Electrolyte Imbalance and Adrenal Fatigue Syndrome – Part 1

By: Dr. Michael Lam, MD, MPH; Dr. Justin Lam, ABAAHP, FMNM; Dorine Lam, RDN, MS, MPH



Electrolyte imbalance issues need to be taken seriously, especially when adrenal fatigue is present.The average adult human body is fifty to sixty-five percent water. Those who are overweight will have more water compared to those who are lean. While one can survive fifty days or more without food, the body can only be depleted of water for a few days before survival is at risk. Maintaining optimum fluid balance, and not having an electrolyte imbalance, is important in achieving general good health. This is especially critical in Adrenal Fatigue Syndrome (AFS), where fluid dysregulation and electrolyte imbalance are common occurrences, especially in the advanced stages.

Fluid or electrolyte imbalance presents in a continuum. Conventional medicine, unfortunately, is versed mostly when fluid or electrolyte imbalance reaches extreme opposites, with severe dehydration on one extreme and a massive fluid overload at the opposite pole. Fluid overload clinically results in pulmonary edema, peripheral edema, and congestive heart failure. They are quickly resolved with administration of medications called diuretics that increase urine output to reduce body fluid load. Deficiency in fluid, or clinical dehydration, is clinically treated with fluid replacement.

Little attention is paid when fluid or electrolyte imbalance lies between the two extremes, when symptoms can be evident but laboratory tests are normal. This is especially evident for those in the fluid depletion side of the spectrum. In this subclinical state of dehydration, signs and symptoms are mild and subtle at best. It is often missed and ignored as important contributing factors to ailing health.

For the healthy person, thirst is the first compensatory response to low fluid levels or an electrolyte imbalance. This is usually felt when the body has lost around two to three percent of its water. At the cellular level, however, damage begins to occur with as little as one percent loss of body water. Those with AFS fare worse. They can exhibit signs and symptoms of fluid and electrolyte imbalance and subclinical dehydration at a lower threshold and well before laboratory tests become positive.

Fluid Regulation and Electrolyte Imbalance

We begin our discussion on electrolyte imbalance with first understanding how the body handles fluid or water as a whole.

Body fluids are comprised of intracellular and extracellular fluid. The intracellular fluid makes up about two-thirds of body water. The extracellular fluid makes up the remainder and consists of mainly interstitial fluids between the cells, plasma and lymph, spinal fluid, and in the GI track.

Water moves from one compartment freely to another due to osmosis. Osmosis is influenced by dissolved solutes in fluids such as minerals and electrolytes. When each compartment of the body contains the appropriate concentration of water and electrolytes, the body is said to be in fluid balance. This is the way nature intended it to be. Problems begin to occur when one compartment has more fluid than others do.

The bulk of our daily body water needs come from food and drink that averages 2,300 ml per day. Another 200 ml is produced from our internal metabolic breakdown of nutrients. Together, the average total daily intake of 2,500 ml should equial the total output through the skin, lungs, kidneys and GI track for the body to be in balance.

When our body is depleted of fluid, the brain initiates a chemical chain reaction that leads to a sensation of thirst by increasing the osmotic pressure of blood passing through the hypothalamus. We respond to thirst by taking in more fluid orally. When the body has too much fluid on board, output is automatically increased, usually by way of the kidneys in those who are healthy.

Aldosterone and Adrenal fatigue are crucial in electrolyte imbalanceWater output is regulated by antidiuretic hormone (ADH) and aldosterone. Both hormones cause the kidneys to reabsorb more water from the urine for the body.

Antidiuretic Hormone

Antidiuretic hormone (ADH), also known as arginine vasopressin, is secreted from the posterior pituitary gland. After travelling to the kidneys, antidiuretic hormone binds to receptors on cells in the collecting ducts. It promotes reabsorption of water back into the circulation, reducing water output. Without ADH, water flows freely out in urine, as the collecting ducts are virtually impermeable to water. The most common disease of man and animal related to ADH is diabetes insipidus. This clinical condition arises from either dysfunction in the hypothalamus or in the kidneys. The major sign of either type of diabetes insipidus is excessive urine production, and thus accompanied by dry mouth and thirst. Fortunately, ADH dysregulation is seldom a problem encountered as the root cause of thirst and fluid imbalance in adrenal fatigue.

Aldosterone 101

On top of our kidneys, sit the walnut sized endocrine glands called the adrenal glands. These glands secrete over fifty different types of hormones, regulating our ability to deal with stress, libido, inflammation response, fight-or-flight response, and fluid balance. Each gland contains two layers. The outer layer is called the adrenal cortex. Three different types of steroid hormones are secreted here: mineralocorticoids, glucocorticoids and sex hormones. The main mineralocorticoid is called aldosterone. Mineralocorticoids are hormones that the body secretes to maintain an adequate fluid and salt balance. Salts are composed of electrolytes like sodium and potassium; these electrolytes affect the body’s fluid content. Cortisol is the body’s main anti-stress hormone. It also has a weak mineralocorticoid effect and in high, enough doses can work like aldosterone.

Basic biochemistry dictates that where sodium goes, water follows. They are like twins. Aldosterone signals the kidneys to reabsorb, or hold onto, sodium so it does not leave the body by way of urine. As sodium is retained, so is water. The more aldosterone is released by the adrenal glands, the more water is retained in the body. Because the cardiovascular system is a closed system, more water in the body will lead to a higher blood volume. This added volume increases the pressure within your blood vessels, and translates into higher blood pressure if all else is equal.

The release of the proper amount of aldosterone and cortisol by the adrenal glands is a continuous and automatic process. As the body senses blood pressure being low, more aldosterone will be released. The normal body therefore has an automatic process of internal fluid balance without us knowing.

The problem comes when this regulation is dysfunctional or imbalanced, as in the case with Adrenal Fatigue Syndrome.

Frequent Urination and Adrenal Fatigue Syndrome

Many AFS sufferers have increased and frequent urination, no matter their amount of hydration. Here are three reasons why:

  • In the early stages of Adrenal Fatigue Syndrome, aldosterone levels first rise as the body tries to conserve water. As AFS progresses to advanced stages, aldosterone level tends to fall, resulting in low body fluid level. Next, low blood volume results and blood pressure falls. With reduced aldosterone, sodium retention is reduced, and fluid loss increases, leading to increased urine flow.

Frequent urination and electrolyte imbalance

  • Severe short term stress increases adrenaline release as the body begins the “fight-or-flight” alarm response, which in turn increases the rate of urine flow.
  • Chronic stress increases HPA (Hypothalamic-pituitary-adrenal) axis stimulation to the adrenal glands, resulting in increased cortisol output from the adrenal cortex. Cortisol causes reduction in Anti-Diuretic Hormone (ADH), which increases urine flow as the production of urine is not held back by ADH in the body. To put it simply, high cortisol leads to low ADH.

It comes as no surprise that most sufferers of AFS are in a chronic stage of fluid depletion, either clinically or sub-clinically, with increased urination.

Adrenal Fatigue and Aldosterone

The adrenal glands are the key stress control center of the body. Stress can be physical, such as over-exercise, or emotional. Under chronic stress, its function may be overly burdened beyond what it is capable of handling, resulting in AFS. When adrenal gland function is compromised, the body experiences fatigue and other symptoms.

There are four progressive stages of AFS. Stages 1 and 2 are considered mild. Typical symptoms include lack of energy, insomnia, anxiety, salt craving, afternoon slump, and waking up unrefreshed. Coffee and sugary snacks are common socially acceptable ways to boost adrenal function and to temporarily increase energy. The adrenal glands are working extra hard to help the body handle stress. This can go on for a long time. The adrenal function will gradually decline as it becomes overworked and exhausted if the stressors are not removed or worsen. This is when AFS enters stages three and four. More severe symptoms include reactive hypoglycemia, low blood pressure, postural hypotension, dizziness, faster than normal resting heart rate, tachycardia on slight exercise, irregular menses, low libido, PMS, low thyroid function, heart palpitations, depression and adrenaline rushes. In severe cases, one could be house bound and bedridden, unable to perform the basic tasks of normal daily living without assistance.

Out of the myriad signs and symptoms, two specifically reflect the dysregulation of aldosterone as AFS progresses—salt craving and low blood pressure.

When under stress, the adrenals are put in overdrive to secrete more compensatory hormones, such as cortisol and aldosterone. Typically, both rise in early AFS stages. Because of increased aldosterone, blood volume increases and thus blood pressure rises for those who are low. It is common to hear of people under stress having a higher blood pressure than normal. This, is part, is due to higher aldosterone. If stress is unrelenting and becomes chronic, adrenal burnout and fatigue progresses to its more advanced stages. Aldosterone output, along with cortisol, after reaching its maximum output in early stages, start to fall as the adrenal glands become exhausted. The more advanced the stage of AFS, the lower the aldosterone output. As aldosterone output falls, the body’s ability to retain fluid is compromised. Salt craving becomes more severe and is a warning sign of underlying problems. A girl who is stressed and may be suffering Adrenal fatigue and electrolyte imbalanceMany under stress automatically reach for salty foods such as potato chips for this reason. They also tend to salt their food more. This represents the automatic response to low internal aldosterone level in an AFS setting.If unresolved, the aldosterone level will continue to drop, contributing to a chronic state of low blood pressure. One can feel dizzy, lightheaded, and reduce urine output. Efforts to increase blood pressure fail with increased water intake.

Multiple visits to conventional medical doctors are usually made. Under these circumstances, unless a physician is alert and on the lookout for underlying adrenal dysfunction, the focus of investigation is usually placed on the cardiovascular system and kidneys. A thorough work up is usually conducted and unremarkable.

The key lies in the history. Classically, those under chronic stress report increased salt cravings and low blood pressure that remains chronically low despite taking in more salt in their diet. They often do well with drinking a glass of water with salt in the morning and in the afternoon. Taking food and snacks high in salt and fat also helps. Unfortunately; few are asked these key questions to rule out adrenal fatigue as the possible root cause. As long as laboratory tests are unremarkable, another classic sign, patients are discharged and told all is normal. Even for those astute physicians that do blood tests to rule out aldosterone deficiency, sub clinical low aldosterone is seldom recognized because tests invariably come back normal or borderline low. Few recognize that this is also a classical sign of adrenal fatigue where low aldosterone level is not expected. Instead of focusing on the history for more clues, patients are abandoned. There is seldom if any recognition that the symptoms are the consequence of subclinical fluid depletion caused by aldosterone dysregulation when AFS is present.

Read Part 2 Now!

© Copyright 2015 Michael Lam, M.D. All Rights Reserved.


Dr. Lam’s Key Question

Potassium and sodium are opposing forces. They balance each other. If you have an imbalance in potassium, you need to see your doctor and find out why because that is not normal. In AFS, both potassium and sodium level in serum is normal unless in advances stages.

Electrolyte imbalance issues need to be taken seriously, especially when adrenal fatigue is present.

DrLam.com
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I really enjoy reading the articles on the website to further my understanding of this difficult diagnosis. Always written in language anyone can understand. Dr Lams writing style is gentle and supportive whilst remaining informative and genuine. It is really a difficult problem to live with and the do it yourself management information is life changing, putting me back in control. Thanks Dr Lam.




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71 Comments

  • Mary says:

    How would you know the difference between needing an IV and just adding salt to your water?

  • elaine says:

    I have hashimotos and adrenal fatigue + gluten intolerance and a lot of digestive issues.
    According to a saliva test i have high cortisol as from 12 midday onward and low morning cortisol.
    I have high aldosterone blood levels.

    My symptoms are:
    Anxiety, fear (new symptom)
    weight loss (new symptom)
    fatigue
    cold intolerance
    heat intolerance (new symptom)
    slightly low blood sodium and potassium levels every now and again (new symptom)
    low blood pressure
    no strength in upper body
    white tongue after eating sugar or carbs
    bleeding gums sometimes (new symtpom)
    stress intolerance
    exercise intolerance
    no muscle tone
    easy bruising
    Low vit D
    Low Iodine
    lengthy recovery from illness

    I am gluten free, low sugar, low dairy, I take Vit D3 K2 and Vit C…i take T3 onyl medication.

    Any Idea what could be going on? how can i have high cortisol and high aldosterone but low blood pressure and low sodium?? i am so confused.

    Any idea what is causing my anxiety? i really cant take it much more ( i lost my father almost 2 years ago now and i am still trying to cope)

    • Dr.Lam says:

      Your labs do make sense because you have overlapping data from a transition in AFS staging. It is not unusual. The body is complex and straightforward interpretation is not accurate unless clinical correlation is there. Anxiety is a natural part of that picture. Click Neurotransmitters & Adrenal Fatigue Syndrome for more information.

      Dr.Lam

  • James says:

    are bananas okay to replenish potassium when you have adrenal fatigue?

  • Polly says:

    Thanks for your input. This article has given me insight to the salt cravings I’ve been having.

  • Kathy says:

    What is the best way to catch dehydration?

  • Shanni says:

    What are the implications if aldosterone levels are too high?

  • George says:

    Didn’t realize how much of a role electrolytes can play in dealing with adrenal fatigue..thank you for the insight!

  • Nicky says:

    Hi,

    I have suffered fatigue on and off for years, after particularly stressful times. Now experiencing a dramatic increase in urination, any water I drink is excreted (therefore I don’t drink enough), and even if I don’t drink water I’m still up every hour or two at night. I find I move between water retention if I’m on my feet for a few hours, or it’s particularly warm, and then constant urination. Perhaps aldosterone is the key? I’ve pretty well removed the external stresses, so you suggest drinking lots of water?

    Thanks,

    Nicky

    • Dr.Lam says:

      Most people in AFS are fluid depleted. Proper hydration is important, but cannot be overdone to avoid electrolyte imbalances.

      Dr Lam

  • Charles says:

    I tried salt water in the morning because of this article. I feel a difference already after 4 days of doing it. Thanks for all the helpful info Dr. Lam!

  • Collette Rickard says:

    I had to have 1 adrenal removed with 5.4 cm tumor intact. Isotope test showed it had not spread into nodes. I was high in cortisol and potassium prior to op. I have a tumor on other adrenal but not growing. I do not take medication. I suffer constipation and I also urinate excessively at night every 2 hours approx, total volume 2-3 litres. I try not to drink water during night and sip about 50mls each time I wake. My mouth is really dry and I end up with a headache by early morning if I don’t. I assumed I was dehydrated from urinating so much. But I do drink about 1-2 litres of water daily plus about 3-5 coffees whilst awake throughout day. I do not drink alcohol at all. About twice weekly I feel the need to have a coffee with sugar in the early hours. I carry out physical work and I struggle some days with feeling very lethargic. I have no problem falling asleep at any time and I sleep heavily but wake constantly to urinate at night but rarely throughout the day.I have to have salt and do this with breakfast. I have toast with tomato and melted cheese with sea salt and pepper and salt all foods. I recently saw my doctor due to being severely lethargic. I felt exhausted and just wanted to sleep. Even walking to bathroom was an effort and I felt like I was going to collapse. All blood works and urine tested. Iron levels checked also as I am allergic to fish and carry an Epipen. All normal. I asked about AFS and was told “not likely” and that urination at night could well be in my mind. I was quite upset. I am to use a pessary of estrogen at night to see if this will improve things. I had a vaginal repair of nip and tuck about 6 months ago hoping to improve nightly urination. It has not helped. I am 60 yrs old, 5’8″ tall, and weigh 90kg. I struggle to lose weight even though I am quite active. I have slight asthma and use Ventolin perhaps once a week if needed and apparently I have COAD. I am a smoker which I have attempted to cease many times. I recently started to have hydralyte when feeling really lethargic and felt an improvement almost immediately. I also do not like meat or any seafood and avoid as much as possible. I do eat meat about once a fortnight though in a stew, goulash etc. I am due for CT scan in January at the hospital where originally operated on for adrenal removal, but cannot have the contrast due to iodine content. Question is: Am I doing the right things to improve daily living.

    • Dr.Lam says:

      You need to continue your work up with conventional docs. When all has been exhausted, you should look into AFS. You can start with AFS diet which give you some guidance on what to do.

      Dr Lam

  • Nancy says:

    Thanks for the info! I didn’t realize aldosterone was such an important hormone in balancing fluids.

  • Maruel says:

    I’m not sure if my dizziness is a blood sugar problem or dehydration issues. What would be the best way to tell?

    • Dr.Lam says:

      You can check your blood sugar at the time where you are dizzy and see whether it is off or not. Dehydration comes in degrees and you can simply test at home by drinking more water and see if the dizzyiness improves, if it is ok with your doctor.

      Dr Lam

  • Nate says:

    How do muscle cramps/ tightening relate to dehydration? Often, I wake up in the middle of the night with my leg muscles tightened so hard, all I could feel is pain. Is this a symptom of dehydration or am I barking up the wrong tree?

    • Dr.Lam says:

      Electrolytes such as potassium and sodium can be thrown off balance when body fluid volume is low as in dehyrdation and that can lead to muscle cramps.

      Dr Lam

  • Norman K. says:

    Do you know how Pedialyte and Gatorade compare to each other to replenish your electrolytes ? Just curious. Thank.

  • Stephanie says:

    A Blood test has shown I have low potassium and normal sodium and other electrolytes level. This seems to be opposite to what you would expected with adrenal fatigue. Could something else be going on?

    • Dr.Lam says:

      The sodium and potassium are both normal by lab in AFS, but the clinical signs are predominate low sodium. you need to talk to your doctor and probably have the test repeated as a first step.

      Dr Lam

      • Stephanie says:

        A retest has shown low potassium again and I have symptoms of low potassium (thought they were due to low sodium). Have been taking one Adrenotone for 18 months and I think it is too stimulatory but when I try to reduce it I crash. Advice of where to turn next much appreciated.

  • Frank says:

    Can regular table salt imbalance my sodium levels? Would taking a daily potassium help?

    • Dr.Lam says:

      In AFS, more salt often is helpful provided that you dont have other issues like heart problem. Potassium is usually not helpful but can make things worse unless there is a special need.

      DR Lam

  • Alice says:

    Could you explain more about how low blood pressure is a sign of electrolyte problems?

    • Dr.Lam says:

      Low blood pressure and electrolyte imbalance are two separate issues. they are however associated as both are found in advance AFS.

      Dr Lam

  • Bruce says:

    Okay, I get all that, but what if you have low Cortisol AND Low ADH? I am going in Monday for an ACTH test because of low (3.5) Cortisol levels after 30+ years with low Vasopressin.

    • Dr.Lam says:

      you are getting into territory that requires much more history to fully understand the picture. YOur endocrinologist should would be best person to guide you.

      Dr Lam.

  • Brandon says:

    Hi Dr. Lam, can electrolyte issues cause seizures? I recently had my first one and my potassium levels were very low.

    • Dr.Lam says:

      It can , when the levels are extremely imbalanced. You need to also make sure if other factors are involved.

      Dr Lam

  • Steve says:

    If I had a doctor that knew which end was up I probably wouldn’t be posting in an internet blog. If my doctor is the best person to help – this isn’t gong to go well for me…

  • Steve says:

    With my doctor it’s always a good idea to have printed information ready to show her. May I ask what medications will increase aldosterone?

    Aldosterone may be self regulating however mine has been steadily going down for several years. Are there diet changes like low sodium or increased potassium that will help Aldosterone climb into a normal range? I was under the impression that aldosterone declines as we age.

    • Dr.Lam says:

      Certain types of steriods can be use to attain salt retention effect. The focus is on the whole issue of fluid balance and not only on aldosterone level alone. If they do not bring it up, there is a reason. I urge you to talk to your doctor .

      Dr Lam

  • Steve says:

    I have had several 24 hour urine Aldosterone tests and 1 serum. All of them were very low with the last urine test being at the very bottom of the reference range. This was to explore bio-identical Aldosterone to restore really bad hearing. After 2 plus months on compounded Aldosterone I can honestly say I don’t see any results. I also have extreme fatigue, especially as the afternoon and evening comes on. There has been no change in those symptoms either.

    I also tend to retain a lot of fluids. However I may expel that fluid at night which is sleep disruptive. Consuming a large amount of sodium right before sleep can prevent multiple bathroom wakings but doesn’t seem healthy.

    Since the Aldosterone is compounded I don’t really know what I’m getting, plus I understand that only one pharmacy in the US compounds Aldosterone which seems odd. If it really restores hearing (under certain circumstances) you would think every pharmacy would have it.

    There’s a lot more to the story but my question is simple – is there a way to raise Aldosterone naturally? And have you ever had anyone raise their Aldosterone naturally and thus restore some or all of their hearing???

    • Dr.Lam says:

      Aldosterone is a self regulating hormone. If your doctor’s approach is not working , you need to go back and seek advise. there are medications that can be considered, but only your doctor will be able to make the decision as these are prescription items.

      Dr Lam.

  • Melinda says:

    I am also taking an adrenal supplement and no less than 2 tsp pink himalayan salt everday including salting my food a couple of times a day. I am a personal trainer so I eat every 2 hours with protein and veggies and some fruit and a little of low glycemic gluten free carbs. Trying not to drink too much fluid but that is not easy.

  • Melinda says:

    I am 49 and had aortic valve replacement in January. I was on adrenal supplements and bioidentical hormones for years. I started retaining fluid right after surgery and became worse despite diuretics including spirolactolone which decreases aldosterone. All cardiac and pulmonary functions are good. Kidney tests have been ok except for some dehydration. I had a NP run the test and it showed very low on the range but he wouldn’t address it. I am retaining up to 10 pounds of fluid usually gaining 3 to 5 during the day and most of the fluid from the thighs, waist, back and chest. Dry mouth and thirsty and feeling lethargic, hydrostatic issues with swelling below the knees and feet and low blood pressure. I have heat sensitivity so when I sweat I also swell with even more fluid. I went to see a functional medicine doctor. He adjusted the thyroid, dhea, testosterone and cortisol and put me on aldosterone. I feel better from a hormone standpoint, blood pressure has increased, hydrostatic issues have decreased and the fluid is easier to pull off with diuretics but still increases during the day. Is this fluid going to decrease or is there another issue that has not been addressed. Would you help direct me.
    Thank you

    • Dr.Lam says:

      Your doctor is doing everything conventionally and is holding you steady. that is the good news. As far as the root issues is concern, I am not sure there is a handle on it , and that is where you should focus on now, because if you dont, I am worried that precious time could be wasted and medications may not work too long in some cases. It all comes down to a detailed history. Find someone who is good AFS literate and put all the pieces of the puzzle together for you. The answer is generally there, if you look deep enough.

      Dr Lam.

  • Bob says:

    I’ve heard of people having serious issues if they drink too much water? What’s that called and how big of a risk is it really?

    • Dr.Lam says:

      Too much of anything , including water, is not good. That usually means well over 100 oz a day. In a setting of AFS, what is important to note is that electrolyte balance is fragile. Excessive water can further worsen the imbalance. In severe cases, hospitalization is required .

      Dr Lam

  • Sandra says:

    I have low blood pressure but I get sick when I have any salt. Why is this?

    • Dr.Lam says:

      You need to see your doctor and ask for further workup. Some normal and healthy people have this issue, and some in AFS also have similar issues as well although it may not make sense logically in our understanding. When this happen in the AFS setting it usually point to further underlying issues that need to be explored by detailed history.

      Dr Lam.

  • Gloria Simonot says:

    I forgot to mention that my saliva cortisol tests showed a level of about 30% from the bottom of the range for the morning reading which quickly fell to very close to the bottom of the range for the REST of the day and evening.

  • Gloria Simonot says:

    I had a severe hemorrhage during the birth of my 4th child (previously had severe strep infection in the salivary gland under my chin–antibiotics and lanced AND also had mono during my 3rd pregnancy). My understanding is that this can cause pituitary damage, so many hormones are dysregulated.
    Off and on I have had frequent urination, lack of flight or fight response and of course, fatigue. I am also hypothyroid and on medications. Now I am having trouble with dehydration and very frequent urination (I drink 2 +litres of water per day) and I have never had low blood pressure, but it has been going up and seems to “spike” when I am moving around or reading adventure type stories. None of the BP meds that I tried have seemed to have any kind of significant effect on my BP (If I sit really still and do something like knitting my BP is between 135 to 145 over 80). My heart rate was getting higher so my Doctor ordered Atenolol to lower the heartrate (but I don’t like the side effects). I have been trying to “balance” the electrolytes (potassium/ sodium) for awhile but still have the dehydration symptoms even when the lab results are in range I work with a friend on energy work and we found that my DNA for most things was nowhere near optimal and even with working on that, I am not better with regard to the dehydration. The energy is more than my usual 10% or so of others., but any extra exertion lowers my energy levels.
    None of the doctors so far have any help for the dehydration (and dry mouth is damaging my teeth). Because of the poor pituitary response, I have been on hormone replacement for 5 or 6 years (I am a 70 woman) — Dhea, testosterone, progesterone, Biest, synthroid (125 mcg), different doses of compounded T3 and some adrenal supplements.

    • Dr.Lam says:

      Balancing electrolyte for cases like yours needs to look outside the box when conventional appraoch is not helping and no forseeable results. The problem of concern is that the more you do hormonal compounds that have stimulatory properties to patch your symptoms, the more sensitive the body becomes and the lower the threshold the point for activation. Yet you cannot stop,or you may have side effects. Its not the dehydration but the underlying imbalance that is drying electrolyte imbalances. I think if you focus on allowing the body to self heal, the feedback loops may return to normal and you may find reward. I cannot be too specific because everyone is different and I am always mindful that people take my educational pointers and try to self navigate and make themselves worse so you need to be very careful and get the right person to help you, and continue your search for someone who understands is the key.

      Dr Lam

      Dr Lam

      • Gloria Simonot says:

        I do not understand what is meant by “allowing the body to self heal”. Ever since I was 12 years old (I am 70 now) and had a severe strep infection in the salivary gland under my chin, I have NOT had ANY “fight or flight” response unless using significant amounts of adrenal supplement.
        I have not been able to tolerate any caffienated beverages for many years!

        • Dr.Lam says:

          By that I mean give the body the basic tools for it to heal itself as the body does have built in mechanisms to do that provided that your situation is not too advance. If you have been struggling for years then the situation can be very different.

  • Blair Watton says:

    I have been on hydrocortisone on and off for years, most recently had a relationship break up and feel back to square one.At one time years ago I was stage three adrenal fatigue.I have never felt the same. But know I require lots of sleep and do have to urinate nightly 5x.Do you know anyone on CT who can help as I am tired of this horrible anxious feeling inside, rapid heartbeats at night…thank you for any help.

  • Renold says:

    Can you please explain to me why dehydration can lead to headaches?

  • Kathy Turba says:

    I have had profound and difficult reactions to Dr. Lam’s oil Matrifix A. The oil acted like a drug in my system, and when my body “wanted more,” if I didn’t comply, I went through what felt like withdrawal. I would love some advice on using this oil.

    • Dr.Lam says:

      The use of essential oil has to be supervised if you are in advance stages of ECM congestion. Its not the oil but the inability of the metabolite to be removed from the body often cause by congestion. People who react like this will also have problems with other modality , not only oil. = Click Extracellular Matrix (ECM) & Adrenal Fatigue Syndrome for more information. Fortunately usually passes on its own over time if you stop right away.

      Dr Lam

  • lilly says:

    So diabetes insipidius can actually be caused by adrenal fatigue? My vasopressin levels were low when I got tested. I have all the symptoms of adrenal fatigue…I have intense salt cravings, especially in the morning..I feel tired all the time, depressed,and I’m always thirsty.

    • Dr.Lam says:

      Fluid imbalance, polyuria , and dehydration is common in AFS. Diabetes insipidius is a specific medical condition that is different though symptoms of polyuria may be alike.

      Dr Lam

  • Kelli says:

    If one has Lyme/Co-infections that are chronic and difficult to treat, how can this balance ever be achieved? To my knowledge, Lyme messes with everything. My hormones are off, ability to deal with stress. I have new weird symptoms popping up all the time. Every area of my body is suffering. Is what you do effective for such a diagnosis without lifetime treatments or even treatable to begin with in dealing with tick borne diseases?

    • Dr.Lam says:

      The recovery plan for each is very different and has to factor in many areas of concern, including what you mentioned plus many more. It is impossible to be precise. Suffice to say that the body has self healing potential that can be harnessed to support internal immune response. When the infection becomes chronic, the approach should be one of existence rather than eradication.

      Dr Lam

  • Deana adams says:

    This is me to the T, but I haven’t any extra money and I can’t get help conventional drs. What do I do?

    • Dr.Lam says:

      Conventional doctors usually is not knowledgable of this . You have to educated them. We do have a telephone coaching program to help those as a last resort.

      Dr Lam.

  • Jonathan says:

    Your article was very informative, thank you.

    I had an endoscopic thoracic sympathectomy operation 15 years ago for hand sweating, and soon after the side effects were numerous: lower body compensatory sweating worse than the original hand sweating, fatigue, frequent urination, venous pooling, cold extremities, orthostatic intolerance issues. If I increase my salt take I urinate less but feel more stressed, chest tension with higher blood pressure.

    I suspect that since the operation my sympathetic nervous system is dysfunctional. It feels like my body entered a negative feedback loop and I’m in a permanent fight or flight state. I am wondering if my problems exist from sweating too much, or the message from my brain not getting through the nerves correctly since the sympathectomy.

    Any advice would be most appreciated.

    • Dr.Lam says:

      The flight or fight system is a perpetual positive feedback loop, not a negative feedback loop . When you enter this loop, things will continue to get worse and becomes more unstable over time. This is the natural progression by design. To correct this, you need to reset the system and allow the balance to return. Medications are usually only symptoms driven and does not deal with the root cause. A personalized comprehensive program but we find good success if done right.

      Dr Lam

  • Richard says:

    Thank you for your reply. I’ll definitely read your book and then consider a consultation. Thanks.

  • Richard says:

    Great site! Thank you. Looking forward to getting your book. I’m 53 and have CFS and thus I assume from your site I have a later stage of AF. Although my CFS is somewhat better, recently I have noticed frequent urination (5x) especially at night- which makes sleep worse . (No diabetes, prostate issues, or infection.) I drink more, although I am not particularly thirsty, but it goes right through me, but still have dry mouth and slightly yellow urine. (Its difficult to drink 1.5 l+/day). I also have hypertension (take lisinopril), which oddly seems to have increased since the nocturia. Thus I am reluctant to take in more salt. Not sure how to proceed. Any suggestions would be greatly appreciated. My GP doesn’t seem to understand CFS/AF very well. Thanks!

    • Dr.Lam says:

      Advance stages of AFS typically is not accompanied by high blood pressure and frequent urination. You may have early stages combined with overactive sympathetic nervous system. My book will go thru with you. If after you read things dont quite fall together in a coherent whole, then something is missing and you can call me and I will take a more detailed history and give you my views. No charge.

      Dr Lam

  • Melinda says:

    What are ways to better regulate lymph fluid in the body?

    • Dr.Lam says:

      Drink lots of water and keep the body well hydrated. Reduce toxin into the liver, and some gentle lymphatic massage can be helpful.

      Dr Lam.