Learn About: ADRENAL FATIGUE

General Information
Symptoms
Testing
Treatment
Other Causes of Fatigue
Web Links

Do you take on more than you can handle or expect too much from yourself? Perhaps you are under constant stress, or dealing with an unresolved difficult situation? If so, and you find yourself low on energy and just not feeling right, you may be suffering from adrenal fatigue, sometimes referred to as adrenal burnout . It is estimated that 80% of us suffer with adrenal insufficiency at some point in our lives.

ABOUT THE ADRENAL GLANDS

The adrenals are walnut-sized glands that sit at the top of each kidney. These tiny glands play an important role in our health as they are the control center for more than 50 hormones. In addition they are responsible for :

• energy production
• fluid and electrolyte balance
• fat storage

The adrenals also work with other hormones and systems in the body, and after menopause and andropause (men), they pick up the slack by producing larger amounts of sex hormones. Good adrenal function is linked to longevity.

The adrenal cortex, the outer layer of the gland, produces cortisol, DHEA, estrogen, and testosterone. The center of the glands produces adrenaline. To give you an idea how important these hormones are, let’s look at just one:
Cortisol - a hormone that keeps the body’s systems in balance and protects the cells. It also controls the strength of the immune system, normalizes blood sugar and regulates blood pressure!

The basic job of the adrenals is to activate your “flight or fight” response, the release of adrenaline and other hormones, which in turn releases stored energy for immediate use, increases heart rate and blood pressure, slows digestion, and sharpens your senses. This reaction was intended for rare and short-term situations “stress” situations, but given our hectic and tension-filled lives, the adrenals can become overworked, creating adrenal insufficiency.

Some of the challenges that tax the adrenals are obvious, such as illness, relationship issues, problems at work, money, and lack of sleep. But unresolved emotional issues, digestive problems, yo-yo dieting or skipping meals, even reliance on stimulants like coffee and carbs can cause adrenal fatigue.

The definition of Adrenal Fatigue/Insufficiency as described by the Mayo Clinic (www.mayoclinic.com):

"Adrenal fatigue is a label applied to a collection of nonspecific symptoms, such as body aches, fatigue, nervousness, sleep disturbances and digestive problems. The term often shows up in popular health books and on alternative medicine Web sites, but it isn't an accepted medical diagnosis.

Your adrenal glands produce a variety of hormones that are essential to life. The medical term 'adrenal insufficiency' refers to inadequate production of one or more of these hormones as a result of an underlying disease. Signs and symptoms of adrenal insufficiency include fatigue, body aches, unexplained weight loss, low blood pressure, lightheadedness and loss of body hair. Adrenal insufficiency can be diagnosed by blood tests and special stimulation tests that show inadequate levels of adrenal hormones.

Fatigue can have many causes — from lack of sleep to lack of exercise. But fatigue may also signal other health problems. Here are some tips on interpreting what causes fatigue and how to beat it.

Some days you're so low on energy that you're drowsy by lunchtime and in need of a nap by midafternoon. What's making you so tired all the time? Stress, poor eating habits, overwork, even medical treatments can wear you down.

Most of the time, fatigue can be traced to one or more of your habits or routines. You have the power to put the vitality back in your life.

Taking a quick inventory of the things that might be responsible for your fatigue is the first step toward relief. Fatigue can have a variety of lifestyle causes, including:

• Lack of sleep. Getting even an hour less than the sound slumber you need each night can leave you drowsy and unable to manage your daily routine. You may not go to bed early enough. Or more likely, you go to bed but can't sleep well. As you get older, it becomes harder to get uninterrupted sleep. You sleep less soundly. You awaken earlier.

• Stress and anxiety. If you're running from one task to the next without a break, it's eventually going to wear you down. Going through life anxious and on edge can keep you from relaxing and getting the rest you need.

• Inactivity. You're too tired to exercise, so you don't. But then when you do exert yourself, you tire easily because you're out of shape. Engaging in moderate physical activity for a half-hour or longer most days of the week may decrease stress, improve mood and leave you feeling energized. Don't schedule your activity too close to bedtime, though, or you might have trouble falling asleep.

• Eating habits. If you're not eating properly or drinking enough fluids, your body isn't getting the fuel and fluid it needs. Trying to remedy this with caffeine can backfire, especially if you consume it late in the day. Caffeine not only makes it harder to fall asleep, it also interferes with sound sleep and may keep you tossing and turning throughout the night.

• Certain medications. Some medications, including many beta blockers and antihistamines, can cause fatigue. In addition, some cold medications and pain relievers contain ca fatigue ffeine and other stimulants that can keep you up at night.

SYMPTOMS OF ADRENAL FATIGUE:

Dr. James Wilson, author of Adrenal Fatigue: The 21st Century Stress Syndrome (www.adrenalfatigue.org) offers the following information about adrenal fatigue:

Symptoms of adrenal fatigue:

• Morning fatigue -- You don't really seem to "wake up" until 10 a.m., even if you've been awake since 7 a.m.
• Afternoon "low" (feelings of sleepiness or clouded thinking) from 2 to 4 p.m.
• Burst of energy at 6 p.m. -- You finally feel better from your afternoon lull.
• Sleepiness at 9 to 10 p.m. -- However, you resist going to sleep.
• "Second wind" at 11 p.m. that lasts until about 1 a.m., when you finally go to sleep.
• Cravings for foods high in salt and fat
• Increased PMS or menopausal symptoms
• Mild depression
• Lack of energy
• Decreased ability to handle stress
• Muscular weakness
• Increased allergies
• Lightheadedness when getting up from a sitting or laying down position
• Decreased sex drive
• Frequent sighing
• Inability to handle foods high in potassium or carbohydrates unless they're combined with fats and protein

Dr. Wilson believes that food allergies and sensitivities can play a role in developing adrenal fatigue and provides the following questionnaire on his website:

Food & Environmental Intolerances Questionnaire:

Below are common signs and symptoms of food or environmental intolerances. These intolerances affect your body's ability to function and contribute to Adrenal Fatigue. They may or may not show up on allergy tests, but if you have many of these signs and symptoms, your body is likely reacting to one or more substances you are eating, drinking or have been exposed to. Once you determine which substance(s) is bothering you and remove it, you should see improvement, provided that your adrenal glands have the capacity to respond and recover.

Note that the signs and symptoms listed below have more than one cause and any single sign or symptom is not a direct indication of a food or environmental intolerance. Taken as a group, however, they are very useful indicators of hidden problems affecting your metabolism.

Following is a listing of the symtoms given on the questionnaire, to view it in full and to take the survey,visit: http://www.adrenalfatigue.org/intolerances.php

Suggested Physical Symptoms:

Head:

• headaches
• faintness
• dizziness
• feeling of fullness in the head
• excessive drowsiness or sleepiness soon after eating
• insomnia

Eyes, Ears, Nose & Throat:

• runny nose
• stuffy nose
• excessive mucous formation
• watery eyes
• blurring of vision
• darkness under eyes
• ringing in ears
• earache
• fullness in ears
• fluid in middle ear
• hearing loss
• recurrent ear infections
• itching ear
• ear drainage
• sore throat
• chronic cough
• gagging
• canker sores
• itching of roof of mouth
• recurrent sinusitis

Heart & Lungs:

• palpitations
• increased heart rate (85 - 100 beats per min. at rest)
• rapid heart rate (tachycardia - over 100 beats per min. at rest)
• asthma
• chest congestion
• frequent or unexplained hoarseness
• Gastrointestinal
• nausea
• vomiting
• diarrhea
• constipation
• malabsorption
• bloating alter meals
• belching
• colitis
• flatulence (passing gas)
• feeling of fullness in the stomach long after finishing a meal
• abdominal pains or cramps

Skin:

• hives
• rashes
• eczema
• dermatitis
• pallor
• repeated itching without apparent reason

Other physical symptoms:

• chronically fatigued
• muscle weakness
• muscle aches and pains
• joint aches and pains
• swelling of the hands, feet, or ankles
• urinary tract symptoms (frequency, urgency)
• vaginal itching
• vaginal discharge
• excessive hunger (and its close ally, binge or spree eating)
  
  Suggested Psychological Symptoms:

• anxiety attacks
• depression
• cravings
• aggressive behavior
• irritability
• mental dullness
• mental lethargy
• confusion
• excessive daydreaming
• hyperactivity
• restlessness
• learning disabilities
• poor work habits
• slurred speech
• stuttering
• inability to concentrate
• indifference
• cloudy or foggy thinking

* A personal note: If you suspect a food or other substance may be causing or aggravating your symptoms, learn more about Muscle Testing - a useful tool to identify substances that are not compatible with your body.

Women to Women (www.womentowomen.com) one of my favorite sources of health information lists the following symptoms on their site. They have several great articles on the site as well that relate to fatigue.

Symptoms/Conditions Caused by Adrenal Fatigue:

• Fatigue
• Weakness
• Insomnia
• Weight Gain
• Depression/Moodiness
• Suppression of Immune System
• Muscle and Bone Loss
• Hormonal Imbalance
• Skin Problems/Acne
• Tired Despite Sufficient Sleep
• Hair Loss
• Reliance on Stimulants (caffeine)
• Poor Immune Function
• Intolerance to Cold
  

TESTING FOR ADRENAL FATIGUE:

SELF TEST METHODS Recommended by Dr. Wilson:
(www.adrenalfatigue.org)

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)

FROM THE MEDICAL PROFESSIONALS AT Women to Women:
(www.womentowomen.com)

Testing for adrenal fatigue

Conventional medicine is truly wonderful at treating disease-state conditions. Unfortunately its focus on drugs also tends to suppress early-stage symptoms rather than treat their underlying causes. This can have the effect of delaying treatment until a disease state has developed. This is true in the case of adrenal fatigue cortisol testing. In the conventional standard of care, any cortisol level within a very broad range is considered normal, and anything outside that range indicates disease.

In our practice, we measure cortisol levels at several points in the day to track the adrenals' day–night pattern (called the "diurnal rhythm") using a panel of simple saliva tests. We hope to see cortisol elevated in the morning to help you get going, lower butsteady throughout the day to sustain energy, then fall in the evening to support restful sleep.

In the early stages of adrenal dysfunction, cortisol levels are too high during the day and continue rising in the evening. This is called "hyperadrenia." In the middle stages, cortisol may rise and fall unevenly as the body struggles to balance itself despite the disruptions of caffeine, carbs and other factors, but levels are not normal and are typically too high at night. In advanced stages, when the adrenals are exhausted from overwork, cortisol will never reach normal levels ("hypoadrenia").

Conventional medicine will detect only the extremes of these conditions, when damage to the adrenals has already occurred (Cushing's disease and Addison's disease). Withinthose extremes, you can feel miserable and still be told your cortisol levels are normal. But by responding to early-stage symptoms of adrenal fatigue, we can reverse the developing dysfunction.

Should you get an adrenal test?

In general, if you feel happy and well, have steady energy and emotions, sleep soundly seven to nine hours a night, wake up feeling rested, recover well from stress, and maintain a healthy weight without dieting, then your adrenals are probably doing well.

On the other hand, if your energy lags during the day, you feel emotionally unbalanced much of the time, you sleep poorly or less than seven hours a night, can't lose excess weight even while dieting, use caffeine or carbohydrates as "pick-me-ups" - these are all red flags indicating adrenal insufficiency.

TREATMENT OF ADRENAL FATIGUE:

"Optimal adrenal health is one of the major keys to the enjoyment of life," according to Dr. Wilson. If you have adrenal fatigue, you can fully live life again by making the necessary lifestyle and dietary changes to treat your disorder.

Dr. Wilson’s suggestions for treating adrenal fatigue:
(www.adrenalfatigue.org)

• Lying down during your work breaks (preferably at 10 a.m. and again anytime from 3 to 5 p.m.)
• 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
• Eating five to six servings of vegetables each day
• Taking calcium and magnesium supplements
• Adding sea salt to your diet
• Taking 2,000 to 5,000 milligrams of vitamin C each day
• Supplementing vitamin E with mixed tocopherols
• Taking B-complex supplements that are high in B6 and pantothenic acid
• Adding licorice root extract to your dietary supplement regimen

If you take your treatment plan seriously, you can expect your adrenal fatigue to heal in:

• 6 to 9 months for minor adrenal fatigue 12 to 18 months for moderate fatigue
• Up to 24 months for severe adrenal fatigue

Advice from Women to Women on natural adrenal support: how to restore healthy adrenal function: (www.womentowomen.com)

The first step is to have a full physical exam to rule out disease or other factors. In our experience, women with mild to moderate cases of adrenal fatigue can see significant improvement through these steps:

• Dietary changes to enrich your nutrition and reduce carbohydrates and stimulants. We also recommend the addition of high-quality nutritional supplements, including essential fatty acids from fish oil.

• Stress reduction, including moderate exercise and taking more time for yourself. It's helpful to make a list of your stressors, especially those that are constant.

• Get more rest. Your body needs time to heal.

Women with more severe symptoms, or those who have reached complete adrenal exhaustion, usually need greater intervention. At our practice we use the steps outlined above with the added natural support of phosphorylated serines, low-dose compounded DHEA, ginseng, and deglycyrrhizinated licorice. We personalize the therapy to each woman's symptoms and test results. (We urge you not to self-prescribe these substances, as they can have adverse health effects.

It's important to emphasize the role of emotional factors. Guilt, pain from past hurts, self-destructive habits, unresolved relationship problems - your past and present emotional experience may serve as an ever-present stressor. Dealing with these problems directly is much more beneficial than trying to compensate for the stress they create, in the same way that "an ounce of prevention is worth a pound of cure."

In all but the most extreme cases, we expect to see dramatic improvement within about four months. For mild to moderate adrenal fatigue the turnaround can be much faster. Remember, you may feel too tired to make changes now, but by moving forward in stages, you'll build the strength you need to stay with it. You will love how you feel when you do!

GENERAL FATIGUE ISSUES:

You may not be dealing with full-blown Adrenal Fatigue, yet struggle with general fatigue issues. The Mayo Clinic website (www.mayoclinic.com) offers some good suggestions for dealing with general fatigue and its causes:

Fatigue can have many causes — from lack of sleep to lack of exercise. But fatigue may also signal other health problems. Here are some tips on interpreting what causes fatigue and how to beat it.

Some days you're so low on energy that you're drowsy by lunchtime and in need of a nap by midafternoon. What's making you so tired all the time? Stress, poor eating habits, overwork, even medical treatments can wear you down.

Most of the time, fatigue can be traced to one or more of your habits or routines. You have the power to put the vitality back in your life.

Taking a quick inventory of the things that might be responsible for your fatigue is the first step toward relief. Fatigue can have a variety of lifestyle causes, including:

• Lack of sleep Getting even an hour less than the sound slumber you need each night can leave you drowsy and unable to manage your daily routine. You may not go to bed early enough. Or more likely, you go to bed but can't sleep well. As you get older, it becomes harder to get uninterrupted sleep. You sleep less soundly. You awaken earlier.

• Stress and anxiety If you're running from one task to the next without a break, it's eventually going to wear you down. Going through life anxious and on edge can keep you from relaxing and getting the rest you need.

• Inactivity You're too tired to exercise, so you don't. But then when you do exert yourself, you tire easily because you're out of shape. Engaging in moderate physical activity for a half-hour or longer most days of the week may decrease stress, improve mood and leave you feeling energized. Don't schedule your activity too close to bedtime, though, or you might have trouble falling asleep.

• Eating habits If you're not eating properly or drinking enough fluids, your body isn't getting the fuel and fluid it needs. Trying to remedy this with caffeine can backfire, especially if you consume it late in the day. Caffeine not only makes it harder to fall asleep, it also interferes with sound sleep and may keep you tossing and turning throughout the night.

• Certain medications Some medications, including many beta blockers and antihistamines, can cause fatigue. In addition, some cold medications and pain relievers contain caffeine and other stimulants that can keep you up at night.

To beat fatigue, try these tips:

Reduce stress

Take some of the pressure out of your day. Learn to say no. Set priorities. Then organize your activities so that you avoid confusion. Pace yourself. Put aside time each day to do something you enjoy. Take a midday stroll around the block, or get up 15 minutes earlier to give yourself more time to start your day.

Manage workplace tension

On-the-job aggravation can add to work-related fatigue. Sit down and try to resolve conflicts with co-workers. Become better acquainted with your boss and clarify what he or she needs from you. Be realistic about your limitations. Take time out to get up from your desk and stretch for a few moments several times a day.

Be active

Try to include at least 30 minutes of moderate physical activity in your day. Don't worry about doing a full workout all at once — start with 10 minutes of activity at a time. Whether you walk, garden or swim, once you get moving, you'll likely notice you have more stamina. While 30 minutes is the minimum recommendation, you may need up to an hour of moderate activity daily to maintain fitness and a healthy weight.

Eat well

Start your day with a low-fat, high-fiber breakfast that includes plenty of complex carbohydrates, such as whole grains and fruits for lasting energy. Stay away from sugary cereals and juices and caffeinated drinks. They can make you feel sluggish later in the day. Don't skip meals; refuel every three or four hours. Very low calorie diets are guaranteed to increase fatigue.

Avoid alcohol

Alcohol depresses your central nervous system and acts as a sedative, making you tired for hours after consuming no more than only a drink or two. It may also disrupt your sleep, if you drink just before bed.

Practice good sleep habits

Avoid eating, reading or watching TV in bed. Keep your bedroom cool, dark and quiet. And set your alarm for the same time each day — the routine can help you establish a regular sleep schedule. Naps are OK, but keep them short and early in the day. Schedule workouts at least six hours before bedtime. Small snacks may help you drift off, but large late-night meals can keep you up. If you can't sleep, don't toss and turn, go into another part of the house and read or relax until you feel drowsy.

When to see your doctor:

Sudden or persistent fatigue, despite adequate rest, may mean it's time for you to consult your doctor. Unrelenting exhaustion may be a sign of an underlying medical problem. In general, talk to your doctor if you're extremely tired or unable to regain your energy after several weeks of increased rest. Medical causes of fatigue can include:

Anemia

This blood disorder results from a number of problems that affect your blood's ability to transport oxygen, causing fatigue.

Cancer

Fatigue can be a symptom of cancer. A thorough checkup, including routine cancer screenings, can help rule out malignancy as a cause of your fatigue.

Depression

A loss of energy that's accompanied by any number of symptoms, including sadness, loss of appetite, difficulty sleeping or oversleeping, a lack of interest in pleasurable activities, and difficulty concentrating may be a part of depression.

Diabetes

Extreme fatigue can be a warning sign of diabetes. Signs and symptoms of diabetes, in addition to fatigue, include excessive thirst, frequent urination, blurred vision and recurring infections.

Medications

Prescription or over-the-counter medications may cause fatigue or make you too restless to sleep well. Antihistamines, cough and cold remedies, some antidepressants, and many other drugs may make you tired. Talk to your doctor if you suspect your medications are making you tired.

Restless legs syndrome (RLS)

This condition is characterized by an inability to keep your legs still and by tingling or aching sensations in your legs, feet or arms. The symptoms generally occur at night, preventing sound sleep.

Sleep apnea

Signs of this disorder include loud snoring, pauses between breaths and awakening frequently while gasping for air. It's a common source of fatigue because it interferes with sound sleep. Losing weight and quitting smoking may help, as well as an adjustment in sleeping position. Lying on your side or facedown may reduce snoring.

Thyroid problems

Hypothyroidism is a condition in which your thyroid gland fails to make or release enough thyroid hormone. Signs and symptoms include sluggishness, chronically cold hands and feet, constipation, dry skin and a hoarse voice. Hyperthyroidism is a condition in which your thyroid produces excessive amounts of hormone. Too much hormone also can cause fatigue, muscle weakness, weight loss, increased heart rate, nervousness and irritability.

A diagnosis of exclusion: Chronic fatigue syndrome

Chronic fatigue syndrome (CFS) is a complicated disorder characterized by extreme fatigue that doesn't improve with bed rest and may worsen with physical or mental activity. Of all chronic illnesses, chronic fatigue syndrome is one of the most mysterious.

Severe and debilitating fatigue, muscle aches and difficulty concentrating are the most commonly reported symptoms of chronic fatigue syndrome. In some cases, low-grade fevers and swollen lymph nodes also may develop.

A diagnosis of chronic fatigue syndrome is based on exclusion. This means that before arriving at a diagnosis, a doctor has ruled out any other disease or condition that may be causing your fatigue and related symptoms.

Web Links:

Food & Environmental Intolerances Questionnaire:
www.adrenalfatigue.org/intolerances

Chart comparing adrenal fatigue to low thyroid function: www.drrind.com/scorecardmatrix.asp

Direct Link to Women to Women medical website on adrenal fatigue: www.womentowomen.com/adrenal fatigue

General Information about Adrenal Insufficiency/Fatigue:
www.mayoclinic.com

Other articles of interest on Heal With Hope: Stress, Allergies/Sensitivities, Chronic Fatigue, EFT, Meditation, Mind/Body, Muscle Testing, Reduce Toxic Exposure, Sleep Well, Thyroid Disease, Visualization