I read an excerpt from your web page on Adrenal Insufficiency.

Q: I read an excerpt from your web page on Adrenal Insufficiency. I am a senior year biochem student and I would like to do research in the area of Endocrinology. I wanted to know your thoughts on how to best restore proper adrenal function – especially when excess androgens are produced due to alternate pathway. Do you think that it is best to utilize Pregnenolone solely or would you use this in conjunction with Progesterone and natural hydrocortisone? DHEA would be less preferable since symptoms of hyperandrogenism are often present (hirsutism, scalp hair loss, acne, etc…). I have noticed in women that this is often the symptom presentation associated with adrenal insufficiency. I appreciate any thoughts that you might have.

A: The best way to restore proper adrenal function is to give it the raw materials for it to decide on its own how much to assimilate into the various hormones (each of which have a negative feedback system). What are these items? They include glandulars, lysine, proline, vitamin C, vitamin B5, all in quite a high dose. If you expect to get well with nutrients, you have to understand that nutrients are nontoxic and not very strong, so more is needed for health challenges. External introduction of DHEA, Pregnenolone, Progesterone, and Natural Cortisol will help short term, and can be used effectively to adjunct the adrenal recovery program (which normally will take 6-12 months). It takes a long time to deplete the adrenal glands, and it will take some time to recoup, so to say. Women do react differently to hormones when compared to men, esp. DHEA as you have noticed. Adrenal recovery therefore requires 3 major factors to be done concurrently:

  • a. basic nutrients as mentioned above properly dosed
  • b. relief of stressor(s)
  • c. time ( together with diet and lifestyle changes)

Most people focus on one of these, and don’t give it enough time. As a result, most people fail. I work with many who are “end stage” adrenal fatigue and repeatedly I have found that if they follow my protocol closely with give it about 3-6 months, they become happy campers. The problem is that they don’t have a lot of patience, and during the recovery process, one is likely (though not all the time) get worse before they get better.

Just buying supplements and loading up will not help, for each person has to be titrated? One person’s nutrient is another’s poison. The dosage depends on each person’s specific metabolic type and unique characteristics of the body’s stress response. As a whole, the body’s reaction to stress is described by the activation the neuroendometabolic (NEM) response. The NEM stress response system is made up of interconnected functional systems distributed throughout the body and across organs. The symptoms you or anyone experiences with adrenal fatigue is directly connected to the way the NEM system reacts to stress.

Since there are so many different functioning components to the NEM response, there can be a variety of different ways these constituent systems contribute to the symptoms of Adrenal Fatigue. The particulars of the way your NEM responds to stress vs. how anyone else’s responds is most important distinction in explaining why the experience of Adrenal Fatigue can be so different between sufferers. The specific NEM components activated in your body and their level of activation in reaction to stress produce the unique set of symptoms you experience in AFS.

What this means from a recovery perspective is that even though there are general similarities across most AFS sufferers, the physiological factors underlying the symptoms and thus their recovery needs can be very different. The level of each NEM component’s activation forms a unique constellation of nutritional and recovery requirements that are needed to best deal with stress and stabilize the body. There isn’t a single best way to use hormones, supplements and nutrition.

The solution is not as simple as most people think, otherwise, there is no need for people like us to study all our lives and gain the thorough insight into this most troublesome syndrome.

Furthermore, you should note that adrenal fatigue in women is seldom standing alone. In 90% of the cases there is accompanying clinical or subclinical thyroid and estrogen imbalance. Keep an eye out as you are doing your research. I call this the OAT Syndrome (ovarian/adrenal/thyroid imbalance).