Posted by Dr. James Wilson on Mon, Nov 16, 2009
The human immune system is a magnificent and well-coordinated network of cells, organs, glands, and physiological processes. Nearly every cell, organ and tissue in the body is involved either directly or indirectly in the immune process. A portion of this elaborate network of immune defense is functional at birth (innate immunity) and the rest develops as the body interacts with the environment (acquired immunity).
Once the immune response has been suppressed to any significant degree, either by illness or by drugs such as corticosteroids, recovery is challenging and often requires extended time and treatment. Immune suppression adversely affects every system in the body.
As a researcher in immunology and as a practicing physician, I have investigated the science as well as the clinical data for many "immune enhancers." In the process of looking for the best among the many, I developed a set of performance criteria for their consistent evaluation. They are as follows:
1) Capable of deep action - able to make fundamental changes in immunity
2) Capable of sustained action - effectiveness does not dissipate or decrease with continued use over time
3) Produce broad immune stimulation
4) Enhance both humoral and cellular immunity
5) Effective in both acute and chronic conditions
6) Dose dependent
7) Versatile - beneficial for a number of health conditions
8) Safe and effective for all ages
9) Reliable - consistent quality, producing same effects time after time
10) Non-toxic
11) History of use in humans
12) Manufactured with high quality controls
13) Compatible with all medications
14) Easy to use
15) Few or no side effects
16) Improvement evident by both clinical observation and lab results
17) Economical
18) High user compliance
My goal has been to find substances that meet all the above criteria. One of the most promising I could find with a scientific basis for immune enhancement was the use of Lactobacilli cell walls and cell wall fractions. Of the various combinations commercially available, the cell wall fractions of specific strains of Lactobacillus bulgaricus (L. bulgaricus) appear to be the most potent.
The results of studies and historical use of dead L. bulgaricus cell walls and cell wall fractions clearly demonstrates the broad clinical effectiveness of enhancing the body's own defenses. In the presence of the dead L. bulgaricus cell wall fractions, the immune system is stimulated to become more responsive even though these cell wall fractions are harmless and not pathogenic.
Because of both the specific and general beneficial effects of dead L. bulgaricus cell walls and cell wall fractions, they have been shown to be effectively boost immune function in a broad range of acute and chronic clinical conditions. These include many upper and lower respiratory ailments such as bronchitis, pneumonia, tonsillitis, rhinitis, sinusitis, COPD and bronchial asthma, and even infectious conditions that are a result of treatment resistant bacteria or are of viral origin (Pedan '99). No bacterial resistance has developed, nor is it expected to be a factor because this mechanism works by strengthening natural immune responsiveness rather than acting directly on the pathogenic organisms.
Other Factors Contributing to Immunity
No matter how effectively a therapy supports immunity, lifestyle has a decisive influence on the outcome of that therapy. If nutritional intake is not sufficient, or air and water quality is poor, sleep is inadequate or of poor quality, or stress levels are too high, recovery cannot be expected to be either rapid or complete. Taking care of these problems may require dietary and habit change, allergy testing, nutritional supplements, environmental improvements, fitness training and psychological or stress management counseling before more focused therapies can produce the desired results.
As mentioned earlier, every cell, tissue and organ is involved in the immune process. Every factor that contributes to the vitality of the immune system is important to regaining or maintaining good health. As the cold and flu season is upon us, it is important to not only look for the best immune enhancers, but also to take personal responsibility for creating a healthy body to house a strong immune system.
Posted by Dr. James Wilson on Fri, Nov 06, 2009
Whether
or not to get a flu shot is an individual decision, even if you have adrenal
fatigue.
My reservation about the HINI flu shot is the same as it is about any
other flu shot in any other year. Each flu vaccine only protects against one or
two specific strains of influenza. However, there are many viruses and bacteria
that make people ill, especially during the winter months. Vaccination against
only one or two strains, albeit common or particularly virulent ones, does
nothing to protect against the many other causes of flu and respiratory
infections. I have had the same question posed to me by my staff and what I
told them is that the most important thing you can do to protect yourself from
this virus or any other cause of the flu or other upper respiratory ailment is
to continually strengthen your immune function. Arm yourself by doing the key
things that lead to a strong and responsive immune system:
• Be proactive by regularly using (especially in the months preceding and
during cold and flu seasons) the supplements that enhance and build your body’s
own natural immune processes over time.
• In addition, take approximately 2,000 mg per day of the best vitamin C you
can find (sustained-release, pH balanced, with 1 mg of bioflavonoids for every 2
mg ascorbic acid), and 15 to 30 mg per day of zinc gluconate or
picolinate.
• Keep a quick-acting, natural immune booster on hand to help nip things in the
bud in case something slips by your immune defenses.
• Adopt an immune-hardy lifestyle by getting eight to nine hours of sleep a
night; eating nutritious foods with abundant vegetables, whole grains and some
fruits; avoid junk foods and driving yourself with caffeine; and exercise
within your tolerance but without exhausting yourself.
It is true that if you are going through adrenal fatigue, you are more
vulnerable to respiratory infections. However, the steps listed above combined
with proper adrenal support will go a long way toward helping you stay healthy
during the winter. If you do get the flu, it will probably be much milder and
shorter-lived than had you not taken care of yourself in this way. By
continuing to support your adrenals, your recovery should be better, faster and
stronger. An important thing to remember during the recovery phase is that once
you begin to feel better, not to push yourself. Already this fall I know of two
incidences where people with adrenal fatigue got the H1N1 virus, but with
continued adrenal support recovered very quickly -- only to over extend
themselves too soon, get exhausted and further weaken already challenged
adrenals, and then become ill with another virus. Had they taken two more days
to rest and recover, or had they also strengthened their immune systems, they
would probably both have been fine.
Having a flu shot can give you a false sense of security and lull you into
believing you are protected from all flus, when in fact you are only protected
from one or two specific pathogens. Taking care of your body and personal
responsibility for your health, including preparing for the winter by
strengthening your immunity as well as maximizing adrenal support if you have
adrenal fatigue, is an important concept to understand.
Yours in health,
Dr. James Wilson
Posted by Dr. James Wilson on Mon, Nov 02, 2009
Food sensitivities can affect your life in subtle ways. They can manifest by increasing your fatigue, clouding your judgement, intensifying your anger and other emotional reactions, or just make you feel bad for no apparent reason. Here are some tools to help you learn which foods, drinks or
substances are the offending agents -- and how to relieve your body's
stress and speed your adrenal recovery time.
Food & Environmental Intolerances Questionnaire
Food and environmental intolerances affect your body's ability to function and can contribute to adrenal fatigue. A “Food & Environmental Intolerances Questionnaire” is available at our website at http://adrenalfatigue.org. It lists common signs and symptoms of food and environmental intolerances. 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.
Elimination/Provocation Confirmation Test
The elimination/provocation test is an accurate, inexpensive and easy way to confirm suspicions about food sensitivities/allergies. To do this, you simply eliminate the suspect food from your diet completely for at least three weeks and then reintroduce it. The first time you reintroduce the food, beverage or substance, it is best to have only a small amount (one or two mouthfuls). Do not eat or drink anything but water for approximately one hour before and two hours after you consume your test item. Take your pulse sitting quietly before eating the food and every 15 minutes after, for an hour. Record any emotional swings, mood changes, or alterations in mental clarity. Note if your energy level goes up or down. One of the most common reactions found in food allergies/sensitivities is to feel especially good, almost giddy, for 30-45 minutes after you ingest the test item, and then to fall into a real low.
If you still do not notice any detectable difference in your pulse, energy level mental clarity, mood or in any other way physically, mentally or emotionally, you are probably not sensitive to that food or perhaps your are only sensitive to it under certain conditions. If you do notice such changes, you are probably sensitive to that food substance. Eliminate this item completely from your diet.
ELISA IgE Test
Getting an ELISA (enzyme-linked immunosorbant assay) IgE food allergy test is the best place to start with laboratory tests. The basic panel covers 90-100 foods, and the more comprehensive panels cover about 175 foods including spices, herbs, condiments and uncommon foods. Despite the usefulness of the ELISA tests, there are certain kinds of food reactions that they do not pick up. For these, the Cellular Immune Food Reaction Tests may be more useful.
Cellular Immune Food Reaction Tests
Also known as delayed-type hypersensitivity reaction tests (DTH) or activated cell tests (ACT), these are less common blood tests that can be valuable in detecting subtle or delayed allergies not caught by the ELISA. These tests look at the part of the immune system’s response to food that can be delayed up to three days after eating the food. Such food allergies are seldom discovered by observations and are not picked up by the usual food panels.
Posted by Dr. James Wilson on Mon, Nov 02, 2009
It is hard to say which is more important when you have adrenal fatigue – what to eat or what not to eat! Eating the wrong foods or combination of foods can throw you off for hours and even days, so do not event try to sneak something by; it is just not worth the price you have to pay. Make regaining your health a major priority and do not sacrifice it for the cheap gratification of a favorite, but unhealthy, food or drink. Pick the foods that are recommended for adrenal fatigue and stick with them. The further you deviate from them, the more problems you are likely to have and the more difficult it will be to balance your body chemistry. In order to heal and maintain your health, you need to stack as many things in your favor as possible.
Eliminate All Foods to Which You Are Allergic, Sensitive or Addicted
If you think that a particular food substance interferes in any way with achieving your optimum health, eliminate it immediately. If you suspect, but do not know which foods or beverages you are allergic, sensitive or addicted to, then it is important to find out. The adrenals are extremely important in all allergies, including food allergies and sensitivities. As your adrenal function improves, you will be less prone to allergies and will be able to eat more things. However, for the first three months, do not push the envelope. Completely eliminate all the foods you are sensitive to or suspect you are sensitive or allergic to. The idea is not to see how far you can test the limits; the idea is to get yourself well.
Role of Allergies in Adrenal Function
Most allergies involve the release of histamine and other pro-inflammatory substances (substances that produce inflammation). The adrenal hormone, cortisol, is a strong anti-inflammatory (a substance that reduces inflammation). Your circulating level of cortisol is the key factor in controlling the level of inflammatory reactions in your body. For this reason, your adrenal glands play an important role in mediating the histamine release and inflammatory reactions that produce the symptoms experienced with allergies. It is therefore not surprising that people with food and environmental allergies commonly have weak adrenal function.
The more histamine that is released, the more cortisol it takes to control the inflammatory response and the harder the adrenals have to work to produce more cortisol.
The harder the adrenals have to work, the more fatigued they become and the less cortisol they produce, allowing histamine to inflame the tissues more.
This vicious circle can lead to progressively deeper adrenal fatigue as well as to larger allergic reactions.
Anything you can do to break this cycle will help your adrenal glands and reduce the effects of allergies.
Eliminating foods that you are allergic or sensitive to from your diet is one of the best and easiest ways to decrease the demands on your struggling adrenals.
Most symptoms of allergies or food sensitivities are first felt between thirty minutes and three hours after the meal, but some may be delayed as long as two to three days.
Because of the abundance of histamine receptors in your brain, an allergen will often cause a greater reaction in your nervous system than it does anywhere else. Ranging from subtle to profound, these cerebral allergy reactions can include such symptoms as a cloudy head, confusion, sudden awkwardness, loss of consciousness, coma and occasionally death.
Responses to particular foods and drinks vary from person to person but there are some food substances that tend to produce allergies more frequently. The most common food allergens are the proteins in cow's milk, eggs, peanuts, wheat, soy, fish, shellfish, and tree nuts. Sugar is not a common allergen, but it can greatly increase an allergic reaction. If you find yourself feeling odd or experiencing more of the signs and symptoms of adrenal fatigue after eating, think of allergies or food sensitivities.
Allergic reactions also vary in magnitude, even within the same individual. At one a time an allergen may produce only a small response, and at other times be incapacitating. It is important to track down and eliminate these food sensitivities and allergies in order to help you adrenal glands recover.
Posted by Dr. James Wilson on Fri, Oct 30, 2009
Recent media reaction to the "Swine Flu" has caused considerable alarm in many people. It is important to protect the adrenal glands as they are one of the key responders to flu and are important in the body's response and recovery.
The main purpose of your adrenals is to enable your body to deal with stress from every possible source, ranging from injury and disease to work and relationship problems. Your propensity to develop certain kinds of diseases and your ability to respond to chronic illness is influenced significantly by the adrenal glands.
During the severe flu epidemic of 1918 that killed an estimated 50-100 million worldwide, 103 of 126 autopsies revealed that the adrenals had been severely affected. In fact, it was postulated that the reason for death may have been adrenal exhaustion rather than the pathogen itself. In another study from the same epidemic, people taking adrenal extracts fare much better through the course of the disease than those who did not.
This strain of flu has been identified as Influenza type A/H1N1, a mutant combination of swine, bird and human influenza viruses, now believed to have likely originated in humans, not pigs. Although a number of people have died with this flu, type A influenzas more typically run their course without complications and end with a full recovery. This type of flu virus usually only severely affects the weak, the sick, the very young and the very old.
So I strongly advise supporting and strengthening adrenal function and your immune system if adrenal fatigue or other related health concerns are present. Our adrenal fatigue website at http://adrenalfatigue.org/ provides information about what is available to effectively support the adrenals.
Additional Measures
Additional measures that help protect against infectious disease include following the usual precautions of washing hands after handling money or shaking hands, and avoiding people who have the flue or are likely carriers of infection.
If someone in the family has the flu, it is especially important to:
- Wash your hands after contact
- Wash all dishes using chlorine bleach (one tablespoon per gallon) in very hot water or the sanitize cycle on the dish washer
- Use separate towels and keep the sick person away from other family members when at all possible
The most common ways to spread infectious disease, besides sneezing and coughing in close proximity, is through commom:
- Handling of telephone,
- Remote controls,
- Doorknobs, and
- Bathroom sink handles
These should be disinfected daily during this time, especially if they are shared.
When traveling, it can really make a difference to:
- Take along moist sterilizing pads
- Wipe down the above items in the hotel room with the sterilizing pads
- Wear a mask while in flight
Posted by Dr. James Wilson on Fri, Oct 23, 2009
People are becoming more aware of the ravages of stress and how it leaks into every corner of their lives. Of course, increased stress means increased
sleep disturbances for many. Less sleep means they experience more stress the day after. This pattern continues in a vicious cycle, making stress and sleep loss in terms of hours and quality intimately interconnected.
If stress has somewhat depleted the adrenal glands, which is often the case, people under stress do not wake feeling rested. Cortisol, an adrenal hormone, is needed to allow that person to wake feeling refreshed and bouncing out of bed in the morning. It is also important to induce an alpha wave, a requirement for the first phase of sleep. If cortisol is low, falling asleep is difficult. Cortisol is also necessary to maintain good blood sugar levels throughout the day and night. If cortisol is low during the day people wake feeling tired and often need coffee, cola and other caffeinated beverages to get going and to keep going during the day. This over consumption of caffeine not only causes blood sugar to rapidly rise and then precipitously fall an hour and a half later, but also tends to interfere with sleep that night. The resulting lack restful sleep creates more stress the next morning and perpetuates the cycle of low cortisol and difficulty sleeping. This low adrenal function is a frequent occurrence in both sleep disturbance and inadequate response to stress. During adrenal fatigue, a condition where the adrenal glands are not able to keep up with the demands placed on them, people often have problems managing their stress and sleeping well.
There can be several reasons for sleeplessness with adrenal fatigue. If you are waking between 1:00 and 3:00 AM, your liver may be lacking the glycogen reserves needed for conversion by the adrenals to keep the blood glucose levels high enough during the night. Blood sugar is normally low during the early morning hours but, if you are experiencing adrenal fatigue, your blood glucose levels may sometimes fall so low that hypoglycemic (low blood sugar) symptoms wake you during the night. This is often the case if you have panic or anxiety attacks, nightmares, or sleep fitfully between 1:00 and 4:00 AM. To help counteract this, have one or two bites of a snack that contains protein, unrefined carbohydrate, and high quality fat before going to bed, such as half a slice of whole grain toast with peanut butter or a slice of cheese on a whole grain cracker.
Both too high and too low nighttime cortisol levels can cause sleep disturbances. To determine if this is a problem for you, simply do a saliva cortisol test at night and compare your night sample levels with your own daytime levels and with the test standards for those times. To do the night test, take a saliva sample at bedtime, another if you wake up during the night and a third when you wake up in the morning. Write the time each sample was taken on the vial and in your notebook on a separate sheet of paper. If cortisol is the culprit, your cortisol levels will be significantly higher or lower than normal for those times. If your nighttime cortisol levels are too low, you may sleep better when you exercise in the evening, before going to bed because exercise tends to raise cortisol levels. If your nighttime cortisol levels are too high, try doing one of the relaxation or meditation exercises to calm you down before going to bed. The specific yoga posture called the alternate leg-pull can be quite helpful in getting to sleep or returning to sleep. This is a basic yoga posture that almost any yoga book or video will describe but an instructor is preferable because there is some subtlety to doing this posture.
Here is a list of some additional things you can do to improve your sleep:
- Above all, go to bed before 10:30 PM and stay in bed until 9:00AM as often as possible, even if it is just on the weekends. It is amazing how restorative sleeping until 9:00 AM is for the adrenals.
- Be sure to get enough physical exercise during the day. Try varying the kinds of exercise you do, their intensity or when you exercise. Many people have told me swimming at night helps them sleep.
- Certain postures in yoga, ta'I chi and qi gong can also be helpful. Check with a teacher of these disciplines to find out which postures or exercises would specifically help you.
- Avoid coffee, caffeine containing beverages and chocolate because they act as stimulants. These can interrupt sleep patterns and increase morning lows. Even if they are consumed early in the day, they can disrupt sleep and make the next morning harder to negotiate.
- Some people are photosensitive and watching television or looking at at computer screen keeps their melatonin from rising and inducing sleep. If you are having difficulty going to sleep and usually are staring at a TV or computer screen late at night, try having an 8:00 PM limit on these visual stimuli.
- If your cortisol levels are low late at night, try exercising in the evening, as exercise raises cortisol levels and may afford you a sound night's sleep.
- There are particular nutritional supplements that can be beneficial. Often melatonin (0.3-1.3 mg) taken 30 minutes before bedtime helps establish normal sleep patterns. Calcium citrate (500mg) taken with 50 mg of 5-hydroxytriptophan (5HTP) at night before retiring is also relaxing and helps many people sleep throughout the night. Trace mineral tablets taken at the evening meal also help relax the body. Adrenal extracts taken ½ hour before bedtime often help those with adrenal fatigue fall asleep and remain asleep. If your adrenal fatigue is moderate or severe, try this one first.
- The hypothalamus is very important in regulating sleep. Although accurately testing hypothalamic function is complicated, a simple test you can do yourself is to try takig one to four tablets of hypothalamus extract and 10-40mg of manganese before bedtime and see if your sleep improves. Sometimes the hypothalamus tablets need to be combined with the adrenal extracts to normalize sleep.
- There are also several herbs commonly used to promote better sleep such as hops (whole plant), catnip (leaves), valerian (root) and licorice (root). Although not known as a sedative, the herb ashwagandha can help indirectly through its ability to normalize cortisol and sex hormones, both of which can produce sleep disturbances.
If none of these help and your life is being deleteriously affected by lack of or interrupted sleep, check your local area for the location of the nearest sleep center. Several cities around the country have these centers that specialize in helping individuals determine the cause of their sleep disturbances.
Take Short Horizontal Rests During the Day
During the day, you will probably notice that you have particular times when you feel more lethargic, cloudy headed, tired or have other symptoms of adrenal fatigue. Try to schedule your breaks so that when these occur, you can physically lie down for 15-30 minutes. Lying down is much more restorative than sitting for the person with adrenal fatigue.
Posted by Dr. James Wilson on Thu, Oct 15, 2009
Probably the most reliable way of rebuilding the adrenals from adrenal fatigue is the use of extracts from liquid or powdered porcine adrenal glands. The first recorded use of an adrenal extract was in 1898 when Sir William Osler administered a crude preparation of adrenal cells to a person with Addison's disease. Since 1918, when they became commercially available, adrenal cell extracts have been a valuable and powerful form of therapy and have been used by thousands of medical doctors in the treatment of non-Addison's type of adrenal fatigue.
Adrenal cell extracts, also known as adrenal cortical extracts, are the liquid or powder extracts of the adrenal cortex. Their action is to support, fortify and restore normal adrenal function, thereby enhancing adrenal activity and speeding recovery. Adrenal cell extracts are not replacement hormones - in fact, the best type of extract to use has been processed to remove the adrenal hormones. What they provide are the essential constituents for adrenal repair, including the adrenal cell contents, such as nucleic acids (adrenal cell RNA and DNA) and concentrated nutrients, in the form and proportion used by the adrenals to properly function and recover from stress.
Various types of adrenal cortical extracts have been used orally and as injectables since the end of World War I and have rarely produced unwanted side effects. They have been, and continue to be, a fundamental part of the treatment protocol for adrenal fatigue used effectively for over 80 years, and provide significant value for alleviating all levels of adrenal fatigue.
Today, by combining our knowledge of adrenal cortical extracts with lifestyle modifications, dietary supplements and herbal formulas, we can stabilize people with adrenal fatigue and accelerate their recovery more efficiently than ever before.
Coritsol vs Adrenal Cell Extracts
It is important to understand the difference between adrenal cell extracts and natural or synthetic cortisol and cortisol-type steroids such as cortisone, prednisone, prednisolone and many other forms of adrenal steroid hormones. Adrenal cell extracts that have been processed to remove adrenal hormones nourish and help rebuild adrenal cells. As these cells recover, they can once again produce the proper amount of the various hormones needed for the many functions performed by the adrenal glands. By this means, they tend to normalize adrenal function. In contrast, corticosteroids, whether natural or synthetic, tend to reduce or shut down the activity of the adrenal glands. This happens because the brain senses the presence of these cortisol substitutes and, in response, withholds the signal of adrenalcorticotrophic hormone (ACTH) it would otherwise send to the adrenal glands to make more adrenal hormones. Thus, corticosteroids suppress the functions of the adrenal glands, over-riding the normal feedback loops that regulate and balance adrenal hormones. In spite of the fact that this action can produce dramatic initial improvements in symptoms, these symptomatic improvements come with a heavy price.
Because corticosteroids mask the symptoms of adrenal fatigue and, when used in excess, depress immune function, the person taking them is at greater risk from stress and infection. Such therapy can become more hazardous than the original disease. Corticosteroids may have quick and dramatic symptomatic results, but unless they are used in their natural form and in physiologic doses that mimic the natural secretion of cortisol, they make the adrenals weaker rather than stronger.
It is difficult to get off a corticosteroid drug once on one for a while. People get caught in the "catch-22" that if they stop taking the corticosteroids, they crash and their symptoms return worse than ever because adrenal activity is suppressed. So they keep taking them, but the longer they take them, the harder it is for the adrenals to regain proper function.
It is important to remember that corticosteroids suppress adrenal function in proportion to the dosage. For this reason, it is important that steroid treatment should be withdrawn slowly, never abruptly.
Conversely, adrenal cell extracts adrenal function and, when taken over time, naturally strengthen the capacity of the adrenals for healthy function. Once the adrenal glands are responding sufficiently, a gradual step-down program can be initiated to reduce and even eliminate the need for adrenal cell extracts. In recovering from adrenal fatigue and stress, it is important to allow adequate time for the optimal adrenal function to become fully established before beginning a reduction schedule.
Posted by Dr. James Wilson on Thu, Oct 08, 2009
Complicating the problem of proper interpretation of laboratory data in adrenal fatigue is the fact that steroid hormones occur in more than one form in your body, but most lab tests measure only one.
Cortisol, for example, takes on three forms in your blood: 1) unattached to any other substance (free), 2) loosely bound and, 3) tightly bound to blood proteins. The most common measurement for hormones is the amount of hormone not attached to anything, called the free circulating hormone. However, this usually represents a meager 1% of the total amount of hormone available. It does not measure the bound hormones, which act as reserves and become free hormones if needed. This reserve can be critical to proper physiological function. For example, very low circulating cortisol levels can be brought to within normal range by the administration of a synthetic cortisol. But people taking synthetic cortisol cannot withstand stress as well as people with naturally normal cortisol levels, even though blood tests for both show normal free circulating cortisol levels. One reason for this is that although free circulating cortisol levels are increased by taking the synthetic cortisol, levels remain low of tissue bound cortisol that provides reserve stores in cases of emergency (stress). Blood tests can often be deceptive because they do not typically give you the whole picture. Therefore, even though both healthy people and people taking cortisol might show normal free cortisol levels, their response to stress will probably differ considerably. The test results would give a very deceptive picture of "normal" in the case of the person receiving the drug, as it tests only the most superficial layer of cortisol availability.
In adrenal function, the extreme low on a bell curve is Addison's disease and the extreme high is Cushing's disease. The other 95% represents an enormous variation in levels of adrenal function that is usually disregarded by lab computers and overlooked by doctors because the scores in this range do not fall into either of the two extreme or "diseased" categories. By default, any scores falling within this range (95%) are considered "normal" The end result of basing laboratory test scores on statistics rather than on signs and symptoms is that many people who have mild to moderately severe adrenal fatigue are never accurately diagnosed; they look "normal" on the tests.
Stress is a factor that significantly affects adrenal hormone levels. Your cortisol level tested after a quiet, relaxing morning will be very different from your cortisol level tested when you are under stress before you arrive at the lab. To obtain a typical value, have your test on a typical morning.
Posted by Dr. James Wilson on Mon, Oct 05, 2009
I use the saliva hormone test to confirm the
other signs and symptoms of adrenal fatigue. I start with a saliva cortisol screening test that measures cortisol levels at four different times during the day: between 6-8AM (within one hour after waking) when cortisol levels are highest; between 11AM-12PM; between 4-6PM; and between 10-12PM. This shows how your cortisol levels vary during the day – something you cannot easily do with blood or urine tests.
Another way I like to use the saliva test, when possible, is to compare samples taken when a patient is experiencing an energy high or low with samples taken during a regular day when the patient is feeling relatively normal (baseline samples). After we have a baseline, these patients carry around some spare vials to take saliva samples at times when they are feeling especially good or especially bad. Again, they record the symptoms(s) they were experiencing, as well as the date and time. They also record the date and time on each vial and send them off to the lab. This is an excellent way to determine whether the lows and highs you experience correspond to relatively low and high cortisol levels.
I also usually measure DHEA-S levels with the saliva test, as well, because the adrenals are the primary source of DHEA-S (but not necessarily of DHEA). Adrenal fatigue syndrome often involves decreased DHEA-S. The DHEA-S level is a direct indicator of the functioning of the area within the adrenal glands that produces sex hormones (the zona reticularis). Saliva tests for testosterone, the estrogens, progesterone and other hormones can also be done, if needed, and may be of value in working with adrenal fatigue. Testosterone and DHEA-S levels are two of the most reliable indicators of biological age. Testosterone and DHEA-S levels below the reference range for the person’s age may be indicators of increased aging. If the cortisol levels are also decreased, the three tests together further indicate chronically decreased adrenal function.
If a doctor does not use the saliva hormone tests, piecing together a correct diagnosis of adrenal fatigue from other laboratory tests is more difficult. Most laboratory tests are designed to look for “disease” states in the human body and adrenal fatigue is not a disease. In addition, there has never been a reliable urine or blood test that checks for, and can definitively diagnose, mild forms of hypoadrenia.
The main reason I prefer the saliva test is that it gives clearer and more direct indications of hormone levels at the actual site where they are utilized – inside the cell. None of the blood or urine tests typically give you as much useful information about your adrenal function as you will get from the combined use of the adrenal fatigue questionnaire from page 61 in the my book,
Adrenal Fatigue: The 21st Century Stress Syndrome, clinical self-tests, and saliva hormone tests.
Posted by Dr. James Wilson on Thu, Oct 01, 2009
Saliva hormone testing measures the amounts of various hormones in your saliva instead of in your blood or urine. It is the best singe lab test available for detecting adrenal fatigue and has several advantages over other lab tests in determining adrenal hormone levels. Saliva hormone levels are more indicative of the amount of hormone inside the cells where hormone reactions take place. Blood, on the other hand, measures hormones circulating outside the cells, and urine measures the spillover of hormones out of the blood and into the urine. Although blood and urine hormone tests have their uses, neither of them correlates with the hormone levels inside the cells. The level of a hormone circulating in the blood or excreted in the urine does not necessarily reveal how much of that hormone is getting into the cells. However,
saliva testing for hormone levels is simple, accurate and reliable, and many studies have confirmed its accuracy as an indicator of the hormone levels within cells.
Besides providing this nice little peek at hormone levels inside the cells, saliva tests are easy to perform. All you have to do is spit into a small vial. The tests are non-invasive (no needles) and you do not even have to go to a laboratory to complete them. This means that they are an extremely useful way to monitor your degree of adrenal fatigue and your progress over time because they can be repeated as often as needed. Saliva tests are also less expensive than blood tests for adrenal function. They can be done by many health practitioners other than medical doctors, such as chiropractors and naturopaths, who may not have laboratory privileges in your state, but who perhaps know much more about adrenal fatigue than your family doctor or specialist. Some labs will run this test for you without a physician’s signature, so it is possible to order the kit and do the test yourself. You can even obtain a saliva kit by mail and then send it back to the lab from anywhere in the United States. However, unless you know how to interpret a hormone test, it is far better to have a health practitioner familiar with saliva tests and adrenal fatigue do the interpretation for you. The health practitioner’s experience and understanding of how particular test results relate to your whole health pattern is something that is difficult to provide yourself. In this case it is important to find a practitioner who has experience with adrenal hormone testing and its subtle interpretations, which is unfortunately not widely known to mainstream doctors -- even many endocrinologists.
The best way to determine your particular adrenal hormone (cortisol) status is to use the saliva test that measures your cortisol levels several times per day. Typically, laboratories testing hormonal content of saliva have test kits that take samples four or more times per day. You merely carry around a few small tubes and, at designated times of the day, you spit into one of the tubes and recap it. The samples usually do not need to be refrigerated and can be sent by mail to the laboratory. For a list of laboratories that do accurate and reliable saliva testing, as well as a list of doctors familiar with this test, see our website at
http://adrenalfatigue.org. By measuring your saliva hormone levels at least four times per day, you will be able to see for yourself where your cortisol levels are compared to the norms. After you receive your report, you can see whether low cortisol levels may be responsible for the feelings of fatigue that you experience during particular times of day. Because saliva hormone levels correlate well with the amount of hormone inside the cells (tissue levels) and samples can be taken as needed without inconvenience or adverse side effects, saliva testing is often more useful than blood or urine testing of hormone levels.