Adrenal fatigue implies that your adrenal glands are exhausted, causing you to feel extremely tired all the time. You wake up tired and stay tired during the rest of the day. Some people get energetic at night and have difficulty going to sleep. Some of the other associated symptoms are: anxiety, depression, chronic pain, muscle aches (fibromyalgia), allergies, abdominal pain, nausea, weight loss and low blood pressure.
Common medical conditions associated with Adrenal fatigue are: Autimmune thyroiditis ( Hashimoto's thyroiditis), irritable bowel syndrome, vitamin B12 deficiency, lupus, Fibromyalgia, asthma, eczema, vitamin D deficiency and low testosterone in young-to-middle aged men.
The Mechanism of Adrenal fatigue:
The mechanism of adrenal fatigue is low cortisol level (hypocortisolism.) Cortisol is a hormone produced by the adrenal glands. It plays a crucial role in maintaining our health. Cortisol affects every organ in the body. So when you are low in cortsiol, you develop a variety of symptoms, as mentioned above. In addition, low cortisol contributes to water retention, inflammation, coronary artery disease, cancer and osteoporisis.
The Root Cause of Adrenal fatigue:
The main reason for adrenal fatigue is the stress of daily living. In the normal stressfree humans, cortisol is at its highest level in the early morning hours. Then, it gradually declines throughout the day and is at its lowest level at about midnight. The high level of cortisol in the morning hours gives us a lot of energy to carry out our daily activities. The low level of cortisol in the evening helps us to relax and eventually go to sleep. This is called the diurnal rhythm, and is the basis of our biologic clock.
Cortsiol production is regulated by the brain in the following manner: Hypothalamus in the brain produces a hormone called CRH (Corticotropin Releasing Hormone), which stimulates the production of another hormone, by the pituitary gland, called ACTH ( AdrenoCorticoTropic Hormone). ACTH travels to the adrenal glands located on top of the kidneys, and causes the production of cortisol as well as DHEA-S ( DeHydroEpiAndrosterone sulfate.) This is called the HPA axis ( Hypothalamic Pituitary Adrenal axis.)
In response to an acute stressful situation, your brain orders the adrenal glands to produce a large amount of cortisol as well as adrenaline, and noradrenaline, which causes an increase in your heart rate, blood pressure, glucose level, breathing rate and dilatation of your eye' pupil. All of these changes prime you up to deal with the stressful situation: either fight or run away as fast as you can. This is the basis of the so-called "fight or flight" response. For example, somone is about to rob you. Your adrenal glands repond to this acute stressful situation and prepare you to fight or run away. Soon afterwards, the adrenal glands come back to the resting "relaxed state."
Now what happens when you are stressed-out all the time. In other words you are overwhelmed by the stress of daily living. Initially, your adrenal glands produce large amounts of cortisol. But, eventually, your adrenal glands get exhausted due to the overwork and do not respond to the signal (ACTH) from the pituitary gland ( downregulation), which itself gets tired and does not respond to the signal (CRH) from the Hypothalmus (downregulation). Your Hypothalamus is connected to the "emotion center" in the brain. That's how your chronic emotional state influences the cascade of hormonal events that ultimately lead to the state of low cortisol (hypocortisolism), which leads to severe fatigue.
Saliva cortisol test is the best way to diagnose adrenal fatigue. Contact an online laboratory that does it. Regular Laboratories either don't do it or their reference range is geared towards the diagnosis of Cushing's syndrome (overproduction of cortisol), and not for low cortisol state ( hypocortisolism.)
The laboratory will send you a kit. You collect your saliva four times in a 24-hour period- morning, noon, evening and midnight and send it to the laboratory. They will send you the result in a few days. Discuss these results with your physician.
Beware: Traditional endocrinologists typically order a special test to diagnose adrenal insufficiency. This test is called ACTH stimulation test (also known as Cortrosyn stimulation test). This test diagnoses adrenal insufficiency due to the damage to your adrenal glands usually due to an autoimmune process or other disease affecting the adrenals such as tuberculosis. But, it does not diagnose hypocortisolism due to the problem at the level of the pituitary and/or the hypothalamus. This is called secondary adrenal insufficiency. Stress of daily living causes secondary adrenal insufficiency. Therefore, the diagnosis of adrenal fatigue due to chronic stress is often missed if your endocrinologist simply orders the ACTH stimulation test.
This is one medical condition where prevention is the best treatment. "How to be stressfree while living in a stressed-out world", you wonder. Well, here is a You Tube video of my talk in this regard.
While you work on your stress management, your physician may prescribe hydrocortisone tablets to replenish your low cortisol levels.
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