Welcome to Dr. James Wilson's Adrenal Fatigue Blog

Minimizing Adrenal Fatigue & Letdown After a Stressful Event

The letdown that almost invariably follows an illness, a stressful event or even the holiday season is largely attributable to adrenal fatigue. However, with proper adrenal support you can often minimize or avoid the letdown and maintain a healthy ability to handle stress.

To understand why letdown occurs, it is helpful to know a little about the pattern of physiological adjustments your body makes in response to stress -- regardless of its source.

Primarily through adrenal hormones, you prepare for the same physical "fight or flight" reactions as did primitive man, even though modern day stress rarely requires that you physically fight or flee.

Your initial stress reaction produces a large rise in cortisol, adrenaline and other adrenal hormones that mobilize your energy, mental and physical resources to take action. This lasts for a few minutes to a few hours -- essentially how long it might take you to fight or run away from a threat. At the end of this alarm phase there is a recovery period lasting a few hours to a few days (depending upon the magnitude of the stress) when levels of cortisol and other adrenal hormones drop and remain low. This is a natural letdown phase during which you likely feel more tired and listless and want to rest. At this time your adrenals are temporarily fatigued and less able to respond to stress. The more fatigued or depleted your adrenals were at the time of the initial alarm, the longer and more debilitated your letdown.

If stress continues, your adrenals adapt to handle it by producing slightly elevated levels of hormones, particularly cortisol, in a kind of constant semi-alarm phase. This phase can last for weeks, months or even for many years. However, your body's prolonged biochemical readiness for "fight or flight" without commensurate physical action causes increasing problems in your body the longer it goes on, and it becomes another source of stress. If stress persists beyond your adrenal's capacity to maintain this higher function, or another stressful event occurs, your adrenals may eventually become depleted, leaving you in the more lasting letdown of adrenal fatigue and no longer able to respond adequately to stress.

Stress intensifies the demands on your body -- nutrients are used up faster than they can be replaced by food, toxic by-products rapidly build up, and every organ and gland (including your brain) is asked to work harder. Your adrenal glands must respond to every stress you experience by producing hormones that help your body cope with the stress and maintain homeostasis.

When you can anticipate stressful times, you can make a significant difference to how you will feel and the amount of letdown you will experience by paying attention to what your body needs and stepping up your level of self care. The following tips should minimize letdown, and help you bounce back more quickly, become more stress hardy, sustain good energy, experience more refreshing sleep, and remain calm, clear-headed, focused and steady.

• Eat what your body needs to function optimally by choosing fresh, wholesome food. When your adrenals are stressed, it is especially important to eat regular meals morning, noon and evening which each contain protein, healthy fat and complex carbohydrate.
  

• Avoid foods that stress your body, such as sugar, white flour/refined grains,hydrogenated oils, excessive additives and junk food.

• Minimize substances that over-stimulate your adrenals, such as caffeine.

• Exercise regularly and make sure you get up and move around frequently throughout the day to help keep that “fight or flight” reaction from creating further internal stress.

• For at least ten minutes a day take a mental break – concentrate on your breathing, meditate or focus on something peaceful.

• Take dietary supplements specifically designed to support and strengthen your adrenal glands for at least a month leading up to the anticipated stressful time, as well as for as long as needed afterward. Look for supplements, like the ones suggested below, formulated by an expert in stress to provide your adrenals and stressed body with precise forms, amounts, and ratios of high quality, natural ingredients they can optimally assimilate and utilize to enhance your health and minimize letdown.  The right supplements can make a world of difference.
  
  
• If you are stressed and having difficulty staying balanced during the day, tend to feel anxious or mildly depressed, or are having trouble sleeping, look for a combination of organic herbs designed to support the Hypothalamus/Pituitary/Adrenal (HPA) axis and adrenal function to help balance you during the day and promote sound sleep at night.
  
  
• Adrenal hormone production is very nutrient intensive, so supplementing with the precise nutrients your adrenals need to make these hormones can help you feel good and maintain a healthy response to stress. To enhance your response to and feel better while under stress, look for a combination of vitamins and minerals formulated in precise ratios, forms and amounts to replenish the specific nutrients used up by stress, facilitate the production of adrenal hormones, and support adrenal health.
  
  
• To replenish the vitamin C that gets rapidly used up during stress, look for a true sustained release supplement that provides a steady supply of an optimal amount of vitamin C, plus a 1:2 ratio of bioflavonoids to vitamin C to enhance the vitamin C activity and help protect your tissues from the oxidizing damage of stress, as well as trace minerals to neutralize the acidity of vitamin C so it’s easier on your stomach.
  
  
• If you have been depleted by stress, your adrenal glands may need deep replenishment and extra support to maintain healthy function and adequately respond to further stress. Look for a hormone-free multiglandular that contains adrenal, hypothalamus, gonad and pituitary concentrates designed to provide natural building blocks that fundamentally support and strengthen the structure and function of the adrenals and other glands affected by stress.
  
  
• Many people who feel stressed also experience energy lows at in the morning, mid-afternoon, or after exertion. To help temporarily bolster your energy at these times, look for a caffeine- free energy booster that is designed specifically to both provide support to your adrenals and naturally enhance your energy levels.
  

By taking steps to bolster and protect your health from stress, you can minimize the debilitating letdown that often occurs during and/or after a stressful event, and discover a new level of steadiness and stamina that allows you to enjoy life more fully, even in stressful times.

 

 

Adrenal Cell Extracts & Cortisol in Adrenal Fatigue

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.

Problems Interpreting Cortisol Lab Tests in Adrenal Fatigue

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.

Saliva Hormone Testing for Adrenal Fatigue

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.

Stress, the Workplace, and Adrenal Fatigue 2

A meta-study on the cost of stress to business revealed that 75 to 80% of the stress in a person's life is work related. Much of the stress at work is actually unnecessary and can be eliminated or minimized. Many people are not aware that the typical work-related behaviors listed below actually stress their adrenals and can lead to health problems that will eventually interfere with their ability to work. The following are warning signs that you are mistreating your body and are risking some aspect of your health breaking down on you:

• using caffeinated beverages to keep going instead of taking proper nourishment or getting enough sleep
• missing meals
• eating non-nourishing foods
• continually working through lunch hours and past the hours of a normal work day
• coming to work sick
• not exercising regularly
• not taking time to relax and enjoy life

In addition, there are many common workplace situations that increase stress. These fall into two categories:

1) The physical environment:

• poor lighting
• air quality
• noise
• inadequate tools for the job
• lack of access to facilities, etc. and

2) The work culture:

• insufficient job training
• office conflicts
• inadequate access to resources
• low compensation
• responsibility without commensurate power (common with middle management)
• unrealistic expectations and deadlines
• absence of positive feedback, etc.

Your health is a very valuable, but often ignored, aspect of success. Consciously redesigning your lifestyle and work place with the goal of decreasing these stress factors can profoundly affect your long term success as well as your health. When you are healthy and work in a physically and psychologically healthy environment, you are capable of greater productivity, a higher level of cooperation, more enthusiasm for work, and a deeper commitment to your job. You get to spend more time getting work done rather than trying to cope with stress fallout. Discovering how to minimize and manage stress in your personal and work life so you can avoid or recover from adrenal fatigue could turn out to be one of the most worthwhile lessons learned.

 

Stress, the Workplace, and Adrenal Fatigue

How many companies do you know give an employee award for a balanced life? In reality, most businesses unknowingly encourage stress in the workplace. Many operate on a crisis to crisis basis, going from one urgent short term goal to the next. They reward and encourage the person who stays late and comes in early day after day. Missing lunches, pushing through fatigue, living for work, and adding extra responsibilities to an already full workload often earn applause rather than words of caution from superiors. We have created a culture in which many individuals take pride in how much stress they are under.

However, the physiological effects of stress often go unnoticed and build insidiously over time until they become too disruptive to ignore. Some people experience total burnout, but most just experience a gradual decline in their productivity, powers of concentration, ability to handle stress, energy and enthusiasm. They find themselves missing deadlines, getting sick, quarreling with coworkers, and playing catch-up more and more frequently. Understanding the changes that occur in your body as a result of stress may give you some insights that can help you design your workplace and your life to minimize these problems.

Stress affects everyone from the CEO to the entry level clerk in similar physiological ways. Your adrenal glands respond to every stress you experience by secreting hormones that mediate the many physiological accommodations your body must make to adapt to the stressor and maintain homeostasis. In physiology, these walnut-sized glands situated over your kidneys (hence their Latin name, ad-renal) are known as the “glands of stress” because their primary function is to produce adequate responses to all the stresses your body experiences. Stress elicits the same physiological reaction whether it is from a physical, psychological or emotional source.

At first your adrenal glands can adapt and increase their production of hormones to enable your body to handle more stress. However, these higher levels of circulating stress hormones, such as cortisol and adrenaline, can have detrimental effects on your body when they are repeatedly or chronically elevated. The damage they do then becomes an additional stressor. With continued stress and too little rest and replenishment to allow recovery between stressful times, your adrenal capacity to respond to stress gradually diminishes. I coined the term "adrenal fatigue" in 1998 to describe this state of low adrenal function.

Adrenal fatigue is a decrease in your body's ability to respond to stress because your adrenal glands are no longer able to function optimally under stressful conditions. This dysfunction can range all the way from being mild enough to only slightly interfere with daily life, to being so severe that you become nearly incapacitated. In its more moderate forms adrenal fatigue has become a common occurrence in the workplace, affecting all occupations, work levels, body types and ages. Burnout and “breakdown” are severe types of adrenal fatigue caused by stress. People vary in their ability to withstand stress; some have congenitally low adrenal function due to maternal or inherited factors, and some lose hardiness through poor environment, lifestyle choices or illness. When chronic or severe, adrenal fatigue accelerates aging, and can have a negative impact on many aspects of health, including immune function, allergies, libido (lack of sex drive or function), blood sugar metabolism, hormone balance, sleep patterns and mental acuity. 

Because the hormones secreted by your adrenal glands affect almost every gland, tissue and organ in your body, decreased adrenal function can manifest itself in a variety of ways. 85% of patient complaints to their medical doctor involve some sort of fatigue, but only adrenal fatigue produces this unique daily fluctuation in energy. The cardinal signs of this episodic daily fatigue pattern are:

• Unexplained tiredness upon rising - even after 8-9 hours of sleep
• Difficulty getting going or feeling awake in the morning without the help of caffeinated drinks such as coffee and cola beverages
• Low energy in the mid to late afternoon lasting from 15 minutes to 2 hours that may be so slight you just want to sit for awhile or so severe you need to lay down
• Renewed energy at around 6:00 PM that lasts until 9:30 or 10:00 PM (like a switch is turned on making you feel better than you have during most of the day)  
• New burst of energy around 11:00 PM that can last until 1-2 AM
• Best, most refreshing sleep between 7-9 AM in the morning 

What is unique about the typical adrenal fatigue energy pattern is its episodic waxing and waning throughout the day at specific time periods. No other fatigue pattern has this unique characteristic. If you recognize this energy pattern in yourself and you answered yes to the questions listed in my previous article, you are probably experiencing some level of adrenal fatigue.