cortisol level (different expected levels at or near 8am, Noon, 4pm, bedtime).
- Testosterone level (men) / Estradiol & Progesterone levels (women)
Remember that if your serum cortisol level is near the bottom of the reference range remember that this “normal range” is derived from average people, many of whom are over-stressed too but consider themselves to be “normal,” thus incorrectly portraying what is the optimal cortisol level. Also note that your serum cortisol doesn’t have to be near zero (such as the case with severe adrenal deficiency, called Addison’s disease), in order to get symptoms of adrenal fatigue stress syndrome.
According to the American Academy of Anti-aging Medicine  which is comprised of nearly 22,000 prevention-minded physicians, testing for abnormal cortisol levels in saliva is more sensitive than in blood. This is largely true because saliva reflects your tissue levels of a substance, whereas your blood will always maintain optimal levels because it is your homeostatic fluid.
Another reason for saliva testing is that you can test for things not reliably tested in blood or urine. In saliva you can test for melatonin, cortisol (morning, noon, afternoon and bedtime without 4 blood draws in one day!), DHEA-Sulfate, free Testosterone, total Testosterone, Estrone, Estradiol, Estriol, and Progesterone. All these have overlapping symptoms when out of balance so it is best to check them all.
There are many lab companies that check for adrenal hormone levels in saliva. I usually set up my patients to get saliva testing through Access Medical Labs (http://www.accessmedlab.com/blue-print.html) or Genova Diagnostics (https://www.gdx.net/product/adrenocortex-stress-hormone-test-saliva). These labs can assist you to find a nearby physician to supervise your testing. Alternatively, search online for an A4M physician near you at http://www.a4m.com/directory.html or a BodyLogicMD physician at www.bodylogicmd.com.
I’ve learned that testing and treating adrenal fatigue is validated when patients’ symptoms improve and so do their cortisol levels.
Now that you can evaluate yourself (by questionnaire) for adrenal dysfunction and you know where to look to get tested, you’ll be ready to turn your symptoms around and feel better. Next week, I’ll get into the details of reversing this condition through a few simple but vital lifestyle interventions and natural supplements you can buy without a doctor’s prescription.
To feeling good so you can maintain optimal health,
Michael Cutler, M.D.
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