ADRENAL EXHAUSTION
Each of us has an important gland that is thumb sized and located
on top of each kidney. The adrenal gland secretes adrenaline
to support the body during “fight or flight” situations.
The other important hormones that are made in a different part
of the gland are cortisol and DHEA (dehydroepiandrosterone).
Cortisol has numerous effects on our health. It helps our body
to resist stress of all kinds, counteracts inflammation and allergies,
helps maintain blood volume and pressure by regulating sodium
balance, and regulates amino acid, fatty acid and glucose (sugar)
metabolism.
Chronic stress increases the output of adrenal cortisol to counteract
the damage the stress would otherwise do to us. Adrenal stressors
include negative emotions (anger, fear, anxiety), excess carbohydrate/sugar,
overwork, inadequate sleep, chronic infection, surgery or major
physical trauma, chronic pain or illness, severe allergies, excessive
exercise, temperature extremes, inflammation, and disruption
of sleep/wake cycles (shift workers).
Eventually, the adrenal gland may reach a stage of exhaustion where it is unable to continue to produce adequate amounts of cortisol or DHEA. Measurement of free cortisol and DHEA levels in saliva appears to be the most dependable way to assess adrenal function. Blood tests of cortisol do not usually tell if the biologically active free form (unbound to proteins in the blood) of cortisol is normal. The ACTH stimulation test will only show a problem if the adrenal gland is completely exhausted and unable to respond at all.
Symptoms associated with adrenal exhaustion
include fatigue, weakness, depression, irritability, poor concentration,
poor
memory, dizziness upon standing up,
lightheadedness, low blood pressure, insomnia, PMS, craving sweets, headaches,
muscle pain/spasm in the upper back and shoulders, low blood sugar, excessive
hunger, indigestion, heart palpitations, low resistance to infections,
food allergies, dry skin, low body temperature, hair loss,
difficulty building
muscle, and increased tendency to have autoimmune diseases like lupus or
thyroiditis.
If you and your doctor suspect adrenal exhaustion, testing for saliva levels
of cortisol and DHEA can guide the treatment.
A healthy whole foods diet that is low in sugar, little or no caffeine
or alcohol, and with adequate protein is advisable. Ginseng is an herb
that
contains chemical
precursors that the adrenal gland needs to make its hormones. Licorice
root is another herb that increases the period of time that cortisol remains
active
in the blood before being metabolized. Vitamin C, bioflavonoids, Vitamin
B-5, Vitamin A, magnesium, zinc, Vitamin E and flax seed oil are all beneficial
in supporting the adrenal gland to return to normal functioning.
Managing stress is crucial and may require lifestyle changes. Adequate sleep beginning at 10 PM for 8 hours is more restorative than 8 hours beginning at 1 or 2 AM. Learn to take several breaks during the day to relax. Learn to say no when asked to take on more duties in an already crowded schedule. Make time for fun and laughter (cortisol levels go up!). Light to moderate exercise is best, at least until you recover. Avoid stimulants like decongestants and caffeine. Adrenal glandular supplements may contain adrenaline and aggravate your condition so avoid them. In severe cases, your physician may prescribe low doses of cortisol (as hydrocortisone) and/or DHEA. Although DHEA is marketed as a supplement and does not require a doctor’s prescription, it has several potential hazards and should only be taken under supervision and periodic monitoring.
Daniel Blodgett MD