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Adrenal Fatigue

Adrenal Fatigue/Burnout/Exhaustion

Are you concerned that you may have adrenal fatigue? We offer complete laboratory testing to identify and diagnose adrenal fatigue and other stress syndromes. Our treatment options are designed to correct any chemical, hormonal, and neurotransmitter imbalances, restore proper function, and promote better overall health.

Because of the overlap among the terms adrenal fatigue, adrenal exhaustion, and adrenal burnout, we will use them interchangeably in this section.

Please be aware that there is no substitute for salivary cortisol/DHEA and urinary neurotransmitter testing to determine how your adrenals are functioning and to guide treatment recommendations. Such testing takes the guess work out of treating this increasingly common condition. Although you are unique and so too will be your signs and symptoms (and laboratory test results), certain common themes are emerging. Take, for example, results of a 50 year old woman who recently presented to our practice with fatigue, depressed mood, weight gain, sugar cravings, low libido, stress, anxiety, and cognitive complaints.

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Testing revealed that she was suffering from late stage adrenal burnout (low, flat cortisol curve) and estrogen dominance (low progesterone to estrogen ratio). Based on her presenting symptoms and the results of her testing we were able to come up with a customized treatment plan to help with immediate symptom relief and, more importantly, help balance and rebuild her neuro-endo-immune systems.

As her testing and symptom complex demonstrated, she was one of many suffering from: The Silent Epidemic of Adrenal Fatigue. This silent epidemic is so common and potentially devastating that we have developed a new more comprehensive way of conceptualizing and treating it: The 4 Faces of Adrenal Burnout.

Adrenal Fatigue or Hypoadrenia Those with adrenal fatigue can recover with proven and safe lifestyle interventions and adrenal fatique supplements. Adrenal fatique occurs when poor nutrition, physical and/or emotional stress weakens and depletes the adrenal glands to the point that they no longer are able to provide balanced amounts of steroid hormones. The adrenal glands can deplete the body's hormonal and energy reserves, and may either shrink in size or hypertrophy (enlarge).

Adrenal Fatigue Syndrome is a collection of signs and symptoms that is the result of the adrenal glands' inability to produce enough hormones to supply the body's demand. It should not be confused with Addison's Disease which is adrenal failure. Adrenal Fatigue Syndrome can worsen if appropriate adrenal fatigue treatment is not undertaken.

Although we strongy recommend that you have your adrenal hormone and neurotransmitter levels tested, you may for many quite appropriate reasons opt to forge ahead with treatment of your tired adrenal glands without getting tested. As such, we have added this new content – The 4 Faces of Adrenal Burnout – to help you identify the state of your adrenals and to get started replenishing them immediately.

Also and for the first time, we have in this section bundled together several of our most popular adrenal and neurotransmitter support supplements. Each bundle corresponds to a specific stage of adrenal fatigue as detailed below. We hope this makes it easier for you to figure out exactly which supplements are most likely to address your individual stage of adrenal output. Otherwise, you and we are just guessing.

The 4 Faces of Adrenal Burnout /_uploaded_files/4-faces-line.png

Introduction

Stress is not what happens to us. Rather, stress comprises our conscious and unconscious responses to external or internal stimuli (stressors).

This brilliant set of ancient and automatic responses has been fine-tuned over millions of years to ensure the survival of the species.

But if your fight/flight mechanism does not return to baseline, and remains chronically activated, you are setting yourself up for burnout and other stress-related disorders.

Stress, and your capacity to cope with it, is the most important influence on your overall health and pursuit of happiness. Stress exerts powerful effects on normal, and as it turns out, pathological, physiology of nearly every organ in your body.

A key point to emphasize here is that not all stress syndromes are the same. That said, stress syndromes have one thing in common: they start with the adrenal glands.

These adrenal/stress syndromes can be divided into four distinct but overlapping categories. Each of these stages is associated with specific symptoms and measurable biochemical imbalances.

Moreover, each of these stress syndromes requires its own treatment approach.

The graphic below summarizes these overlapping but biochemically and clinically distinct stages of adrenal burnout:

  1. “Wired for Sound’
  2. “Wired and Tired” – Allergic and Infected
  3. “Wired and Tired” – Inflamed and in Pain
  4. “Just Plain Tired”

This is the closest we can get to customizing your treatment without you obtaining a personal consultation with us.

/_uploaded_files/4-faces-of-adrenal-burnout-blue.png

This approach is most appropriate under the following circumstances: if

  • You opt not to get testing, or
  • You want to get started while awaiting your test results, or
  • You have already gotten your adrenal hormones and neurotransmitters tested and do not feel you need a consultation before proceeding, or
  • You know, based on your signs and symptoms, which stage you are in and what treatment you need.

Please remember that you can consult with us before, during, or after you start nourishing and rebuilding your adrenals (and thereby your health).

Even if you have already decided which adrenal-related bundle of products you need, please read the following sections for more details.

#1 - “Wired for Sound” or SuperNova Diva

The first stage is where you are “Wired for Sound.” You are in action mode because all of your stress chemicals are cranked. If you are in this category, you are a high flier, a racehorse, a shooting star. Your body and mind are constantly on the go. You’re going full throttle, putting everything into every moment of every day. You're accomplishing so much, but at the expense of borrowing from tomorrow, next week, and next month.

/_uploaded_files/wired_for_sound.png

You are carrying so much responsibility. You do a great job without whimpering for years. You’re high-wired and operating at full tilt. You feel pretty good most days, particularly if you act in ways that are socially acceptable and productive.

You are the super-woman (SuperNova Diva), raising three kids, taking care of the house and the finances, perhaps supporting a husband, maybe even taking care of an elderly parent with Alzheimer’s. You run at full throttle 24/7, 365 days a year. You accomplish so much you begin to get addicted to your adrenaline high.

This approach can work for a time.

But remember, the shooting star shines brightest just before it burns out.

The problem is that this high adrenal output is designed to last approximately 15 minutes NOT 15 months or 15 years. For further details on your stress-response system please see Dr. Dave’s article “An Epidemic of Stress.”

When you stay so stressed for so long your adrenal glands become overtaxed. If you continue to crank your cortisol levels you run the risk of experiencing increasing damage to your adrenal glands unless your stress goes away (ha ha, good one) or unless you -ASAP (i.e. today) - begin to safely and gently support your adrenals with nutrition, sleep, stress management, and strategic use of vitamin, mineral, amino acid, and herbal supplements.

If you do not, you are likely to go on to develop a condition known as adrenal burnout (also called adrenal fatigue) which in turn can trigger an escalating cascade of modern diseases including fatigue, obesity, diabetes, depression, and leaky gut.

Our “Wired for Sound” Bundle

You’re under a great deal of stress. But you’re holding your own, taking care of business. In fact, you’re looking good and feeling fine. That’s because your stress hormones (cortisol and DHEA) and neurotransmitters (adrenaline, norepinephrine, and dopamine) are soaring.

But unless your stress soon goes away – and when does it ever? – you cannot continue to run full throttle forever. The longer you stay stressed, the faster you burn through your stress hormones and neurotransmitters. And unless you enjoy a near perfect health-related life style – and who does? – your adrenals will soon start to falter.

That’s why we created the “Wired for Sound” adrenal support bundle of products. These supplements were hand-picked to keep you functioning at your best even during times of sustained stress.

More specifically, they provide the requisite vitamins, minerals, amino acids, and botanicals to ensure you replenish your stress hormones and neurotransmitters as fast as you are using them up. Moreover, this bundle will help “right-size” your immune response to your stressful life and ensure you get enough high quality sleep.

Perhaps most importantly, however, our “Wired for Sound” adrenal bundle will help prevent your chronic intense stress from leading to the ravages of adrenal burnout.

/_uploaded_files/wired_for_sound_bundle.png

Don’t Burnout. Support Your Adrenals Now.

#2 & #3: “Wired and Tired”

Unfortunately, if you are like most of us, you have taken your ample adrenal output for granted. And because you have not been regularly providing your body with the proper nutrients to continually replenish your adrenals, you have absolutely no reserves.

At a physiological level, your over-active alarm system has been pumping out more and more cortisol until your bodily organs and tissues have become immune or resistant to ever-increasing levels of this all important stress hormone. This “cortisol resistance” is similar to the Insulin Resistance seen in Type 2 Diabetes.

When you’re under stress for a long time, cortisol, your main stress hormone, remaines elevated. Your cortisol receptors become less sensitive, and require more and more cortisol to keep you going, until your overworked and underpaid adrenals can no longer keep up with the demands of your stressful life. /_uploaded_files/wired_and_tired.png

That’s when you experience adrenal fatigue and exhaustion.

This remarkably common progression is not at first intuitive. It is caused by the strain on your adrenals from a prolonged intense demand for cortisol. Because your adrenals cranked out high levels of cortisol for so many months or even years, they have started to wear out and will, in time, partially or totally burn out.

Prolonged Stress and Increased Demand For Cortisol Leads to Adrenal Burnout

As your adrenal glands start to fail, you may find that some of your old symptoms will go away, others will worsen, and new ones will emerge.

As an aside, it is important to note that your adrenal glands – which consist of three main layers – do not fail all at once. In some people, the cortex (that section of your adrenals that manufactures cortisol, aldosterone, and certain sex hormones) fails first; in others, the medulla (that section of the adrenals that makes adrenaline and norepinephrine) collapses first.

This state of mixed adrenal output – high cortisol with low neurotransmitters or low cortisol with high neurotransmitters – can look the same superficially but require different treatments.

Because these two mixed states share so many symptoms – particularly the combination of fatigue with anxiousness bordering on agitation – it is particularly important for you if experiencing this tandem to have your cortisol and neurotransmitters tested.

Are there symptoms unique to these two very similar mixed states of adrenal burnout? In my clinical experience, the answer is yes: allergic and infected versus inflamed and in pain.

“Wired and Tired” – Allergic and Infected

If you fall into a "Wired and Tired" profile and suffer with recurrent infections and frequent allergies, then you are more likely to be in a high cortisol/low neurotransmitter state. In that case our bundle of adrenal support products below is your best choice.

/_uploaded_files/wired_and_tired_bundle.png

Our "Wired and Tired" - Allergic and Infected Bundle

The “Wired and Tired” – Allergic and Infected profile is associated with fatigue, anxiousness, tension, insomnia and increased frequency of infections and allergies. During this stage, your cortisol is elevated while your adrenaline and norepinephrine are low. This bundle focuses on lowering cortisol, restoring sleep, supporting neurotransmitter tone, improving your mood and general outlook, and bolstering your immune activity.

“Wired and Tired” – Inflamed and In Pain

If, on the other hand, you have the hallmark mixed adrenal state duo of fatigue and anxiousness with inflammation and pain, then your adrenal needs would be better served with our “Wired and Tired” – Inflamed and in Pain Bundle below.

Our "Wired and Tired" - Inflamed and in Pain Bundle

The “Wired and Tired” – Inflamed and in Pain profile implies that your adrenal cortex (that part of your adrenal gland that makes cortisol and DHEA) is failing earlier and faster than your adrenal medulla (where adrenalin and norepinephrine are made). As such, your cortisol is low and your adrenaline and norepinephrine are still cranked. This is the most common mixed adrenal state we see in our clinics. As the name suggests, this state is most prominently associated with fatigue, anxiousness and tension, multiple physical aches and pains, and evidence of other illnesses of inflammation. This bundle, as you would expect, among other things, aggressively supports your adrenal cortex, right-sizes your overactive immune response, decreases pain, and soothes your frazzled ‘nerves.’

/_uploaded_files/wired_and_tired_inlfamed_and_in_pain_bundle.png

#4 – “Just Plain Tired”

As your stressful life continues to bombard your adrenal glands, they falter faster and you finally collapse into exhaustion. Your cortisol, adrenaline, and norepinephrine are all low. In addition, even your dopamine – associated with pleasure, reward, and motivation – has plummeted. You may find you develop a few new symptoms, while others may improve and still others may seem to go away all together. Even though these could provide clues as to the true nature of your problems, many if not most doctors will miss them because few have been educated about these tell-tale signs of adrenal burnout.

You have trouble dragging yourself out of bed and once up want to go right back to the sack. You might experience “leaden paralysis” where your limbs feel so heavy that simple movement becomes overwhelming. When you force yourself to be active, the pain both during and after any exertion makes you wonder if the effort is really worth it. You avoid others, are increasingly sensitive to the scrutiny and rejection of others, and run a very serious risk of feeling and looking depressed.

Our "Just Plain Tired" Bundle

The goal of treatment in this end stage of adrenal burnout is to start low and go slow. This bundle combines key adrenal vitamins, minerals, and herbal adaptogens as well as amino acid building blocks to manufacture your depleted neurotransmitters. In addition, this bundle powerfully addresses your ongoing state of heightened inflammation and pain. Moreover, this bundle adds aggressive support for one additional neurotransmitter: dopamine.

/_uploaded_files/just_plain_tired_bundle.png

Find out more about the Adrenal Fatigue Supplements we have available.

Further Background

The overproduction of adrenal hormones caused by prolonged stress can weaken the immune system and inhibit the production of white blood cells that protect the body against foreign invaders (in particular lymphocytes and lymph node function). Adrenal dysfunction can disrupt the body's blood sugar metabolism, causing weakness, fatigue, and a feeling of being run down. It can also interfere with normal sleep rhythms and produce a wakeful, unrelaxing sleep state, making a person feel worn out even after a full night's sleep.

Many patients appear in their practitioner's office with symptoms of depression, anxiety, panic attacks and are placed on antidepressant or anti-anxiety medication when in reality they suffer from adrenal fatigue.

Normal Adrenal Gland Functions

Your adrenal glands are two tiny pyramid-shaped pie/_uploaded_files/anatomy-of-stress.jpgces of tissue situated right above each kidney. Their job is to produce and release, when appropriate, certain regulatory hormones and chemical messengers as part of their primary mission: coordinate your response to stress.

The adrenal glands are controlled via the hypothalamus-pituitary-adrenal (HPA) axis. There is an existing negative feedback loop that governs the amount of adrenal hormones secreted under normal circumstances. The inner layer or medulla modulates the sympathetic nervous system through secretion and regulation of two hormones called epinephrine (adrenaline) and norepinephrine (noradrenaline) that are responsible for the fight or flight response.

The outer layer or cortex manufactures the steroid hormones cortisone, hydrocortisone, testosterone, estrogen, 17-hydroxy-ketosteroids, DHEA and DHEA sulfate, cholesterol, pregnenolone, aldosterone, androstenedione, progesterone and a variety of intermediary hormones. The adrenals are the major steroid factories of the body.

In addition to helping you handle stress, the two primary adrenal hormones, adrenaline and cortisol, along with others similarly produced, help control body fluid balance, blood pressure, blood sugar, and other central metabolic functions.

Adrenaline

Adrenaline (epinephrine) is the "fight-or-flight" stress hormone. Epinephrine is a neurotransmitter secreted by the adrenal gland that is associated with sympathetic nervous system activity. It prolongs and intensifies the following effects of the sympathetic nervous system:

  • Causes the pupils of the eyes to dilate
  • Increases the heart rate, force of contraction, and blood pressure
  • Constricts the blood vessels of nonessential organs such as the skin
  • Dilates blood vessels to increase blood flow to organs involved in exercise or fighting off danger, skeletal muscles, cardiac muscle, liver, and adipose tissue
  • Increases the rate and depth of breathing and dilates the bronchioles to allow faster movement of air into and out of the lungs
  • Raises blood sugar as liver glycogen is converted to glucose
  • Slows down or even stops processes that are not essential for meeting the stress situation, such as muscular movements of the gastrointestinal tract and digestive secretions

Cortisol

Cortisone and hydrocortisone are the major "glucocorticoids." They help regulate the level of glucose in the body through a process known as "gluconeogenesis."

Cortisol, your long term stress hormone is made in the exterior portion of the adrenal gland, called the adrenal cortex. Cortisol, commonly called hydrocortisone, is the most abundant -- and one of the most important -- of many adrenal cortex hormones. It:

  • Stimulates the liver to convert amino acids to glucose, the primary fuel for energy production
  • Stimulates increased glycogen (the storage form of glucose) in the liver
  • Mobilizes and increases fatty acids in the blood (from fat cells) to be used as fuel for energy production
  • Counteracts inflammation and allergies
  • Prevents the loss of sodium in urine and thus helps maintain blood volume and blood pressure
  • Maintains resistance to stress (e.g., infections, physical trauma, temperature extremes, emotional trauma, etc.)
  • Maintains mood and emotional stability

Effects of elevated cortisol

  • Stimulates fat deposits and can result in weight gain
  • Increases fat accumulation around waist
  • Increases blood pressure
  • Increases protein breakdown that can lead to muscle loss
  • Causes demineralization of bone that can lead to osteoporosis
  • Interferes with skin's ability to regenerate and heal
  • Causes demineralization of bone that can lead to osteoporosis
  • Suppresses the immune system resulting in bacterial, viral and yeast infections
  • Increases blood sugar, which leads to reduced insulin sensitivity and diabetes
  • Estrogen dominance, leading to PMS, uterine fibroids, and breast cancer
  • Impaired memory and brain (hippocampal) atrophy


Symptoms of elevated cortisol

  • Fatigue/ decreased energy
  • Insomnia
  • Anxiety
  • Restlessness
  • Crying
  • Feelings of hopelessness
  • Impaired concentration
  • Impaired memory

DHEA

  • Is a precursor for testosterone and estrogen
  • Reverses immune suppression caused by excess cortisol levels. thereby improving resistance against viruses, bacteria and Candida albicans, parasites, allergies, and cancer
  • Stimulates bone deposition and remodeling to prevent osteoporosis
  • Improves cardiovascular status by lowering total cholesterol and LDL levels, thereby lessening incidences of heart attack
  • Increases muscle mass and decreases body fat
  • Facilitates the thyroid gland's conversion of the less active T4 to the more active T3
  • Reverses many of the unfavorable effects of excess cortisol, creating subsequent improvements in sleep, energy/vitality, mental clarity, and premenstrual symptoms
  • Accelerates recovery from any kind of acute stress (e.g., insufficient sleep, excessive exercise, mental strain, etc.)

Pregnenolone

Leading to the production of progesterone and as an intermediary in the production of cortisol, pregnenolone is one of the most important intermediate hormones produced in the hormonal cascade. Prolonged deficiencies in pregnenolone will lead to reduction of both glucocorticosteroids and mineralocorticoids such as cortisol and aldosterone respectively.

Causes Of Adrenal Fatigue

Stress, Stress, and more Stress!

The most common causes of stress are work pressure, death of a loved one, changing jobs, relocating, physical illness and marital problems.

Other Adrenal Stressors:

  • Anger
  • Fear
  • Worry/anxiety
  • Depression
  • Guilt
  • Overwork/ physical or mental strain
  • Excessive exercise
  • Sleep deprivation
  • Light-cycle disruption
  • Going to sleep late
  • Surgery
  • Trauma/injury
  • Chronic illness
  • Chronic inflammation
  • Chronic infection
  • Chronic pain
  • Temperature extremes
  • Toxic exposures
  • Gastrointestinal malabsorption
  • Maldigestion
  • Chronic-severe allergies
  • Hypoglycemia
  • Nutritional deficiencies

Adrenal Fatigue Test

In order to determine the health of your adrenal glands you need to have a blood, urine, or saliva test performed by a practitioner trained to treat adrenal fatigue. Most doctors are unfamiliar with this condition for the simple reason that it is difficult to diagnose effectively by traditional blood tests. Conventional labs set their ranges to detect adrenal failure (Addison's Disease) which is different from adrenal fatigue.

Cortisol levels may be checked throughout the day by a saliva test to determine if they are highest in the morning and lowest in the evening. Saliva testing is preferred as it measures the amount of free and circulating hormones instead of the binded hormone more commonly measured in blood tests. DHEA, epinephrine, and norepinephrine are other indicators of adrenal function. The information provided by testing can help determine the most appropriate type of treatment.

Self-Screening Tests for Adrenal Dysfunction

Ragland's sign (blood pressure test) -- (Equipment required: Home blood pressure kit) Take your blood pressure while sitting down. Then, stand up and immediately take your blood pressure again. Your systolic (first) number should have raised 8 to 10 mm. If it dropped, you probably have adrenal fatigue.

Pupil dilation exam -- (Equipment required: Flashlight and a mirror) Look into the mirror and shine the flashlight into the pupil of one eye. It should contract. If after 30 seconds, it stays the same or, even worse, dilates, you most likely have adrenal fatigue.

Pain when pressing on adrenal glands (located over kidneys)

Adrenal Fatigue Symptoms

  • Low body temperature
  • Weakness
  • Unexplained hair loss
  • Nervousness
  • Apprehension
  • Irritability
  • Feelings of frustration
  • Mental depression
  • Difficulty gaining weight
  • Hypoglycemia
  • Excessive hunger
  • Difficulty building muscle
  • Inability to concentrate
  • Moments of confusion
  • Poor memory
  • Tendency towards inflammation
  • Indigestion
  • Alternating diarrhea and constipation
  • Osteoporosis
  • Lack of energy
  • Auto-immune diseases
  • Palpitations (heart fluttering)
  • Lightheadedness
  • Dizziness that occurs upon standing
  • Low blood pressure
  • Poor resistance to infections
  • Insomnia
  • Food and/or inhalant allergies
  • PMS
  • Craving for sweets
  • Dry and thin skin
  • Headaches
  • Scanty perspiration
  • Alcohol intolerance

Adrenal fatigue treatment requires diet and lifestyle changes. It may take 6 months to 2 years for adrenal fatigue to resolve.

Find out more about the Adrenal Stress Test that is available.

Lifestyle changes recommended:

Reduce Stress. Family, job, financial, and marital stress are factors that must be reduced or eliminated when possible. Sometimes, seeing a mental health counselor to develop coping skills to deal with life's stressors can be helpful.

Eat steadily, all day long. Skipping meals is one of the worst things you can do for your body. When you're hungry, your blood sugar drops, stressing your adrenal glands and triggering your sympathetic nervous system. That causes light-headedness, cravings, anxiety and fatigue.

Skipping breakfast is particularly bad, as it is a sure-fire way to gain, not lose, weight. If you start each morning with a good breakfast and "graze" healthfully every two to four hours, your blood sugar won't take any sharp dips. You'll feel more rested and energetic. Another drawback to skipping meals: the resulting low blood sugar can slow the speed at which you process food.

Exercise to relax. Walking, YOGA, deep breathing, and stretching are great stress reducers. Vigorous or aerobic exercise can deplete the adrenals. If your symptoms are severe wait until you feel a little stronger to do these.

Get 8 hours of sleep or more. During sleep, your adrenal glands are restored and repaired. Unfortunately, most of us place little value on sleep and end up getting less than we need, night after night. Result: Your adrenal glands stay depleted.

Foods to Avoid with Adrenal Fatigue:

  • Eat protein with every meal. Eat complex carbohydrates such as brown rice. Avoid sugar, junk food, white pasta, white rice, white bread.
  • Alcoholic beverages in excess reduce the functioning of the immune and energy production systems
  • Artificial sweeteners (Stevia is okay)
  • Foods high in potassium make adrenal fatigue worse (bananas, all melons, dried figs, raisins, dates, oranges, grapefruit, etc.)
  • Chemicals, additives and preservatives such as sodium nitrate, MSG
  • Oysters, clams, lobster, deep-sea fish such as tuna, mackerel, and swordfish that may contain toxic levels of mercury.
  • Absolutely NO caffeine
  • Coffee/Sodas over stimulates your adrenals. They deplete important B vitamins and alter your pH levels. Coffee does not give you energy; coffee gives you the illusion of energy. Coffee actually drains the body of energy and makes you more tired, because of vitamin and adrenal depletion.
  • Sweetened fruit juices

The following have been shown to relieve Adrenal Fatigue symptoms:

  • Sleeping until 9 a.m. as often as possible
  • Laughing
  • Exercising
  • Minimizing stress
  • Taking negative people out of your life
  • Eating regular meals
  • Chewing well
  • Doing something fun each day
  • Combining unrefined carbohydrates with protein and oils
  • Avoiding junk food, white potatoes, white bread, white flour, white rice, and refined sugar
  • Eating five to six servings of vegetables each day
  • Taking calcium and magnesium supplements
  • Adding sea salt to your diet (May add ½ tsp sea salt to 8 oz water in the morning)

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