Adrenal Dysfunction | Thyroid Imbalance

Adrenal Fatigue: Our Exhaustion Epidemic

We probably currently live in the most hypervigilant, fast-paced society of all time, and that is taking a heavy toll on our health. Most people are overwhelmed, feel burnout, have trouble recalling information and have brain fog. Some wake up 2 or 3 am and can’t fall back to sleep. Others have cravings for sugar, salty snacks, and carbs, while some cannot get rid of the belly fat they are carrying around. The feeling of anxiety is becoming an epidemic. If that sounds like you, then you may have adrenal fatigue.

Is Chronic Stress Driving us to An Early Grave?

Ideally, when we face any crisis situation, our bodies produce stress hormones that get us through the crisis. In today’s society, this survival response is always on, and we were never designed to be this wired all of the time. Dr. James Wilson, who coined the term adrenal fatigue in 1998, described a group of signs and symptoms that result when the adrenal glands function below the necessary level. Conventional medicine only recognizes two primary problems with the adrenals. Addison’s and Cushing’s disease, where one disease produces too little and the other too many hormones respectively. Unfortunately, everything between these two conditions is often considered “in the normal range” and left untreated. As a matter of fact, adrenal fatigue is not even accepted as a medical diagnosis.

Functional Medicine (the whole body system approach that focuses on identifying and addressing the root cause of disease). Functional Medicine recognizes that the untreated in between is where 99% of adrenal fatigue lies. Treating the human body as one integral system rather than a collection of body parts is the best approach to treating all chronic diseases.

You may have adrenal fatigue if you regularly notice one or more of the following symptoms

- - - Unexplained tiredness
    - Difficulty falling and staying asleep
    - Trouble waking up in the morning
    - You feel more awake and energetic after 6 pm. than you did all day
    - Cravings for sugar and salt
    - Unintentional weight loss
    - Loss of body hair
    - Feeling faint/dizzy when getting up quickly
    - Dependency on caffeine
    - Low blood pressure
    - Longer healing time
    - Feeling worse after skipping meals
    - Poor memory and reduced productivity
    - Alternating diarrhea and constipation

Chronic elevation of the stress hormone cortisol causes the production of other hormones to slow down. If the body thinks it’s running away from a white tiger, it would not produce, enzymes for digestion nor would it produce sex hormones like estrogen, progesterone or testosterone- which can lead to low libido and sexual dysfunction. The longer stress persists, the more the adrenal response becomes worn out, and the more trouble it has keeping up with the demands of the body.

Stage 1

Your body has an immediate reaction to stress and creates the many hormones needed for the response. Fatigue is normally mild at this point, and you may turn to caffeine, energy drinks, sugary, or high-carb foods for fuel.

Stage 2

In this stage, severe stress on the body continues to increase cortisol, while DHEA goes down. The body is able to conduct normal activities, but you are always very tired, and it’s getting worse. Digestive issues may set in, body aches/pains, irritability, sleep disruptions, a sense of being jittery, or nervousness starts to settle in. The thyroid can begin to be affected. Many people start to use a lot of caffeine to try and compensate at this point.

Stage 3

By this stage, your body starts to focus on producing stress hormones. And then, the raw material for your other sex hormones, DHEA drops substantially. At this point, because your immune system is suffering, you tend to get infections easily, your quality of life dips significantly. The body isn’t getting enough cortisol, so it tries to conserve energy. Muscle tissue starts to break down as it struggles to produce energy and then you start to feel like you are crashing.

Stage 4

Often called the crash and burn stage, the adrenal glands cease to function at this point, and not much can be done to restore the body’s natural balance. During the final stages of burnout, we lose all sex drive, depression can set in, restlessness, anxiety, and you have little to no interest in your surroundings. The inability to get out of bed becomes profound as unbearable fatigue takes over. Most people would need years of bed rest and prolonged therapy at this point to recover.

Treatment and Recovery from Adrenal Fatigue

Conventional treatment for adrenal fatigue is normally dismissing the experience of the patient as “all being in your head” and then antidepressants are given to patients as a bandage. Functional medicine, on the other hand, uses a root cause approach by doing saliva and/or dried urine test to pinpoint the dysregulation in the hypothalamic-pituitary-adrenal (HPA) axis.

More about the HPA

The hypothalamic–pituitary–adrenal (HPA) axis is part of the endocrine system, the chemical messenger system of the body through which hormones are secreted. It consists of the hypothalamus, the pituitary gland, and the adrenal glands. When you face a stressor (big or small), it is this system that creates the stress response in the body, releasing a hormone known as corticotropin-releasing hormone, or CRH, which triggers the release of another hormone, adrenocorticotropic hormone (ACTH), from the pituitary gland. Once it has been released, ACTH travels through the bloodstream down to the adrenal glands, where it triggers the release of the steroid hormone cortisol. Cortisol prepares the body for the “fight or flight” state to face potential threats by suppressing certain systems and giving it a burst of energy with a surge of glucose.

The HPA axis works as a feedback loop, meaning that the output of one of the glands loops back around to become input elsewhere. When the hypothalamus and pituitary gland receive signals that high levels of cortisol have been released, they stop the production of CRH and ACTH, which in turn stops the production of cortisol from the adrenals. The stress response ends with the decrease of cortisol, and the body can calm down and hormone levels return to normal.

When the body experiences chronic stress, dysfunction can occur in this system. Hormones continue to be released on an accelerated basis. Over time, this can cause the glands of the HPA axis to become desensitized and stop recognizing signals to stop producing hormones. When this dysfunction is not corrected, it becomes the norm and can lead to adrenal fatigue. ADRENAL FATIGUE-This condition is the collection of symptoms that occur when the adrenal gland is underproductive. It has become popular in the natural and alternative health world in recent years and is surprisingly common in the United States. It is most often associated with periods of intense or prolonged stress but can also develop during or after acute or chronic infections.

While many alternative practitioners focus on the adrenal glands as being the main source of dysfunction, it is only part of the problem. It is actually the entire HPA axis that is malfunctioning and therefore, treating only one part would be insufficient and ineffective. The feedback loop of the HPA axis must be addressed and corrected to relieve symptoms associated with adrenal fatigue)

The key to the treatment of adrenal fatigue is to remove the source of the chronic over-activation of the adrenal glands, and lifestyle modification is very important to the success of any treatment plan. Removing triggers, be it mental/emotional or psychological stress, physical and chemical stress is very crucial. Additionally, the following are essential to ensure healing:

1. Rest- get at least 7-8 hours of sleep each day to maintain good health.
2. Balance blood sugar– reduce your carbs intake and eat more healthy fats and proteins.
3. Reduce stress- pray and meditate regularly. Take a few minutes every hour to decompress. There are apps for that now
4. Reduce inflammation– eliminate gluten, dairy, and sugar for at least 3 months. Do the Elimination diet to reduce food sensitivities. Test and remove any chronic gut infections like H. Pylori, Giardia, Blastocystis, and candida that may be causing gut Inflammation.
5. Address your Nutritional Deficiencies– eating healthy may not be enough to meet your nutritional needs, so take high-quality supplements as needed. We stock high-quality supplements here in our pharmacy.
6. Take Adoptogenic Herbs and Supplements

Adaptogens are supplements that helps the body’s resilience in dealing with physical and emotional stress. They have been used for thousands of years in Ayurveda medicine for altering the production of hormones or altering stress chemicals, thereby assisting the body’s immune system and helping it to work optimally

Making healthy lifestyle choices will lead to positive and lasting changes in your overall health and well-being. If you need help on your journey to wellness, please contact Julius the Autoimmune and Hormone Compounding Specialist at Towne Lake Family Pharmacy for the programs he offers his patients.

References:

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Schloms, L., Smith, C., Storbeck, K.‐H., Marnewick, J.L., Swart, P. and Swart, A.C. (2014), Rooibos influences glucocorticoid levels and steroid ratios in vivo and in vitro: A natural approach in the management of stress and metabolic disorders. Mol. Nutr. Food Res., 58: 537-549. doi:10.1002/mnfr.20130046

References for THYROID HEALTH:

Santini F, Ceccarini G, Pelosini C, Giannetti M, Ricco I, Querci G, Grossi E, Saponati G and Vitti P (2019) Treatment of Hypothyroid Patients With L-Thyroxine (L-T4) Plus Triiodothyronine Sulfate (T3S). A Phase II, Open-Label, Single Center, Parallel Groups Study on Therapeutic Efficacy and Tolerability. Front. Endocrinol. 10:826. doi: 10.3389/fendo.2019.00826.crinol Invest. (2002) 25:106–9. doi: 10.1007/BF03343972

Pearce CJ, Himsworth RL. Total and free thyroid hormone concentrations in patients receiving maintenance replacement treatment with thyroxine. Br Med J. (1984) 288:693–5. doi: 10.1136/bmj.288.6418.693