Adrenal fatigue is a condition that occursbecause of our busy American lifestyle. Withall of the demands placed on upon us physi-cally and emotional today, this condition is

seen in all practices. Surveys indicate that more than70% of the American people feel that their lives havebeen affected by the recession and feel added stress.Many of you are already seeing these changes in yourpatients and practices. Times are very different than justa few years ago and it is directly affecting our patient’sphysical ability to cope with these changes.

Adrenal fatigue is defined as a deficiency in the func-tioning of the adrenal glands. People who suffer fromadrenal fatigue do not suffer from full-blown disease.The extreme variations of adrenal disease are Addison'sand Cushing's disease. Addison’s Disease is the rarestform of Hypoadrenia. It occurs in 4 out of every 100,000people. Hypoadrenia is responsible for 70% of theadrenal disease and is an autoimmune disorder.

Adrenal Fatigue is a collection of broad signs andsymptoms, known as a "syndrome” that results whenthe Adrenal glands function below the necessary level.

Over the past century this disorder has been knownas: Non-Addison, Hypoadrenia, Sub-clinical Hypoad-renia, Neurasthenia, Adrenal neurasthenia, andAdrenal apathy.

Who Suffers From Adrenal Fatigue?Anyone; an illness, a life crisis, or a continuing difficultsituation can drain the Adrenal resources.

Lifestyles can make one more prone to Adrenal issuessuch as: poor diet, substance abuse, too little sleep andrest, or too many pressures all result in the symptoms ofAdrenal Fatigue. Life events such as a death in the fam-ily, a marriage or even the birth of a child can also bringon Adrenal issues.

A lifestyle example that could lead to Adrenal issuesis that of an executive working 60-70 hours a week, jug-gling family life, kids, a home, and financial stress. Thissituation goes on for several years; finally symptomsstart to present but the person keeps going.

What Are The Symptoms Of Adrenal Fatigue?Symptoms of Adrenal Fatigue include: fatigue, weightgain, low blood pressure, low pulse, depression, lightheaded/dizziness, hypoglycemia, hair loss, decreasedsex drive, decreased immune function, allergies, andarthralgias/myalgia.

Do these symptoms sound familiar? It is estimatedthat 50% of the people diagnosed with hypothyroidismalso suffer from adrenal fatigue. Many people who suf-fer from hypothyroidism cannot be completely balancedbecause they never receive adrenal support. Withoutadrenal support the thyroid gland continues to get stim-ulated without any support leaving the adrenal glandsdepleted even more. This process then increases thesymptoms of hypothyroidism. A conservative estimateindicates that 50% of the people with thyroid disorderare also affected with adrenal disorder. The followingfigure shows the connection between thyroid andstress hormones.

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HealingFrom

AdrenalFatigue/ChronicFatigueBy Debra Muth, BS, MS, WHNP, ND

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Common DiseasesMany associated diseases can occur with chronic

stress or adrenal fatigue. Symptoms of these disordersvary from mild to severe and these include: hypo-glycemia, allergies, arthritic pain, decreased immunefunction, psychiatric disorders, and Syndrome X.

The Stress ResponseThe stress response cycle is very complex. There are

four different zones of the adrenal cortex each secretingdifferent hormones such as: cortisol, DHEA, testos-terone, aldosterone, and progesterone. The adrenal cor-tex produces over 50 hormones all working as bridgesto form other adrenal hormones. These changes affect:carbohydrate, protein and fat metabolism, insulin andblood sugar control, fluid and electrolyte balance, car-diovascular system and sex drive.

Testing For Adrenal FatigueA simple saliva test can be conducted at home to

diagnose adrenal fatigue. Blood or saliva testing can beused to evaluate hormones to determine if adrenalfatigue is a concern. The most common hormones test-ed are testosterone, DHEA in saliva or DHEA-S inblood. Cortisol should always be tested using saliva.Typically a diurnal cortisol is evaluated but you canorder one or two if you prefer. If you chose to order oneor two you will usually order a morning or evening cor-tisol or both. When ordering a diurnal cortisol, collec-tion of the sample is done between seven and eight o-clock in the morning, and noon, then the third sample iscollected between three and four o-clock in the after-noon. The last sample is collected between ten o-clockand midnight.

Iris testing: If a person’s adrenal glands are workingproperly the pupil will normally contract if a light isshined across the eye. If adrenal issues are present thepupil will not be able to hold the contraction despite thelight shining on it. This dilation will take place over 2minutes and last 30-45 seconds.

Ragland’s Test: Is commonly done in a medical office fora variety of reasons and not ever thought of as a test foradrenal function. This test is done by the evaluation ofblood pressure readings. Have the patient sit andobtain a blood pressure reading. Have the patient standand take the blood pressure. The patient will rest for 6minutes lying down; then the patient will stand up andimmediately have their blood pressure taken.

If the blood pressure is 10 mm Hg. lower after stand-ing, suspect adrenal gland weakness. The greater thedrop in blood pressure the greater the degree of adrenaldysfunction.

Sergent’s White Syndrome: This test was first described in1971 by a French physician Dr. Ser-gent. The test is simple and doesn’tcost the patient anything. Simply usethe end of a pen and lightly draw aline of about 6” on the abdomen.Watch for a line to appear within afew seconds; this is a normalresponse. The line should initially bewhite then turn red within a few sec-onds. If adrenal issues are present theline will remain white.

HPA AxisThe regulation of cortisol is done

by the HPA Axis. The hypothalamusmediates between external and inter-nal states to keep the body balanced.Cortisol is the chief agent used by thehypothalamus to balance body chem-istry. Any stressors listed above can

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trigger the body’s stress response and interrupt normalrequirements for cortisol.

Cortisol protects the body by normalizing bloodsugar levels. A drop in blood sugar triggers the adrenalglands to produce more cortisol. Cortisol increasesblood sugar by converting fats and proteins to energy.Cortisol also has anti-inflammatory properties whensecreted in normal levels.

Cortisol levels affect white blood cells, and specifical-ly produce lymphocytes. Cortisol regulates blood pres-sure and the central nervous system function by affect-ing: behavior, mood, excitability and all other neuronsin the brain.

Stress hormones and neurotransmitters provide aquick burst of energy. They speed up the necessarybody systems by increasing heart rate and breathing. Itcan also shut down the unnecessary body systems suchas the reproductive system and immune system.

Cortisol receptors exist on almost every cell in thebody and have an important role in brain function. Ifserotonin is depleted it can result in fatigue, depressionand inflammation. Moderate and transient amounts ofcortisol increase the release of dopamine. If dopaminelevels reach abnormally high levels people will experi-ence symptoms of attention deficient or attention defi-cient with hyperactivity. Dopamine will also becomeelevated when people consume diets high in sugarwhich often happens when cortisol levels are lowbecause people are looking for a rush to increase theirenergy levels. High and chronic levels of cortisoldecrease the production and release of dopamine.The immune system can be directly affected by the

adrenal function. Allergies involve the release of his-tamine a pro-inflammatory. Cortisol is a strong anti-inflammatory. It is the histamine and Cortisol reactionthat produces the symptoms experienced with allergies.

Food allergies are common during adrenal fatiguebecause of these added stressors placed on the immunesystem. The most common food allergies are corn,wheat, eggs, and dairy. The symptoms can vary inseverity and may be temporary if the adrenal glandscan be restored.

How common Is Adrenal Fatigue?According to “The Adrenal Fatigue Organization” it

is estimated that 80% of North Americans suffer fromAdrenal Fatigue at some point in their lives.

Treating Adrenal FatigueOnce Adrenal fatigue is diagnosed an individualized

adrenal program can be initiated. An adrenal programcontains life style changes and nutritional supportwhich will help balance the body. It will restore thebody’s ability to balance and correctly utilize sugar,support in digestion, and rebuild the adrenal glandsto properly handle stress and return the body back toits normal state. In some cases it is necessary forhormones to be replaced for short periods of timeuntil the body can repair and produce them on theirown. The hormones replaced are DHEA, testosteroneand hydrocortisone.

Unfortunately, restoring the adrenals is not a quickfix. You can expect a patient to be on this program forsix to twelve months at minimum. If patients have beenill for several years they can expect to be on an adrenalprogram for one to three years before they are healed.Patients can expect to have periods of time that they feelgood and then crash. It is important to provide patientswith education and support during this time.

An example of an adrenal program includes usingsupplements: Vitamin C, B, and trace minerals. Herbsthat are used to assist in treatment include ginseng, rho-diola, withania, ashwaganda, and licorice. Many othersupplements can be used but these are the most com-

mon. A variety of programs can beinitiated and all practitioners whoare knowledgeable with adrenalfatigue will create variations in theirtreatment programs.

About the Author: Debra Muth, BS, MS,WHNP, ND, is co-owner of Spring CityHealth Centre, an integrative anti-agingand regenerative medicine clinic in Wis-consin. She is a consultant and speakerfor Standard Process and uses StandardProcess whole food supplements in herpractice. In addition to being a nationalspeaker, Dr. Muth is a radio and televi-sion talk show guest on alternativehealth topics. She has authored continu-ing education programs, health newslet-ters, and magazine articles.

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