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Thursday, November 11, 2010

Endocrine Disorders Series Part 3: Adrenal Fatigue In A Nutshell

Whether or not you know it, probably all of you reading this have experienced adrenal fatigue to one extent or another. Basically, unless you live inside a spa in Hawaii and have a fairy godmother, you've probably experienced your fair bit of stress. My favorite book on Adrenal Fatigue's explains how broad the problem is: Adrenal Fatigue, the 21st Century Stress Syndrome. Adrenal Fatigue revolves around how your body handles stress. And yes, you guessed it. We think our bodies can put up with how-ever-much stress (physical and emotional) we throw at it, but no, it can't.


MY STORY

This is how I became sick with adrenal fatigue: no sleep in high school, no sleep in college, especially in college, eating like crap and pulling all-nighters. Then law school was the king grand-daddy of stress and not taking care of yourself. Experts say adrenal fatigue can take up to 10 years to develop, and this is where it really started for me. I would have panic attacks in law school because I was under so much pressure. During law school I got married (good stress, but stress nonetheless), then my dad died, then 9/11 happened, the DC Sniper and Hurricane Isabel. Very difficult to go through for someone with anxiety, but no counseling, no help whatsoever. I would just tell myself to "buck up." I had Eli the next year. I didn't know this at the time, but Eli has a disorder that made him SCREAM and SCREAM as a baby and toddler for no reason (the reason was: he didn't want anything to touch him- even fabric or my own hands touching him & he would get over stimulated... the disorder is called Sensory Processing Disorder.) The stress of a screaming toddler and brand new baby Mia pushed me to the point of almost having a nervous breakdown.

The nail in the coffin was over-exercising. What I didn't know then was that the little cortisol I had left all went towards healing and muscle repair from my exercise sessions, and none for average every day stress demands. My immune system started to break down, and last fall I kept getting sick and just could not get better. I got 5 sinus infections in a row before I could take no more and finally went to see an integrative physician because no one else could help me!

And I would ask myself why I couldn't handle all the stress without getting depressed or sick or anxious. "Other moms" can do hard things, why can't I? I expected way too much of myself even for a healthy person, but I had no idea at the time that my body's physiological ability to handle stress was in danger of completely pooping out on me.

PHYSIOLOGY

So from a gal that hasn't had a science class since 1991, here's a crack at explaining what the adrenal glands do.

First of all, they are located in the back of your body, just above your waist, one above each kidney. The adrenal gland is about the size of a grape, and it has 2 sections. The adrenal cortex is the outer region, where cortisol is secreted, and the inner region where adrenaline is secreted. Cortisol and adrenaline are both good and bad. They are mostly useful in fight or flight situations. The problem is that the way our lives are in the 21st Century, our bodies are tricked into thinking that every 5 minutes we have a life or death situation, and the adrenal gland works overtime.

When I had gestational diabetes, I learned that your body will not produce insulin forever. It can run out if too much is used by continually eating sugar. If you eat enough sugar, you WILL get diabetes. The adrenal glands work the same way. When we have stress, cortisol is released to help the body deal with it. But if we stress too much, or if your adrenal glands are genetically predisposed to be a little weak, you WILL run out of cortisol at some point. But as the adrenal glands weaken, the warning sign they give is the overproduction of cortisol.

Stage 1 of Adrenal Fatigue is cortisol overproduction. In Stage 2, cortisol will start to decline, and you will feel a little fatigue during the day. Stage 3, the exhaustion will really set in, and your sex hormones, and other important hormones will become imbalanced, as well. If things get worse from there, Stage 4 is total collapse, meaning heart failure.

Cortisol does the following things for your body:
1) It increases the blood sugar in your body. This was good when we were running away from the dinosaurs. Our body needed energy during Emergency Life or Death situations. But it is really bad in our day and age. High blood sugar just means a huge belly, and pre-diabetes.

2) It is an anti-inflammatory hormone, commonly known as a corticosteroid. In the later stages of adrenal fatigue, you will notice that injuries are not healing as they should, or your allergic reactions are out of control (swelling) or you continue to have sinus or bronchial trouble (everything is inflamed). This is also why people with adrenal fatigue are likely to also develop auto-immune conditions.

3) Too much cortisol can stop the white (good) blood cells from multiplying. Lots of white blood cells means a strong immune system. Therefore, lots of cortisol means a weak immune system.

4) Cortisol causes vasoconstriction, which means increased blood pressure. Someone in the later stages of adrenal fatigue, as cortisol declines will probably have chronically low blood pressure. (But I didn't. I had HIGH blood pressure when my cortisol was almost at zero. The lab result of my salivary cortisol test was the lowest they'd ever seen at that doctor's office.)

Now you know why they call cortisol the hormone of death.

TREATMENT

This all sounds really horrible so far, right? So why aren't we able to go to our regular traditional neighborhood doctor and get treated for it?

1) There is no diagnostic code (what doctors are constrained by thanks to health insurance companies) for adrenal fatigue. The closest thing is Addison's Disease, a much more serious and rare disease where the adrenals underproduce cortisol (usually due to extreme things like overuse of steroids, surgical removal of adrenal glands or other extreme strain on the adrenal glands.) Based on the symptoms I listed in Part 2 of this blog series, yet knowing I don't have Addison's disease, wouldn't you definitely say I needed help from a doctor? All I got was a head shake and maybe some rolled eyes. This is why you need to find an integrative physician.

2) When a doctor does give you a test to check your cortisol levels, they will only give you a blood test. Many believe that blood tests for cortisol (and thyroid and sex hormones, too, for that matter) are less accurate. What you want is a salivary cortisol test. Blood tests measure the cortisol level in the bloodstream. Hormones like cortisol don't perform in the bloodstream. They act on the tissue level at their target sites. Saliva testing is better because it measures the level of hormone not bound to blood proteins. (More information can be found in this book.) There is no way of knowing simply by looking at your symptoms whether your cortisol is too high or too low. Symptoms of high cortisol versus low cortisol are extremely similar. The best thing to do is ask for a salivary cortisol test and see exactly where you are at.

3) Many believe that natural remedies have been almost eradicated from medical practice because no one gets rich off of them. Natural remedies are definitely the key to getting better from Adrenal Fatigue. Prescription Prednisone (and similar drugs like hydrocorisone, etc.) made me sicker. Non-prescription natural cortisol and adaptogenic herbs have changed my life.

4) There is a clash in the school of thought between integrative physicians and traditional doctors. Traditional doctors are taught in medical school that you can only have a glandular disorder (like adrenal or thyroid) if your lab test results are in a certain specific, narrow range. The "normal" range is so broad, that there are people like me that are told, "You are not sick, you are healthy. Go home." Integrative physicians believe that you can have "a little bit" of a glandular disorder. For example, the MD I see has given me medicine for hypothyroid even though my regular GP tested me and concluded I was normal. My integrative physician looks at more detailed tests, and looks at symptoms, not just lab results.

Note: Instead of doing detailed posts about Hypothyroid and PCOS, I will refer you to these sites for more info. Click here for Hypothyroid. Click here for PCOS.

Stay tuned for more tips on how to cope and heal from these problems.

4 comments:

RebeckerOnline said...

Wow! This is really interesting stuff. I'm going to have to read your other posts about this now.

I've been WAY stressed for about five or six years now. This past year I created a new job for myself at work, which for the most part I love. However, at the same time I moved from a beautiful large personal office into a "cube farm" that they thought was innovative. Because of my role, people pull "drive by cubings" on me all day - asking questions, needing me to come to work out a dispute, wanting to discuss an idea. I've timed it and the longest I'm left alone is two songs on the iPod. And, when I'm not interrupted, I'm anticipating it.

So, it feels like I'm in a constant mode of fight or flight behavior because I'm someone that needs a lot of alone time to think and to perform well.

My weight has taken a hit, I'm completely mentally exhausted a lot, and it impacts other physical symptoms as well. On Fridays I work at home and it is amazing how much I get done and how my body functions normally over the weekend.

Anyway, this is LONG, but will learn more about this. Thanks for sharing!

Mary said...

My dad was also given prednisone. . He had a 2 year autoimmune response to it that caused his muscles to waste away and almost killed him. . . some integrative medicine finally saved his life and 3 years later he is almost back to 100%. Very interesting post.

Natalie C. said...

Rebecca- I feel your pain about the constant stress. I hope you get some relief!

Mary- Wow. How scary. I'm so glad he got something that helped him. Adrenal Fatigue (even without the autoimmune response) actually does eat away at your muscles. Starting with your thigh muscles. This caused me to injure my knee really badly a few years ago!

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