The adrenals are a pair of pea-sized glands located just above the kidneys. Each adrenal gland consists of two sections: the
medulla (inner portion) and the cortex (outer portion). The adrenal glands release certain hormones that allow us to be able to
deal with immediate and long term stress. These glands and the hormones they release allow us to be resilient to day-to-day stress.
Under-active adrenal glands are evident in about two-thirds of CFS (Chronic Fatigue Syndrome) patients. The majority of patients
that we treat for chronic illnesses or chronic pain syndromes are also suffering from adrenal fatigue. They have literally burned
their stress-coping organs out. Amid years of poor sleep, unrelenting fatigue, chronic pain, excessive stimulants, poor diet, and
relying on a veritable plethora of prescription medications, the adrenal glands and the hormones they release have been used up.
Once adrenal exhaustion sets in, it’s not long before the body begins to literally "break down". Getting “stressed out” and
staying “stressed out” is the beginning of chronic illness.
Adrenal fatigue is known to cause:
- hypoglycemia (low blood sugar)
- hypotension(low blood pressure)
- neural mediated hypotension (become dizzy when stand up)
- decreased mental acuity
- low body temperature (a sign of low thyroid function)
- decreased metabolism
- a compromised immune system
- decreased sense of well-being (depression)
- weight loss
- hyperpigmentation (excess skin color changes)
- loss of scalp hair
- excess facial or body hair
- vitiligo (changes in skin color)
- auricular calcification (little calcium deposits in the ear lobe)
- GI disturbances
- abdominal pain
- cravings for salty foods
- muscle or joint pains
The Adrenal Gland
In the inner region of each adrenal gland is what’s known as the medulla. The adrenal medulla produces norepinephrine
and epinephrine (adrenaline). These hormones are known as catecholamines. The medulla hormones are primarily involved in acute
(immediate) responses to stress.
Restoring adequate levels of epinephrine and norepinephrine is important. This can be done with SAMe. However, it's been shown
that by restoring the adrenal cortex and its hormones (cortisol and DHEA), adrenal fatigue can also be overcome.
- increases the speed and force of the heart beat.
- increases systolic blood pressure (the top number -120/80)
- increases pulse rate
- increases cardiac (heart ) function
- dilates (opens) the airways to improve breathing
- increases the rate and depth of respiration to allow more oxygen to reach the bloodstream
- mobilizes sugar from the liver to the blood stream in preparation for the 'fight or flight' response
- regulates circulatory, nervous, muscular, and respiratory systems when needed.
- inhibits the muscle tone of the stomach, so you may feel a “knot” in your stomach during times of stress.
The adrenal cortex is primarily associated with response to chronic stress (infections, prolonged exertion, prolonged stress
[mental, emotional, chemical or physical]). The hormones of the cortex are steroids. The main steroid is cortisol.
Chronic over secretion of cortisol leads to adrenal exhaustion, which accelerates the downward spiral towards chronically poor
health. Once you're in adrenal exhaustion, your body can’t release enough cortisol to keep up with the daily demands. Eventually
you become deficient in cortisol and then DHEA.
Chronic headaches, nausea, allergies, nagging injuries, fatigue, dizziness, hypotension, low body temperature, depression, low sex
drive, chronic infections, and cold hands and feet are just some of the symptoms that occur with adrenal cortex exhaustion.
Abnormal Circadian Rhythm
Cortisol levels are affected by stress and the body’s circadian rhythm (sleep-wake cycle). Cortisol secretions rise sharply in the
morning, peaking at approximately 8 a.m. After its peak, cortisol production starts to taper off until it reaches a low point at
Fluctuations in cortisol levels can occur whenever normal circadian rhythm is altered (a change in sleep-wake times). Traveling
through different time zones (jet lag), changes in work shifts, or a changing bed time can cause drastically altered cortisol
patterns. Some patients will report that their symptoms started when they began working at night. Some will begin to have symptoms
after staying up several nights in a row to take care of invalid family members or newborn babies. Changes in circadian rhythm can
lead to insomnia and poor sleep. An example of this occurs when a person tries to go to sleep at a certain time but can’t wind down.
They may catch a second wind when their cortisol levels kick-in. This is why it is important for you to try to go to bed
(preferably before 11:00 p.m.) and wake-up at the same time each day. Establishing normal sleep and wake times is crucial in
restoring normal circadian rhythms.
People often experience stress reactions every few minutes when bombarded by stimulus coming from our radios, driving in traffic,
cell phones, pagers, and from electromagnetic pollution. Studies show that chronic noise exposure, for example, can significantly
raise cortisol levels. This leads to fatigue and problems with concentration. Persistent, unrelenting stress will ultimately lead
to adrenal burnout.
Not Enough DHEA
The adrenal cortex, when healthy, produces adequate levels of dehydroepiandrosterone (DHEA). DHEA boosts:
DHEA levels tend to be notoriously low in both FMS (fibromyalgia) and CFS (chronic fatigue sndrome) patients. Chronic stress
initially causes the adrenals to release extra cortisol. Unfortunately, continuously high stress levels lead to abnormally high
elevations of cortisol. Then the adrenal glands can’t keep up with the demand for more cortisol. As the cortisol levels continue
to become depleted due to this high on-going stressload, the body attempts to counter the problem by releasing more DHEA. Eventually
the individual's adrenals can’t produce enough cortisol or DHEA. Of course, the aging process makes holding on to DHEA even tougher.
Even in healthy individuals, DHEA levels begin to drop after the age of 30. By age 70, they are at only about 20% of their peak
levels from our younger years.
- sex drive
- resistance to stress
- self-defense mechanisms (immune system)
- general well-being
- cortisol levels
- overall adrenal function
- cellular energy (ATP)
- mental acuity
- muscle strength
Stress and DHEA
DHEA helps prevent the destruction of tryptophan (in the form of 5-HTP), which increases the production of serotonin. This helps
provide added protection from chronic stress. Studies continue to show low DHEA to be a biological indicator of stress, aging, and
age-related diseases including neurosis, depression, peptic ulcer and IBS (Irritable Bowel Syndrome).
DHEA and Immune Function
The decrease in DHEA levels leads to both general decline of cell-mediated immunity and an increased incidence of cancer. DHEA
protects the thymus gland, a major player in immune function.
Billie Jay Sahley, PhD, writes, “over secretions of the stress hormones [cortisone, cortisol, and corticosterone], caused by
long-term mental or physical effort, could lead to cancer, arthritis, and susceptibility to infections. Many psychosomatic
disorders are transmitted from the brain to the skeletal muscle system. Anxiety, stress, anger, or any other psychic state can
greatly change the amount of nervous stimulation to the skeletal muscles throughout the body, and either increase or decrease the
skeletal muscular tension.”
These same stimulatory responses that affect the muscles also cause changes in various bodily organs: abnormal heartbeats, peptic
ulcers (from too much stomach acid), hypertension, spastic colon, and irregular menstrual periods. This is why you can’t separate
emotional stress from physical stress. Testing for DHEA levels is recommended. However, It makes sense to place patients on a
trial of DHEA (25mg for women or 50mg for men) prior to testing.
Testing for Adrenal Fatigue
Self Test Methods
A quick blood pressure test that monitors lying and standing systolic blood pressure numbers can help us begin a trial treatment
of adrenal boosting supplements.
Orthostatic Blood Pressure
Ragland’s sign is an abnormal drop in systolic blood pressure (the top number) when a person arises from a lying to a standing
position. There should be a rise of 10 mm. in the systolic (top) number. A drop or failure to rise, indicates adrenal fatigue.
Example: Someone takes your blood pressure while you’re lying on your back. The systolic number is 120 and the diastolic number is
60 (120 over 60). Then your blood pressure is taken again immediately after standing up. The systolic number (120) should go up
10 points (from 120 to 130). If it doesn’t increase 10 points, this indicates adrenal fatigue.
Note: It’s not unusual for the systolic number to drop 10 or more points, a sure sign of adrenal fatigue.
Pupil Dilation Test
Another way to test for adrenal dysfunction is the pupil dilation exam. To perform this on yourself, you’ll need a flashlight and
a mirror. Face the mirror, and shine the light in one eye. If after 30 seconds the pupil (black center) starts to dilate (enlarge),
adrenal deficiency should be suspected. Why does this happen? During adrenal insufficiency, there is a deficiency of sodium and an
abundance of potassium, and this imbalance causes an inhibition of the sphincter muscles of the eye. These muscles normally
initiate pupil constriction in the presence of bright light. However, in adrenal fatigue, the pupils actually dilate when exposed
Rogoff’s sign is a definite tenderness in the lower thoracic (mid-back) spine where the ribs attach.
Adrenal Fatigue Protocol
1. I Make sure my patient’s are consistently going into deep restorative sleep each night. 5-HTP (and/or Melatonin) supplementation
therapy may be needed.
2. I place my patient’s on a good optimal daily allowance (as opposed to Recommended daily allowance) multivitamin/mineral
3. I also start my patient’s on adrenal cortical extracts. These help repair and restore normal adrenal function: Adrenal extracts
have been recommended and successfully used for a variety of conditions that involve low adrenal function, including asthenia,
asthma, colds, burns, depletion from infectious diseases, from colds, coughs, dyspepsia (poor digestion) early Addison’s disease,
hypotension (low blood pressure), infections, infectious diseases, neurasthenia (low energy/weakness), tuberculosis,
light-headedness and dizziness, and vomiting during pregnancy.
Adrenal cortical extracts are used to replenish and eventually normalize adrenal function. They have an advantage over prescription
cortisol hormone replacement in that they can be instantly discontinued once they have done their job of repairing adrenal function.
Adrenal extracts have been successfully used to treat many conditions related to adrenal fatigue, including many symptoms of FMS
and CFS. They can increase energy and speed recovery from illness. Adrenal extracts are not a new treatment. In the 1930s, they
were very popular, used by tens of thousands of physicians. They were still being produced by leading drug companies as recently
as 1968. Today, these extracts are available without a prescription as adrenal cortical glandular supplements.
Adrenal Cortex Glandular Supplements
I recommend my patients start with 500 mg of adrenal cortex glandular twice a day with food. Patients usually notice improvement
from taking adrenal cortex glandular supplementation (along with the steps above) within one–two weeks.
4. I recommend my patients drink at least 64 ounces (8 glasses) of water every day.
If my patients continue to experience adrenal fatigue symptoms even after steps # 1 through 4 above, then:
5. I’ll recommend DHEA if needed. Most females with FMS or CFS will usually need 25mg daily and males 50 mg daily.
I’ve found sublingual (dissolving under the tongue) to be the best form of DHEA, but micronized (much easier to absorb) forms of
DHEA are also a good choice. I normally wait to see how the patient responds to adrenal cortex supplementation before recommending
6. Increase vitamin C intake if necessary. It’s perhaps the most important nutrient in facilitating adrenal function and repair.
Dr. Wilson writes that “The more cortisol made, the more vitamin C is used. Vitamin C is so essential to the adrenal hormone
cascade and the manufacture of adrenal steroid hormones that before the measurement of adrenal steroid hormones became available,
the blood level of vitamin C was used as the best indicator of adrenal function level in animal research studies.”
Vitamin C Dosing
I recommend all patients take a minimum of 2,000 mgs per day of vitamin C. Much larger amounts of vitamin C may be needed for
adrenal restoration, but it’s best to begin with 2,000mg daily and increase by an additional 1,000–2,000mg a day, up to 10,000 mgs
daily or until a person has a loose bowel movement. If a loose bowel movement occurs, I recommend they reduce their dose by 1,000 mgs.
They should keep reducing the dose by 500–1,000 mgs daily until they no longer have loose stools. This would then be the ideal
dose of vitamin C.
I encourage my patients to always eat breakfast and to never skip meals. Individuals with low adrenal function are usually not
hungry when they wake up. They instead rely on chemical stimulants (coffee, sodas, cigarettes, etc.) to get them going. These
stimulants raise blood sugar levels as well as serotonin levels. However, these stimulants also increase adrenaline and cortisol
levels. This curbs their appetite even further. However, the body needs to break the eight hour fast (breakfast) it has been
under. The brain especially needs to be fed; forty percent of all food stuff fuel goes towards maintaining proper brain function.
This is one reason a person may have problems with “Fibro fog” and mood disorders (anxiety and depression).
Cortisol levels are at their highest around 8:00 a.m. A person may be hypoglycemic (low blood sugar). If so, their cortisol levels
will be extremely high in the morning. They may feel nauseated, mentally and physically drained, jittery, and suffer from headaches.
If this is the case, then eating is the last thing they feel like doing. They need to eat anyway! A small snack (avoid simple
sugars) is all they need until hunger comes, usually a couple of hours later. Then they should eat another balanced snack to tie
them over until lunch. They should never skip lunch! It’s best to eat little meals throughout the day.
Slowly Reduce Caffeine Consumption
I encourage my patients to eliminate (or at the very least limit) all caffeine, nicotine, sugar, and alcohol. I know this can be
tough. But if they are really sick and want to get well, this is really not an option. At the very least, they will need to
drastically reduce their consumption of these adrenal hormone robbers. I recommend they wean off caffeine slowly to avoid headaches.
It’s best to wean off caffeine over a period of two to three weeks.
Austin Family Chiropractic is also a proud retailer of an excellent book by Dr. Rodger Murphree which explains adrenal exhaustion
in much greater detail. The book entitled "TREATING & BEATING ANXIETY & DEPRESSION with Orthomolecular Medicine" sells for $15.88
(which includes sales tax).
If you'd like to know more about our office or our protocols for 'Adrenal Exhaustion', please feel free to
give us a call (M/W/F, 8 AM-12PM & 2-6 PM CST & SAT AM by appointment) at (217)965-3100.
157 North Springfield Street / West Side Square
Virden, Illinois 62690
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