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PsychoNeuroImmunology (PNI)

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We have put considerable thought into our 4 Faces of Adrenal Burnout (/adrenal_fatigue.html) and are very proud of the supplement bundles we credr._oz_recapo.pngated for each of these stages of stress. So naturally we were pleased to see Dr. Oz endorse a similar (albeit much less detailed and specific) approach to categorizing your stress type:

To review, our approach combines your individual symptoms (roughly equivalent to Dr. Oz’s “Stress Type”) with specific biological (hormonal, neurotransmitter, and immune) imbalances to develop a specific treatment plan for you combining lifestyle, nutritional supplements, and adrenal support.

This novel approach is called Psycho-Neuro-Immunology (PNI) and is based on the hypothesis that recurrent stress causes progressive imbalances among multiple physiological systems. Because these progressive imbalances can be measured, they should be measured. Hence, our motto: Test Don’t Guess. Moreover, this PNI approach is integral to our overall practice of integrative psychiatry – a specialty of functional medicine. For more about functional medicine, please refer to Dr. Dave’s article “Functional Medicine – Everything Else is Just a Band-Aid.”


PNI, a term originally coined in 1975 by Robert Ader and Nicholas Cohen (Ader R. Psychosomatic Medicine 1975;37:4), represents “a convergence of disciplines – namely, the behavioral sciences, the neurosciences, endocrinology, and immunology – intended to achieve a more complete [as opposed to mere guessing] understanding of the way the interaction among these systems serves homeostatic ends and influences health and disease.”

This integrative model attempts to provide unifying theories behind the development of the degenerative diseases of civilization that dominate the health landscape these days. This approach is a refreshing departure from the dominance of the “organ cartels” that have dominated the medical professions for so many decades. These organ cartels flourished during a time of exponential growth in medical knowledge that led to the establishment of medical sub-specialization. Unfortunately, this level of expertise came at the cost of a cohesive, holistic, unifying perspective with an emphasis on treating the whole person, not just a single organ system.

Remember, stress is not what happens to us. Rather, it 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.

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.

For more specifics please see Dr. Dave's Slideshare: The 4 Faces of Adrenal Burnout

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