Introduction to Adrenal Fatigue Syndrome

(This is a general overview and meant for your information only.  It is intended to be educational and not meant to be prescriptive for anyone.  No one should embark on any program to restore adrenal health without the supervision of a qualified clinician.  No one should make choices and/or selections about nutritional supplements, diet programs, exercise programs, or medications of any kind without appropriate medical supervision.  Please read and become educated.  Do not treat yourself by yourself under any circumstances).

Fatigue and lethargy is one of the most common complaints amongst adult patients. If you have symptoms such as tiredness, fearfulness, allergies, frequent influenza, arthritis, anxiety, depression, reduced memory and difficulties in concentrating, insomnia, worn-out, inability to loose weight after extensive efforts, you may be suffering from adrenal fatigue (technically known as hypoadrenia).

Adrenal fatigue has a broad spectrum of non-specific yet often debilitating symptoms. The onset of this condition is often slow and insidious. Patients are told that they are stressed and need to learn to relax more. Yes, we all know that “stress kills” to a large extent. But, the question is how?

The real truth is that stress and adrenal fatigue is not a mysterious entity at all. Our body has a built-in mechanism to deal with it. Being able to handle stress is a key to survival, and the control center in our bodies is the adrenal glands. When our adrenal glands become fatigue and unable to handle stress.

Adrenal fatigue was first described in the medical texts in the 1800s as a clinical condition. It was one of the most prevalent conditions, afflicting almost every adult in one way or another. Despite effective diagnostic tools and treatment programs, most conventional physicians were simply not informed of adrenal fatigue and not prepared to take adrenal fatigue as a serious threat to health. This condition was seldom diagnosed as a sickness for the past 50 years. Instead, adrenal fatigue was considered as a condition whereby no treatment was available other than to tell the “relax” and take anti-depressants. This often makes the condition worse as the root cause is left unresolved. Over time, the condition worsen as the natural progression of this pathology takes it course.

Adrenal fatigue should not be confused with another medical condition called Addison’s disease where the adrenal glands are not functioning. While Addison’s disease is often caused by auto-immune dysfunction, adrenal fatigue is largely caused by stress. Adrenal fatigue is the non-Addison’s form of adrenal dysfunction. Unfortunately, conventional medicine only recognizes Addison’s disease as hypoadrenia, despite the fact that adrenal fatigue is a fully recognizable condition. As such, do not be surprised if your doctor is unfamiliar with this condition.

Signs and Symptoms of Adrenal Fatigue

• Tendency to gain weight and unable to loose it, especially around the waist.
• High frequency of getting the flu and other respiratory diseases and these symptoms tend to last longer than usual.
• Tendency to tremble when under pressure.
• Reduced sex drive.
• Lightheaded when rising from a laying down position.
• Unable to remember things.
• Lack of energy in the mornings and also in the afternoon between 3 to 5 pm.
• Feel better suddenly for a brief period after a meal.
• Often feel tired betweeen 9 – 10 pm, but resist going to bed.
• Need coffee or stimulants to get going in the morning.
• Crave for salty, fatty, and high protein food such as meat and cheese.
• Increase symptoms of PMS for women; period are heavy and then stop, or almost stopped on the 4th day, only to start flow again on the 5th or 6th day.
• Pain in the upper back or neck with no apparent reasons.
• Feels better when stress is relieved, such as on a vacation.
• Difficulties n getting up in the morning.
• Lightheaded.

Other signs and symptoms include:

• Mild depression
• Food and or inhalant allergies
• Lethargy and lack of energy
• Increased effort to perform daily tasks
• Decreased ability to handle stress
• Dry and thin skin
• Hypoglycemia
• Low Body Temperature
• Nervousness
• Palpitation
• Unexplained hair loss
• Alternating constipation and diarrhea
• Dyspepsia

Common Causes

Chronic stress is very common in the western society. The most common causes of stress are work pressure, death of a love one, moving house, changing jobs, illness and marital disruptions. Adrenal fatigue occurs when the amount of stress overextends the capacity of the body to compensate and recover from stress.

Stressors that can lead to adrenal fatigue include:

• Anger
• Chronic fatigue
• Chronic illness
• Chronic infection
• Chronic pain
• Depression
• Excessive exercise
• Fear and guilt
• Gluten intolerance
• Low blood sugar
• Mal-absorption
• Mal-digestion
• Toxic exposure
• Severe or chronic stress
• Surgery
• Late hours
• Sleep deprivation
• Excessive Exercise
• Excessive sugar in diet
• Excessive caffeine intake from coffee and tea

One of the most commonly overlooked causes of adrenal fatigue is chronic or severe infection that gives rise to an inflammatory response. Such infection can occur sub-clinically with no obvious signs at all. Parasitic and bacterial infections including Giardia and H. pylori are often the main culprits.

Adrenal Fatigue Progression

Stage 1: Alarm Reaction (Flight or Fight response)

In this stage, the body is alarmed by the stressors and mounts an aggressive anti-stress response to reduce stress levels. Some doctors called this the Early Fatigue stage.

Typically, there is an increased ACTH from the pituitary gland that stimulates the adrenal glands into full gear to mount an retaliation response. The adrenal medulla is stimulated to secrete more epinephrine, and the total cortisol output from the adrenal cortex is increased from the excitatory stimulus. There is a corresponding reduction in DHEA production. During this period, the body needs cortisol to overcome stress, and production of cortisol is therefore increased. After some time, the adrenals will experience difficulties in meeting the body’s ever increasing demand for cortisol.

Stage 2: Resistance Response

With chronic or severe stress, the adrenals eventually are unable to keep up with the body’s demand for cortisol. As such , the cortisol output will start to decline from a high back to a normal level, while the ACTH remains high. With protracted ACTH and adrenal fatigue, less cortisol is produced due to the adrenal becoming exhausted. While the morning, noon, or afternoon cortisol levels are often low, the nighttime cortisol level is usually normal. Anxiety starts to set in, and the person becomes easily irritable. Insomnia becomes more common, as it takes longer to fall asleep. There is also frequent awakening as well. Infections can become more recurrent. PMS and menstrual irregularities surface, and symptoms suggestive of hypothyroidism (such as a sensation of feeling cold and sluggish metabolism ) become prevelant.

A phenomenon called pregnenolone steal (also called cortisol shunt) sets in. Cortisol production becomes the predominant pathway of hormone production as the body favors the production of this hormone. Other hormones such as pregnenolone, DHEA, testosterone and estrogen are less favored and their production will decline. As a result, total pregnenolone output is reduced but total cortisol output continues to be maintained at a normal level. Careful analysis of the daily diurnal cycle of cortisol shows a dysfunctional pattern of abnormally low cortisol in the morning. This is a time when cortisol is needed the most. Nighttime cortisol is usually still normal.

Stage 3: Adrenal Exhaustion

Despite rising ACTH, the adrenals are no longer able to keep up the increased demand for cortisol production. This may happen over a few years. Total cortisol output is therefore reduced, and DHEA falls far below average. The nighttime cortisol level is usually reduced as the hypothalamic-pituitary-adrenal axis “crash” and the body is unable to maintain homeostasis. Early in this stage, mild symptoms characteristic of first and second stage adrenal fatigue continues to worsen and becomes persistent or chronic. As the condition worse, multiple endocrine axis imbalances tend to occur. This is commonly menifested in the form of ovarian-adrenal-thryoid (OAT) axis imbalance in female and adrenal-thyroid axis imbalance in the male. As the body continues its downward path of impaired function, it gathers steam. Gradually, the body becomes severely compromised in trying to maintain the fine controls of homeostasis. Normal equilibrium is therefore lost. The body enters a state of reactive disequilibium.

The body will try its hardest maintain equilibrium with activation of the autonomic nervous system (ANS), but its crude response and damaged receptor sites along with impaired metabolic, clearance, and detoxification pathways give rise to paradoxical , unpredicable, and exaggerated outcome. Reactive sugar imbalances, fragile blood pressure, postural hypotension, heart palpitations, POTS, dizziness, anxiety reactions, being “wired and tired”, periodic adrnaline rushes, fragile fluid state such as hypersensitive diluational hyponatremia, sudden onset of anxiety and sensation of impending doom are common. There is a strong mind-body connection. No system is spared as every though process invoke physiological response. Many of these symptoms represent what is known as a “reactive sympathoadrenal response”. This response is the result of over-activation of two components of the ANS – the sympathetic nervous system (SNS) and the adrenomedullary hormonal system (AHS). Collectively , these two components constitute the sympathoadrenal system (SAS). When the SAS is over-activated due to stress, the body is bathed in a sea of adrenaline and norepinephrine. These two hormone are responsible for many of the above mentioned symptoms.

Finally, as the body’s key hormones, such as cortisol, falls below the minimum required reserve for normal function and output fails, the body may down-regulates the amount needed in order to preserve what is on hand for only the most essential body functions. This near-failure state is quite serious and requires professional attention. This is a state of extreme low energy as the body tries to conserve to survive. Nutrients that normally is helpful may be blunted in its action and indeed may backfire with paradoxical responses being the hallmark. Traditional macro-nutritional approaches may be helpful but the clinical outcome overtime is often blunted and may fail if the body continues to decompnesate. In such a case, a carefully titrated micro-nutitional program may be necessary to faciltate restorartion of equilibrium.

Stage 4: Failure

Eventually, the adrenals are totally exhausted.When adrenal fatigue has advanced to this stage, the line between it and sub-clinical and clincial Addison’s disease, also called adrenal insufficiency, can be blurry.

Typical symptoms of Addison’s Disease may start to emerge. Fatigue becomes extreme, with weight loss, muscle weakness, loss of appetite, nausea, vomiting, hypoglycemia, headache, sweating, irregular menstrual cycles, depression, and orthostatic hypotension, dehydration, and electrolyte imbalances. The body appears to have lost its normal homeostasis and is breaking down. If not attended to, the natural progression of this condition may be fatal.

Why Conventional Medicine Missed

Despite sub-clinical adrenia with its various stages was recognized as a distinct clinical syndrome since the turn of the 20th century, most doctors are unfamiliar with this condition for the simple reason that it is difficult to diagnose effectively by traditional blood test. Normal blood tests are designed to detect severe absolute deficiency of adrenal hormones known as Addison’s disease. This disease afflicts only 4 out of 100,000 and is often the result of auto-immune disease or infectious origin. Blood tests are also useful to detect extreme excessive levels of adrenal hormones in a condition known as Cushing’s disease.

Let’s examine this in more detail. the conventional test used is called the  ACTH (adrenocorticotropic hormone) challenge test. This test  recognizes extreme underproduction or overproduction of hormone levels, as shown by the top and bottom 2 percent of a bell curve. In other words, adrenal function has to be extreme low ( the bottom 2 percent) before a diagnosis is made. Symptoms of non-Addison’s  adrenal malfunction, meanwhile, can start to present itself symptomatically  after 15 percent deviation from  the mean on the bell curve.  Therefore, the adrenal glands could be functioning anywhere from 15-48  percent below the norm and not detected by the ACTH test.

To sum it up, adrenal hormones are low in the case of Adrenal fatigue, but still within the “normal” range and not low enough to warrant the diagnosis of Addison’s disease by regular blood tests. Such “normal” level of adrenal hormones does not mean that the patient is free from adrenal malfunction. Conventional doctors are not taught the significance of sub-clinical Addison’s Disease, or Non-Addison’s Hypoadrenia (commonly referred to as adrenal fatigue). They are misguided by blood tests. As a results, patients tested for adrenal functions are told they are “normal” but in reality, their adrenal glands are performing sub-optimally, with clear signs and symptoms as the body cries out for help and attention.

Women and Adrenals

Ovarian Adrenal Thyroid (OAT) Axis Imbalance. There are very strong interlinked relationships between the ovarian, adrenal, and thyroid systems in the women. These three organs are intimately co-dependent on each other for optimal function. This axis, also called the Ovarian Adrenal and Thyroid axis (OAT), must be balanced if a woman wants to feel good. When medication alters one of the organ’s functions, it will invariably lead to an often unrecognized change in the other two organs. For example, if thyroid medication is administered, it is not uncommon to see concurrent menstrual irregularities, a function of ovarian hormones, and reduced ability to deal with stress, a function of the adrenals.

Let us look more closely at the reason. In adrenal fatigue, internal cortisol often creates a condition of multiple organ resistance, including the thyroid and ovaries. Thyroid tissues fail to respond as efficiently to the hormonal signal. Adrenal fatigue is often accompanied by clinical or sub-clinical hypothyroidism. Laboratory values can be normal but classical signs of hypothyroidism may be present. Physicians and patients alike are often confused. Anti-depressants are often prescribed as a solution. However, this seldom works but will instead often make the condition worse.

A cortisol induced organ resistance applies to nearly all other hormone regulated organs including the ovaries and the pancreas. Few hormones are allowed to work at optimal levels in the presence of adrenal fatigue. A multitude of hormones including insulin, progesterone, estrogen, and testosterone become affected. The normal negative feedback loop in place can be disrupted. The ability of each hormone to regulate and fine tune its target organ to achieve homeostasis is often compromised. Blood pressure can becomes erratic, blood sugar levels may experience wide swings, bipolar and anxiety states come at will, and menstrual flow can become irregular. Even the brain may become less sensitive to estrogen.

Let us look more closely at how the ovarian system is affected in particular. Today, women often have exhausted adrenal glands by the time they reach their mid-thirties or early forties due to a stressful lifestyle. Stress is primarily regulated by our adrenal glands. In early stages of adrenal fatigue, cortisol output is high as the body attempts to neutralize the stress by producing more of it. However, when too much cortisol is produced, it will have multiple undesirable effects. For example, cortisol blocks progesterone receptors, making them less responsive to progesterone. Progesterone normally produced by the adrenals comes to a halt in favor of cortisol. Insufficient progesterone production leads to an imbalance of estrogen to progesterone. With reduced progesterone to offset estrogen, the body may experience a host of undesirable side effects associated with excessive estrogen. This leads to a condition known as estrogen dominance. It is no coincidence that we see a proliferation of conditions associated with excessive estrogen such as PMS, fibroids, and pre-menopausal syndrome when women reach their mid thirties and early forties.

It is interesting to note that most post- menopausal women who are experiencing hair loss have an adrenal function problem. Hair loss is a sign of excessive androgen. Some women tend to produce too much androstenedione, which then gets converted into estrone and testosterone. Testosterone in turn is converted into DHT, the more potent form of testostorone largely responsible for excessive hair loss. . Estriol can be given to offset the testosterone effects as estrogen balances testosterone in the body. Cortisol can be considered when closely supervised and used for a short period of time. It keeps the adrenal glands from getting stuck in the androgen part of the stress cycle if indeed it is in that state. Cortisol also complements the use of progesterone as well. The effective cocktail therefore consists of estriol, cortisol and progesterone. Each of these hormones, especially cortisol, have their own side-effects. Knowing what to use and when to use is critical, or hair loss could worsen.

Any serious attempt to normalize this axis should consider adrenal recovery as the first step. Adrenal normalization should precede hormone modulation. The adrenal glands deal with the daily stresses of life. A woman must normalize her adrenal glands in order to have a total body hormonal balance. In fact, replacement of deficient hormones alone without addressing the overall health of the adrenal gland is a band-aid approach and is often ineffective in the long run. The normalization process can begin with investigating and eliminating stressors. Stressors are often chronic in nature, and can be related to lifestyle, dietary, mental, and inflammatory causes. Women with heavy menstrual bleeding and adrenal exhaustion can normalize their adrenal functions with natural compounds to boost internal cortisol production, adequate sleep, proper diet, and nutritional supplementation before considering progesterone therapy. Exogenous cortisol replacement should only be considered as a last resort due to its long term negative effects.

Often times, the use of anti-depressants, thyroid replacements, and ovarian hormones often make women with OAT axis imbalance worse. Estrogen replacement often becomes ineffective, and symptoms of estrogen dominance like hot flashes, weight gain at the hips, water retention, and moodiness are commonly observed despite normal estrogen levels. Patients become frustrated as it seems that nothing can help when a downward spiral of multiple symptoms commonly surface: depression, insomnia, fatigue, metabolic and hormonal imbalances. Failing conventional therapy, many turn to natural compounds. It is not unusual to see many people take a full battery of these nutrients. For example, Vitamin C, DHEA, pregnenolone, natural progesterone, and natural thyroid replacement, just to name a few. In the beginning, this might be helpful. Unfortunately, a short-gun approach by taking many nutrients seldom works and often backfire with time. The higher the dose the worse the patient can become. That is why chronic stress and adrenal fatigue can make one feel so rotten, like a slow-motion train wreck in progress. In severe cases, the patient often feels like the “walking dead” caught in a vicious downward cycle of deteriorating physical and emotional functions.

Adrenal Fatigue Notes

1. Removal of the stressors. This is the most important step. Emotional stressors such as marital, family, relationship, or financial problems needs to be dealt with and normalized.

2. Sleep. The most important is to have enough rest. It is important to go to sleep by 10 p.m. every night. Why? This is because our adrenal glands kick in for a “second wind” to keep us going from 11 pm to 1 am. This puts tremendous stress on the adrenals. When we rest early, our adrenals are fully rested and the high gear is avoided. Between 10 p.m. and 1 a.m., our adrenals work the hardest to repair the body. We should also try to sleep in until 8:30 a.m. or 9: 00 a.m. if possible. This is because our cortisol level rises to its peak from 6:00 a.m. to 8:00 a.m. in order to wake us up and get us going for the day.

In later stage adrenal fatigue, the level of cortisol falls and we feel tired. It will be more difficult to wake up. If we were to wake up too early, this will only increase stress on the adrenal glands, which will have to produce more cortisol when it is already exhausted.

A good night sleep is therefore mandatory. Without a good sleep, our bodies cannot regenerate itself to deal with stressors the next day. We should also rest in a completely dark room to maximize melatonin production.

3. Avoid Coffee or Caffeinated Beverages. Coffee and tea act as stimulants and interrupt sleep pattern. Herbal tea is acceptable because it does not contain caffeine.

4. Avoid TV and Computers. Some people may be photosensitive. Watching television or working at the computer may prevent the melatonin level from rising to induce sleep. If you are one of these people, you should turn off your television or computer by around 8 p.m. at night.

5. Exercise. This is a wonderful stress reducer and a tremendous oxygenator. Exercise reduces depression, increases blood flow, normalizes level of cortisol, insulin, blood glucose, growth hormones, thyroid, and makes you feel generally much better. The key is to adjust the level of exercise in accordance to your capacity.

6. Eating Pattern. When our cortisol levels are at its peak from 6 a.m. to 8 a.m., we may have no appetite. Many people skip breakfast because “they are not hungry”. This is because our bodies need sugar to run on. Furthermore, our body’s energy requirement does not change during this period. Even a small snack is better than nothing at all and will provide the needed energy even though there is no urge to eat.

Skipping breakfast is not a good idea. If you are low on sugar, the adrenals are instructed to secrete cortisol because cortisol activates gluconeogenesis to increase blood sugar level and allow the body to function. It is therefore important to have a healthy breakfast soon after waking and not later than 10 a.m. This will prevent the body being put in a position to play “catch-up” for the rest of the day.

Sugar

Glucose is a simple sugar found in food. It is an essential nutrient that provides energy for the proper functioning of the body cells. After meals, food is digested in the stomach and is broken down into glucose and other nutrients. The glucose is absorbed by the intestinal cells, carried by the bloodstream to cells throughout the body. However, glucose cannot enter the cells alone. It needs assistance from insulin in order to penetrate the cell walls. Insulin therefore acts as a regulator of glucose transport and metabolism in the body.

Insulin is called the “hunger hormone”. As the blood sugar level increases after a meal, the corresponding insulin level rises with the eventual lowering of the blood sugar level and glucose is transported from the blood into the cell for energy. As energy is produced by the cell, blood glucose level slowly is lowered, the insulin release from the pancreas is turned off. As energy continue to be generated, the blood sugar level continues to drop. When it drops below a certain level, hunger is felt. This often occurs a few hours after the meal. This drop in blood sugar triggers the adrenals to make more cortisol. The cortisol increases the blood sugar by converting protein and fat into its component parts. With this, the blood sugar rises to provide a continuous supply of energy for our use between meals. Cortisol therefore works hand in hand with insulin to provide a steady blood sugar level 24 hours a day and keep blood glucose levels in a tightly controlled range.

When the adrenal gland is in a state, the amount of cortisol production drops below the normal level, and the amount of sugar available to the cells is reduced. With less sugar, less energy is available to the body, and fatigue is experienced. As the sugar level drops below a critical point, dizziness and lightheadedness can be experienced. These are common symptoms of low blood sugar (also called hypoglycemia). Low blood sugar is most likely experienced between meals at 10am-12pm, as well as 3-4pm.

To make things worse, the body’s automatic response when more sugar is needed during a stress response is to make more insulin in an attempt to move the sugar into the cell from the blood stream to create more energy. Insulin opens up the cell membrane to push the glucose in, resulting in further reduction in blood glucose. This worsens the already existing hypoglycemic state.

Those with adrenal fatigue often report symptoms such as dizziness and weakness, as the blood sugar level drops below a comfortable level for the body to function normally. To overcome this, the quick fix solution is to take food that is high in refined sugar such as donut or sweets, or drinks that is stimulatory to get the adrenal to put out more cortisol, such as coffee or cola drinks. This gives the person a boost of energy. However, this hypoglycemic symptom relief only lasts for about 1-2 hours. Inevitably, it is followed by a crash to an even lower blood level. Those suffering from adrenal fatigue are constantly on a roller coaster ride in terms of their blood sugar level throughout the day. The sugar level tends to increase after each quick fix, but drops after a few hours. By the end of the day, the body is totally exhausted.

A diet that maintains a constant sugar level in the blood is a critical consideration in adrenal fatigue recovery. This can be done by taking a variety of low-glycemic index food that releases sugar slowly to sustain the body during and between meals. Starchy carbohydrates that are converted quickly into glucose (such as pasta and bread) should be limited. Soda drinks should be totally avoided.

Salt

The amount of salt in the body is highly dependant and regulated by a chemical called aldosterone. This chemical is manufactured in the adrenal cortex under the direction of another hormone called ACTH (adrenocorticotrophic hormone). ACTH is produced by the anterior pituitary gland. ACTH stimulates the adrenal cortex to secrete a wide variety of hormones including aldosterone as well as cortisol. Like cortisol, aldosterone follows a diurnal pattern of secretion, peaking at 8 a.m. , and at its lowest betwee12-4am. Aldosterone is a very specific compound that is responsible to maintain the concentration of sodium and potassium in the cell as well as outside the cell. This in turn has a direct effect on the amount of fluid in the body. Aldosterone therefore plays a significant role in regulation of blood pressure.

It is important to note that in our body, sodium and water goes hand in hand. Where sodium goes, water follows. As the concentration of aldosterone rises in the body, the concentration of sodium and water rises, more fluid is retained in the body, and blood pressure rises. Conversely, when the level of aldosterone lowers, the amount of sodium and water in the body is reduced. The blood pressure goes down.

Unlike cortisol, aldosterone does not have its own negative feedback loop when there are excessive amounts. If the aldosterone level is too high, aldosterone receptor sites will be down regulated and its sensitivity to aldosterone is reduced. In the early phases of adrenal fatigue, the amount of cortisol and aldosterone increases in our body due to the ACTH stimulatory effect from stress. As a result, the sodium and water is retained in the body with a feeling of bloated. The baro-receptors ( receptors that are sensitive to pressure) of the blood vessels are triggered and blood vessels goes into a relaxation mode automatically and this is regulated by the autonomic nervous system. This auto-regulation helps to maintain a stable blood pressure at a time when the total fluid volume increases due to high level of aldosterone triggered by stress. With stress, the adrenal glands also secrete another hormone called epinephrine. This hormone constricts the blood vessels and increases blood pressure in order to ensure that our brain have adequate blood flow and oxygen to help us deal with impending danger. The sum reaction of aldosterone, epinephrine, and the autonomic relaxation response are some of the key factors that ultimately decide the final blood pressure at any point in time. During the early stages of adrenal fatigue, the resulting blood pressure is often normal if all bodily function is well balanced. If the body is unable to overcome the aldosterone and epinephrine response, then the blood pressure is elevated. It is common to find many under stress experiences increase in blood pressure.

As adrenal fatigue progresses to more advance stages, the amount of aldosterone production reduces. Sodium and water retention is compromised. As the fluid volume is reduced, low blood pressure ensues. Cells get dehydrated and become sodium deficient. Hydration of a person in adrenal fatigue should take about 24-48 hrs or more. Flluid with adequate electroytes should be administered 2-4 times a day in intermittent dosages. Coffee, alcohol, and tea (with the exception of herbal tea) should be avoided.

Most with advanced adrenal fatigue reports a low blood pressure as well as a salt craving. The low blood pressure is due to the reduced fluid in the body. Salt craving is because the body is in a absolute deficiency of sodium. Both are due to the lack of aldosterone. In order to compensate for this, potassium is leaked out of the cells so that the sodium to potassium ratio remains constant. The loss of potassium is less then that of sodium, and as a result the potassium to sodium ratio is increased. This imbalance causes another set of problems.

Those suffering from adrenal often have a low body fluid volume accompanied by a salt craving due to absolute deficiency in sodium as well as a normal to high potassium level. While lost fluids should be replaced, it has to be done carefully and slowly. When the fluid is replaced too quickly without adequate sodium, the amount of sodium in the body may be diluted, resulting in an even lower sodium level. This is called dilutional hyponatremia. Symptoms of low sodium includes non-specific symptoms confusion, lethargy, nauseated, headache, seizure, weakness, restlessness. Adrenal fatigue along with low sodium leads to a clinical picture that is very challenging to all but the most experienced clinician.

Those in this state may find themselves visiting the Emergency Room for the many of these disturbing sympotms only to be told that all is normal after extensive workup. Electroytes may actually within normal range and symptoms persist among those who are severly decompensated and in a highly sensitive state consistent with advance adrenal fatigue. Some may need diutics to reduce fluid load while sodium load is being replaced. Symptoms may take some time to resolve.

Commercially available electrolyte replacement drinks such as Gatorade are designed for people who have normal adrenal and excessive loss of potassium during exercise. These drinks are designed to be high in potassium and low in sodium. They can be taken in as fluid replacement if adrenal fatigue is very mild. Sufferers of advanced adrenal fatigue usually have a low cortisol and sodium level. They should take filtered drinking water with & half to one teaspoon of salt on a regular basis, especially in the morning upon awakening. If blood pressure increases, or signs of edema occur and nausea develops, stop the salt and report to a qualified health practitioner.

Only a small number of people with adrenal fatigue have concurrent high blood pressure. Those that fall into this category should check their blood pressure carefully during fluid replacement.

Conclusion

Adrenal fatigue is a decrease in the adrenal gland’s ability to carry out its normal function. The chief symptoms are fatigue, excitability, or depression.

Adrenal fatigue is commonly cause by chronic stress from any source (including emotional, physical, mental, or environmental) that exceeds the body’s capacity to adjust appropriately to the demands placed on it by the stress. It is a condition that afflicts children as well as adults. It can be diagnosed by properly laboratory test, if only the physician pay more attention.

Adrenal glands can be restored to optimum health naturally by adhering to healthy living principals. Proper rest, together with specific nutritionals, proper diet and removal of stressors are key components to adrenal fatigue recovery.

The road to adrenal recovery is not a linear or straightforward path because of the complexity of our internal hormonal and stress-regulation system.

Most people who suffer from adrenal fatigue also have multiple endocrine imbalances including sub-clinical hypothyroidism, insulin resistance, and estrogen dominance. These need to be optimized as well. Adrenal recovery is a process akin to running a marathon. The process is long, but it can be done easily and painlessly, one step at a time. Most will find some improvement in a matter of weeks, depending on the degree of pre-existing damage and the clinical skills of the health professional. Because the amount of hormonal balancing is intricate and is highly sensitive, the process take anywhere from 3 months to 3 years under the best of hands. It is a long marathon, and recovery should not be expected in a matter of weeks. Frustration and disappointments are common and normal. Patience is key. During the recovery process, most, if not all, will go through a roller coaster type ride with advances and setbacks.

The use of the proper amount of nutritional supplement can certainly speed up the recovery process, if done properly. It is critically important to note that while there are many nutrients that can help the adrenal recover, only a few are normally needed at any point in time. Nutrients, if not dosed properly, can become toxic and make the adrenal fatigue worse. A shot gun approach seldom works and can in fact backfires if the adrenal is not able to take in the nutrients at the right rate, time, and dose.

Take it one step at a time under professional guidance is best to ensure that the right step is taken at the right time. This is especially true for advance case. The key is a knowledgeable clinician who takes the time to understand your body and its signal and cries for help. A total nutritional and lifestyle approach that helps the adrenal gland to normalize itself, with on going adjustments in terms of nutritional supplementation to help the adrenal during this recovery is the key.