Adrenal Fatigue FAQ

By: Michael Lam, MD, MPH


What is Adrenal Fatigue?

Adrenal Fatigue Frequently Asked Questions Adrenal Fatigue has a broad spectrum of non-specific yet often debilitating symptoms. The onset of this condition is often slow and insidious. 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 lose weight after extensive efforts, you may be suffering from Adrenal Fatigue 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.

What causes Adrenal Fatigue?

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 sugar in diet
  • Excessive caffeine intake from coffee and tea

Who gets Adrenal Fatigue?

Anyone can suffer from Adrenal Fatigue at some point. It is often triggered by an acute illness or stressful situation, like a life crisis, surgery, or stressful demand of a job, relationship problems. It can afflict those as young as early 20s. Most commonly it affects those 30 and above. Women are more prone to get Adrenal Fatigue than men. This condition is made worse by unhealthy lifestyle, such as poor diet, substance abuse, inadequate sleep, chronic illness, just to name a few.

How common is Adrenal Fatigue?

It is estimated that 80% of adults in developed and modern countries suffer from Adrenal Fatigue at some point in their life. This is often temporary, lasting a few days or weeks. A small number fail to recover and this condition lingers on unresolved, leading to a chronic and debilitated state.

How can you know if you have Adrenal Fatigue?

You may be suffering from Adrenal Fatigue if you regularly experience one or more of the following symptoms:

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 between 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 in getting up in the morning
  • Lightheaded

To find out more about each symptom, take Dr. Lam's 3 minute Adrenal Fatigue test here to determine if you have Adrenal Fatigue.

What are the health conditions related to Adrenal Fatigue?

Conditions commonly associated with Adrenal Fatigue include hypothyroidism, estrogen dominance, PMS, endometriosis, chronic fatigue syndrome, chronic pain syndrome, fibromyalgia, irritable bowel syndrome, auto-immune diseases, diabetes, and metabolic syndrome

Can people with Adrenal Fatigue recover fully?

Yes, with proper treatment most people can fully recover from Adrenal Fatigue. The younger you are, the better the potential. The more mild the form, the better the chances. Most body will experience significant and fast recovery if cared for by experience health care practitioner.

Is laboratory testing required for Adrenal Fatigue?

The best way to test your adrenal health is to measure your level of free key adrenal hormones such as cortisol and DHEA. Saliva testing is preferred as it measures the amount of free and circulating hormones instead of the binded hormone commonly measured in blood test. Due to tremendous individual variance and the body's constant changing state, laboratory tests should be undertaken judiciously under the right setting and only when needed in order to be cost-effective and relevant. It is not uncommon to have Adrenal Fatigue symptoms with "normal" laboratory results, and vice versa. Furthermore, in advance Adrenal Fatigue, the 24 hour cortisol curve invariably becomes flattened most of the time and can stay that way for an extended period of time, even during recovery. Therefore, one can be easily confused as test results can be misleading.

Laboratory tests are best used as supporting tools under the guidance of the right health professional and should not be relied on as a sole gauge of adrenal function and therapeutic options. Consumers often make the mistake of embarking on a self-guided nutritional recovery program that relies on laboratory test without understanding their limitations. Over time, this approach often leads to improper use of nutrients which makes the condition worse.

Is nutritional supplementation needed for Adrenal Fatigue?

Nutritional supplementation can play an important role in adrenal recovery. Useful nutrients include Vitamin C, vitamin B5, pantethine, magnesium, pregnenolone, DHEA, adrenal cortex, various herbs, and cortisol. The dosage varies greatly from person to person.

It is very important to understand that a short-gun approach by taking many nutrients at the same time seldom works and may even backfire. The use of nutritional supplementation in overcoming Adrenal Fatigue needs to be individualized, base on each person's history, background, and body metabolic system. One person's nutrient may be another person's toxin. Each nutrient is like one bullet in the arsenal. Using the right bullet at the right time is critical because there are not many bullets available. Many simply take the whole battery of nutrients without this consideration and that approach seldom works long term in the case of Adrenal Fatigue. Even if some nutrients appear to work well at first, it may subsequently fail as the body developed tolerance. More is not necessarily better and may make things worse in many cases because during the recovery process, the metabolism changes, and it is important to match the dosage to the metabolic throughout the entire journey for maximum effectiveness.

In Adrenal Fatigue, the body's ability to process and assimilate nutrient is often compromised. Testing doses are often used initially to see the amount of reserve the adrenal has before application of any high dose nutrient. Nutrients in the right dose should be administrated in a graded and step-wise approach, with follow up by the health care professional.

What is the best way to overcome Adrenal Fatigue?

The number one cause of Adrenal Fatigue is chronic stress. Removal of stressor is therefore the best way to overcome Adrenal Fatigue. There are numerous lifestyle changes and dietary tips that can be helpful. For most mild cases, this is often sufficient. If this is not sufficient, then nutritional supplementation should be considered. In advance cases, an experienced health professional is often need.

What are special considerations of women afflicted with Adrenal Fatigue?

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. 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.

What are some of the less commonly reported or unusual symptoms of Adrenal Fatigue?

In Adrenal Fatigue, the body can often exhibit multiple paradoxical reactions that one does not normally expect. These are more frequent when the condition is advanced. These include:

  1. A sense of fatigue or malaise instead of a sense of calm when taking steroids
  2. A sudden onset of anxiety attacks and impending doom at rest
  3. Sudden onset of heart palpitations despite normal cardiac function
  4. Sudden onset of dizziness and light-headedness at rest
  5. Sudden onset of fluctuating blood pressure
  6. Being constipated instead of having loose bowel when taking high doses of vitamin C or magnesium
  7. A sense of getting wired up and anxious after taking Vitamin C, adrenal glandular, or herbs
  8. A sense of well-being after taking selected nutrients, only to be followed by a "crash"

One can have any combination of the above. The exact reason of each of these symptoms is not fully known. Collectively, they point to an adrenal that has lost its ability to maintain the fine control necessary of a stable internal homeostasis environment. Self-directed recovery programs normally fail in such cases because normal healing tools do not apply. It is best to consult a professional for help if you have a significant number of these paradoxical reactions.

 

© 2005  Michael Lam, M.D. All Rights Reserved.



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