ADRENAL FATIGUE SYNDROME

Below is a long list of symptoms seen with adrenal fatigue syndrome. Your symptoms will depend on what other organ systems are also involved (eg. thyroid, digestive, immune, etc). Trying to heal these other areas without also correcting the adrenals, often leads to underwhelming results.

With special testing and a complete evaluation of your symptoms, I will tailor a program specifically for you. My goal is not only to make you feel healthier, but younger too!

Please continue reading further for an overview on the basic concepts of adrenal fatigue syndrome.

Symptoms of adrenal fatigue syndrome.
Chronic stress
• Tired all the time
• Inability to concentrate or focus
• Decreased memory
• Brain fog
• Difficulty sleeping (Going or staying asleep)
• Difficulty getting going in morning
• Living coffee to coffee
• Energy crash around 3-5pm
• Depression
• Anxiety
• Irritability
• Panic attacks
• Low or High blood pressure
• Low or high blood sugar
• High cholesterol or triglycerides
• Gallbladder issues
• Heart palpitations
• Low sex drive
• Digestive issues (IBS, Constipation)
• Poor thyroid function (despite medication)
• Sugar or salt cravings
• Temperature intolerance (hot or cold)
• Night sweats
• Hair loss
• Dry, thin skin
• Oily skin, acne
• Eczema, rashes or other skin disorders
• Premature aging of the skin
• Recurring muscle or joint pains
• Increased weight gain
• Decrease in muscle mass
• Restless leg syndrome
• Numbness or tingling in hands or feet
• Headaches
• Dizziness
• Tinnitus (ringing in ears)
• Recurrent mouth sores
• Age spots
• Shortness of breath
• Incontinence
• Osteoporosis
• Mitral valve prolapse
• Increased allergies (food or environment)
• Difficulty tolerating exercise
• Chronic fatigue syndrome/fibromyalgia
• Hashimoto’s
• Lyme disease (not responding to medications)
• H.Pylori that has not resolved despite treatment
• Chronic Candida infection
• Auto-immune disease
• Recurring or chronic infections

Females Associated Symptoms
Uterine or breast fibroids
• Irregular menstrual cycle
• PMS
• Premature menopause
• Anything that has required a hysterectomy
• Endometriosis
• Ovarian cysts
• PCOS
• Difficulty getting pregnant
• Recurring miscarriages (1st trimester)
• Post partum depression/fatigue
• Breast cancer (estrogen dominant)
• Hot flashes
• Vaginal dryness
• Painful intercourse
• Breast tenderness

Male Associated Symptoms
Enlarged prostate
• Prostate cancer
• Erectile dysfunction
• Frequent urination at night
• Balding
• Sterility


Adrenal Fatigue Syndome (Overview)

The adrenal glands are located on top of our kidneys and are responsible for regulating the stress response. It is designed to provide a short term, all hands on deck response to an immediate threat (like escaping from a bear or tiger). Stress is the signal that triggers the adrenal's to jump into action. It slows down processes that aren't needed in the short term (digestion, reproduction, etc..) and diverts that energy to the brain, heart and muscles. When the stress signal is gone, the adrenals reduce stress hormones and go into rest and digestion mode. This self regulating mechanism is referred to as homeostasis. It allows the body to repair itself and restore the normal functions in our body that were slowed during the stress response.

The problem is our adrenals were not designed to handle the constant stress we are exposed to in our society today. (Working too many hours, not enough sleep, not enough money, both parents working, no vaction or personal time, etc..) Constant stress on our adrenal glands causes further and further slowing in other organs in the body as energy becomes scarce. Over time, a steady decline in health in all areas of the body becomes apparent, including the adrenal glands. This process is known as Adrenal Fatigue Syndrome (AFS).

There are four phases of AFS. The first two represent overactive adrenals. The last two represent underactive adrenals. These phases provide a general guideline for adrenal dysfunction, but many variations are possible. With so many contributing factors, a one size fits all diagnosis does not work well when it comes to AFS.

Over active adrenals (phase 1 & 2)

When cortisol and aldosterone levels increase, potassium is excreted through the kidneys causing an increase in sodium (salt) levels in the blood. This leads to water retention and increases blood pressure. Inability to regulate this excess salt and water can be a primary cause of hypertension.

We also often see increases of glucose and triglycerides in the blood as the body attempts to maintain ample sources of energy to deal with the stressful stimulus. For this reason, sugar cravings are very common. Sugar is the most potent substance that stimulates cholesterol production in the liver. The resulting surge in cholesterol levels helps support the increased demand for adrenal hormone synthesis during times of stress. (ALL adrenal hormones are made from cholesterol).

Slowing down of metabolism in parts of the body begins to occur in these early phases of AFS to conserve energy for the stress response. Sugar cravings and excessive eating, combined with a slower metabolism leads to weight gain in those hard to lose areas. The constellation of symptoms above (weight gain, high glucose, cholesterol and triglyceride levels) make up a condition called Metabolic Syndrome, and is associated with poor long term health.

Underactive Adrenals (phase 3 & 4)

During these later phases of AFS we now see insufficient levels of cortisol and aldosterone being produced. This causes sodium (salt) levels to drop, leading to a constant state of dehydration in the body. Increasing water intake at this point will only worsen the problem, as it dilutes the sodium levels further. More water generally leads to increased urination, not increased hydration. The drop in aldosterone and water also cause a drop in blood pressure and can lead to heart palpitations due to electrolyte imbalances.

As nutritional and hormonal levels become more depleted, the body continues to down regulate (slow down) all areas of the body to conserve energy. This can lead to secondary problems in other organ systems. Hormonal, thyroid, digestive, liver, and immune dysfunction are just some of the additional issues seen here. Treatment becomes more complex and paradoxal reactions become more common as the dysfunction worsens.

Adrenal Fatigue Syndrome(Detailed Review)

Phase 1 – Initial Alarm State
During this phase, the body reacts to periodic episodes stress from our daily life. Symptoms are usually brief, and might even be considered normal. As long as the stressful stimulus affecting the body goes away, the body is able to recover. During stressful episodes, coffee or high sugar foods often provide a boost to the adrenals and help suppress symptoms of fatigue. This is completely fine in the short term. But over longer periods of time this method of suppressing symptoms of fatigue can start to take a toll on the adrenals. The body needs time to relax and repair itself. If it doesn’t, you start the slowly drift into further phases of adrenal dysfunction.

Phase 2 – Cortisol Peak
During this phase of AFS prolonged stress stimulates the Hypothalamic-Pituitary-Adrenal Axis to continue to produce higher levels of cortisol (an anti-stress hormone), in the adrenal cortex. Cortisol levels are also boosted through the activation of the Adrenomedullary Hormone System (AHS) through the activation of norepinephrine and epinephrine. This increase in cortisol can start to negatively affect sleep patterns.

Cortisol helps regulate our fuel requirement during periods of stress. Sugar cravings become more common as the body is tries to make sure there is ample glucose in the blood to deal with the perceived threat (stress). There is a problem with this situation though. Not only is the body craving the consumption of high calorie sugary foods. But it is also simultaneously slowing down the body’s metabolism to conserve energy for the stress response. In short, we eat more, and burn less calories, which obviously leads to weight gain. This is the basic premise connecting high cortisol and obesity.

Adding to the weight gain issue, the body also starts to retain water and become bloated. it does this through the action of increased aldosterone, a hormone that regulates blood pressure. Aldosterone increases salt retention in the large and medium sized blood vessels, as well as in the cells. Causing overall water retention and increased blood pressure.

Weight and blood pressure aren't the only things that increase. It's very common to see elevations in triglycerides, cholesterol, or glucose as well. The constellations of these symptoms are known as metabolic syndrome. Adrenal dysfunction can be a direct cause of metabolic syndrome. Medications for high blood pressure, cholesterol, sugar or triglycerides may be simply masking symptoms of adrenal dysfunction. By leaving this dysfunction intact, you may be committing to a life time of medications without actually dealing with the source of the problem. The longer this issue remains unresolved the harder it is to address them with changes in diet and exercise alone.

These first two phases of adrenal fatigue syndrome have less in the way of actual debilitating symptoms, and more to do with what we perceive as a normal part of “getting older”. We suddenly start feeling like our age is catching up with us. The good news is many of these people can reverse their symptoms with diet, exercise and proper sleep. Individuals who don’t listen to these warning signs from our body, and don't make appropriate lifestyle changes, are setting themselves up for progression to the more problematic phases 3 and 4.

Depending on your general health, nutritional status, the health of your various organs, and the amount of stress you are subjected to, this process can go on for years or even decades. However, if progrssion to late stage 2 and beyond occurs, it requires active intervention to restore the function of the adrenals. Doing it through lifestyle modification is almost impossible at that point.


Phase 3 – Adrenal Exhaustion


This phase is where the ability of the adrenals to self regulate (homeostasis) themselves is lost. The stress response becomes stuck in the “on” position. Mild to moderate symptoms in the earlier phases now become more servere and start to interfere with our life. It no longer feels like normal aging. It feels like we hit a wall and our days of feeling youthful are a thing of the past. They are tired all the time, living from coffee to coffee. Dispite being exhausted all day, they still can’t get a good nights sleep. They get sick more often, are stressed all the time, irritable, can’t lose weight, depressed, hair loss and wrinkles increase, and much more (see symptoms list above).

Phase 3 is broken down into 4 sub-phases. Each one represents further shutting down (or down regulation) of non essential bodily systems in order to conserve energy. The origin of our stress response is to maximize our ability to escape from an immediate threat situation, such as escaping from a hungry sabertoothed tiger. During such a situation, we don’t need to digest food, procreate or fight off infections. So these, and many other bodily processes are slowed down. The problem is, this response was designed to be temporary. People in phase 3 have now lost the ability to turn off this response, creating a downward spiral in our health as the body continues to progressively shut down. The goal is to divert all energy to the brain and heart for immediate survival needs. Hormones, nutrients, and other organs are all functionally slowed down to achieve this goal. With this overall process in mind, let’s go though the sub-phases of adrenal exhaustion.

Phase 3A – Early System Dysregulation

As mentioned, in order to conserve energy, the body slows down lower priority body functions. The systems affected first will be different from individual to individual. It is generally the organ system that was weakest in an individual before the adrenal issue started. So if a person has an underlying thyroid or liver problem, it is common to see worsening of these issues. Sleep disturbance, lower energy levels, mild depression, and aches and pains start to become the new normal. The longer this phase remains uncorrected, the further the hormones, nutrition and organs deteriorate.

The adrenal hormone aldosterone controls blood pressure. We saw in the previous phase how it increased blood pressure. The opposite is true here as the body's ability to produce aldosterone begins to drop. This causes potassium levels to rise and sodium levels to drop. Blood pressure will go from high or normal, and slowly decrease over time. We think of low blood pressure as a measure of good health. This is true if the person is completely healthy and youthful. However low blood pressure can also be a sign of an unhealthy person with significant adrenal fatigue syndrome.

Magnesium deficiency is another electrolyte issue seen in all stages of adrenal fatigue, except the very beginning and very end. Deficiency can lead to poor sleep, chronic tight muscles, restless legs, constipation, TMJ issues and more. There are multiple reasons for this lack of magnesium. But one important one is due to the vitamin D deficiencies. Cholesterol is the precursor substance used to make adrenal hormones and vitamin D. Adrenal hormones take priority over vitamin D production, so dysfunction in the adrenals ultimately leads to Vitamin D deficiency. This in turn prevents absorption of magnesium into the body through the digestive tract and contributes to its deficiency.


Phase 3B – Hormonal Axis imbalances

All steroid hormones are derived from cholesterol. Many people being treated for high cholesterol are simply treating a symptom of hormonal deficiency. Cholesterol levels are elevated in the body to aid in the production of our stress hormones. The same can be said for elevated glucose and triglycerides. These are all ingredients required to keep the stress response going. People in phase 3 cannot turn off the stress response, so the level of cholesterol, sugar and triglycerides can also get stuck at elevated levels in some people. We are all aware of the health conditions that can arise from chronic elevation of these substances. Treating the symptoms and not addressing the reason why the levels are elevated, ensures the underlying problem will remain intact and continue to wreak havoc on other areas of the body.

Cholesterol is the primary building block for hormones in our body. In the adrenals it is converted next into pregnenolone. Pregnenolone is then converted into hormones in one of two directions. Either towards the stress response, or towards the relaxation and digestion response (See Diagram below). In phase 3 the body has lost the ability to flip back and forth between these two opposing responses, a process called homeostasis. This means pregnenolone is primarily converted to progesterone, which then converts itself into cortisol or aldosterone. These are a lot of big words but they are important to understand. As progesterone demand continues to ramp up in the adrenals, the body starts to down regulate progesterone receptors around the body to conserve progesterone for use in the adrenals. As the stress response continues unabated, progesterone levels eventually start to drop. This drop will eventually lead to lower cortisol levels (causing more inflammation in the body), and lower aldosterone levels (causing blood pressure to start to drop).

Progesterone is not only an adrenal hormone, it is a major hormone required to properly regulate the sex hormones in both men and women. Low progesterone leads to a condition called estrogen dominance. This imbalance is the primary cause of issues seen in women (fibroids in breasts or uterus, breast cancer, irregular periods, PMS, miscarriages, endometriosis, etc..), as well as issues seen in men (enlarged prostate, prostate cancer, erectile dysfunction, sterility due to low sperm count/motility). It is essential to correct underlying dysfunction of the adrenals to allow the hormones to return to healthy levels.

The effects on the thyroid gland are also generally worsened during this phase. The thyroid gland regulates our metabolic rate. At this point the continued stress has begun to seriously deplete the nutrients required to keep the stress response going. So the down regulation of the thyroid starts to increase even more. Our thyroid produces a substance called T4. This thyroid hormone is then converted into its active form T3 which is the primary driver of our metabolic rate. During times of prolonged or extreme stress, the body produces a substance called RT3 (reverse T3). And as the name implies, it reverses the conversion of T3, and converts it back into inactive T4. This slows down metabolism and further conserves energy being used in the body. Many people who are exhibiting symptoms of low thyroid have normal levels of thyroid hormone in a general blood work up. This process described prevents T3 from getting into the cell where it actually exerts its effects on our metabolic rate. So levels are normal in the blood, but we exhibit all the signs of hypothyroidism. These individuals are actually suffering from adrenal fatigue syndrome. Their thyroid is acting sluggish due to down regulation of the gland by the adrenals. Thyroid medication will provide little to no help if that is the case.


Phase 3C – The final attempts to restore adrenal equilibrium


At this point the adrenals have completely lost the ability to maintain homeostasis. In a last ditch attempt the body recruits the services of our Autonomic Nervous System (ANS) to try to stimulate the ongoing needs produced by the stress response. The ANS can be activated on and off in previous phases in response to stressful stimuli. However its use becomes much more apparent and frequent here. The ANS produces large amounts of norepinephrine and epinephrine (adrenaline), which creates a powerful stress response. This creates exaggerated and unnatural stress responses to even minor stress stimuli. People tend to fly off the handle over seemingly nothing at all. Anxiety and/or depression levels can escalate significantly here. Heart palpitations, increased sleep disturbance, allergies, increased autoimmune symptoms, and low blood pressure are just a few of the symptoms seen during this phase.


To make matters worse, the continued down regulation of energy begins to show up as significant loss of function in our other organs. For example, lower liver function not only leads to poor digestion and gall bladder issues, but also inhibits the body’s ability to detoxify itself. Causing a buildup of toxic substances that create more inflammation and stress on the body. This fans the flames of existing allergies and autoimmune conditions, but also creates new sensitivities to things that never bothered us before. New sensitivities to foods, perfumes, supplements, medications, and environmental allergies seem to pop up out of no where. This stage of treatment starts to get tricky, because we often see paradoxal or exaggerated responses during the initial phases of treatment. Although paradoxal reactions can occur during any phase of treatment, they are almost a certainty during phase 3C and D.

Phase 3D – Pre-Failure

The process of down regulation continues throughout all phases of adreanl fatigue syndrome. During phase 3D, down regulation has reduced the levels of aldosterone and cortisol to a point that it begins to flirt with minimal levels required for basic functions of the body. When it drops below these levels a significant crash can occur in the body that can last for weeks or months. These crashes can be very scary for the individual. They may rush themselves to the emergency room with a sense of impending doom, fluctuating blood pressure, heart palpitations and anxiety. Only to be told that all tests came back normal, and see their medical doctor for the management of their symptoms (usually an antidepresant presciption follows). This very serious wakeup call your body is trying to convey is not going to go away at this point by treating symptoms. Correcting the cause (adrenals and other organ dysfunction) is the only path back to health and vitality.

Phase 4 – Adrenal failure

At this point you now have a medical emergency. Your cortisol and aldosterone levels are well below the minimum requirements for basic functioning. Symptoms here are pretty much indistinguishable from Addison’s disease, where the body cannot produce any cortisol at all. This condition is beyond conservative treatment approaches, and hospitalization is generally required.