Monthly Archives: December 2014

Adrenal Fatigue: symptoms and signs

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-Adrenal-Fatigue S&SThis is a well organized short synopsis for the layperson to understand and be able to ask questions of those they seek for their healing. There are certain signs and symptoms that one should look for to see if low cortisol levels are developing. Keep in mind that at first the continuous, high cortisol levels are also dangerous to our well-being as I wrote about in my blog: What is Adrenal Fatigue.The physician also should have the following in their diagnostic differentiation because there are many illnesses with similar signs and symptoms so that diagnostic conclusions must be done carefully and by experienced healers. A person does not need to have all the listed symptoms and signs, only some to begin to think about stress and adrenal fatigue.

But first let us see what are the functions of  cortisol.

At healthy levels cortisol influences, regulates and moderates:

  • Blood sugar levels
  • Fat, protein and carbohydrate metabolism
  • Anti-inflammatory mechanisms (our immune system)
  • blood pressure
  • The central nervous system
  • Thyroid functioning

Elevated cortisol levels cause:

  •  Impaired cognitive functioning
  •  low thyroid and eventual hypothyroidism
  • Decreased bone density
  • Insomnia
  • Decreased muscle mass
  • Elevated blood pressure
  • Slower wound healing
  • Increased fat deposition which can lead to cardiovascular problems

Low cortisol levels cause

  • Foggy brain
  • Depression
  • Low blood sugar or hypoglycemia
  • Fatigue
  • Insomnia
  • Low blood pressure
  • Decreased immune function
  • Increased inflammation

The following are clues Adrenal Fatigue

1-morning fatigue where the person does not awaken easily and stays groggy until about 10AM.

2-from 10-12 feels awake especially after lunch,

3-starts getting a low about 2-4PM and then picks up again around 6PM,

4-with this burst they are tired again by 9-10 but if they remain up they get another energy burst until abut 1-2AM

5-best sleep is between 7-9AM,

6-during the day they need a lot of caffeine to keep going and

they  often crave salt and hyperventilate [frequent sighing and breaths]

7-liver spots [chloasma],

8-frequent colds and allergies

9-feelings of helplessness which causes more stress.

Clinical tests for adrenal fatigue:

  • Blood pressure drops >10mm/hg when going from supine to upright position.
  • The pupils cannot hold contraction when light is shone in the eyes.
  • Sergant’s sign=a line drawn on the abdomen remains white instead of turning red after a few minutes.

  • Rogoff’s sign= pain or tenderness over the adrenals when pressed. The adrenals are found below the posterior 12th rib. Just put the thumbs over them and let the patient breathe in and out.

Changes occur in carbohydrate, protein and fat metabolism, fluid and electrolyte balance, heart and cardiovascular system and sex drive. So this can lead to the below symptoms and signs. Listed also are some of the illnesses. Notice that so many of them are related to the depletion of hormones because without the proper carbohydrates, fats and protein (amino acids) the hormones cannot be made. Low cortisol also causes the intestine to promote leaky gut syndrome which does not allow normal nutrient absorption. This metabolic interference because of the adrenal influence of changing the carbohydrate, protein, fat metabolism and absorption can lead to other signs and symptoms that give clues to adrenal fatigue. But some of these can also go along with other pathologies, for example low thyroid (hypothyroidism). Low thyroid and adrenal fatigue very often comorbidities (they come on together). Hypothyroidism since the stomach cannot break down protein to amino acids so that the amino acid tyrosine cannot be made. Tyrosine hooks up with iodine to make T4. Also cortisone sensitizes the cell receptors to take in T3.

Additional Potential Problems of Adrenal Fatigue

Feeling tired despite sufficient hours of sleep, always fatigued
Insomnia
Weight gain
Depression
Hair loss
Acne
Reliance on stimulants like caffeine
Cravings for carbohydrates or sugars, hypoglycemia
Cravings for salt
Poor immune function
Intolerance to cold
Hypotension
Fibromyalgia
Hypothyroidism
Chronic fatigue Immune Disease Syndrome (CFIDS)

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Progesterone – the Brain Protector

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progesteroneBefore we get into the title of this blog I wish the reader to understand the difference of what the FDA considers progesterone and what is the true progesterone. The FDA considers progestin to be a true human hormone. This is completely false! The hormone that is provided by nature is progesterone which has a similar but different biochemical configuration then the synthetic progestin. The pharmaceutical companies cannot patent a natural substance so they substitute the biochemical configuration of natural substances (in this case progesterone) for profit. Their combination of synthetic estrogen and progestin was causing so many cardiovascular and cancer problems that it was evident that this combination was very hazardous to a woman’s health. So the Woman’s Health Initiative Study had to be terminated and not finished. Of course, the FDA did not pull this combination off the market and did not investigate the possibility of using true progesterone since economically their pharmaceutical colleagues would suffer. This incorrect usage of interchanging progestin with the natural progesterone has caused fear in some women to the dangers of hormone usage. Anyway this could be another blog in itself and maybe it will be if there is enough interest in the WHI study.

Most of the readers already know the job of progesterone of being an important woman’s hormone in the menstrual cycle and for gestation. So I will not take up the space with the known. I am going to enumerate other findings of progesterone just so the reader can either comment to me or do their own homework of researching these incredible findings

      1. It was found that women that had serious cerebral injury (called Traumatic Brain Injury [TBI]) and were hospitalized got out of the hospital on the average of 3 days earlier if they were on progesterone then women who were not on progesterone. For along time there was no answer to why this was. These TBI injuries in women are more and more common due to our involvement in wars, sports, and accidents . I presume that TBI always existed in large numbers but was not being diagnosed in the past, maybe because our technology is so much better today.

      2. It was then found that progesterone was needed along with cholesterol and omega 3s to produce the myelin sheath (the coating surrounding the cerebral nerves called neurons). This is similar to the insulation around an electric cord. Because of the coating the transfer of signals down the nerve is incredible faster then if the coating did not exist or was damaged. For more on TBI and Progesterone one can go to the internet and just look up this subject. One of the latest is by Miles Cekic in Future Neurology 2010:5. You can see from these articles that progesterone may be a source for curing certain demyelinating diseases (diseases with the myelin sheath involved) or at least in conjunction with other resources in men as well as woman. I believe it would also be worth investigating using progesterone in trials of diseases that have no cure but are known to be demyelinating diseases such as Multiple Sclerosis.

      3. For numerous years – thanks to John Lee M.D. We have known that progesterone and estrogen were important to prevent osteopenia and osteoporosis in women. Why these were not used more frequently then the pharmaceuticals is obvious. But I would like to add that I have found that testosterone in low doses is necessary to prevent and alleviate both former conditions; but still in conjunction with estrogen and progesterone. I have written on this topic in the testosterone blog and in my book (Emotional Vampires and your Hormones; an holistic physicians view of how stress affects your well-being and what you can do about it). Testosterone in natural physiological dosage for women is important for anti-aging. An informed physician can calculate the correct dosage for each individual so that side affects will not exist or the dosage can be minimally tweaked to prevent unwanted side affects.

young brunette sleeping at working time.

In the mists of time the acute stress response protected our survival. For example, it readied us for fight or flight from a saber tooth tiger. Our blood pressure went up, our heart and respirations were quickened; and our non-essential functions (hormones,digestive system) were stopped since one does not need them to fight or flight. All the previous adrenal-cortisol stress reactions are to get more blood, sugar and oxygen to the needed leg and arm muscles and brain for the flight or fight response. All this took minutes and then all went back to normal. One either escaped or not. If it was the latter then there was never stress again. The exact same cortisol stress-response occurs today but now it is a continuous stress response,7days a week, 24 hours/day. The stress response depends on the adrenal glands putting out cortisol for the flight -fight response to occur.  Though we have evolved in many ways there is no stress distinction between an acute or chronic stress response. The adrenal-cortisol reaction is the same for both!

When we have the adrenal glands working overtime due to chronic stress situations at first the cortisol output is high. When high the cortisol depresses the output of many of the  hormones and the digestive system since these are not necessary for flight or fight. The adrenal glands eventually wear out like any machine that is continuously abused. Therefore, the hormones of the adrenal glands, cortisol, adrenaline, and DHEA cannot be produced. This is similar to when the pancreas is forced to put out insulin all the time due to an high output of blood sugar for fuel for the flight-fight response. Cortisol stimulates the liver to utilize the liver’s glucose stores by putting the sugar into the blood for fuel.

Cortisol is a hormone that normally is secreted from the adrenal glands between 6-10 AM. The secretion time span depends on the person’s genetics and habits of time of rising. Theoretically it is put out to help the person awaken by stimulating an energy burst of glucose (sugar). Cortisol has many functions but here we are concerned with stress.

If he/she remains in stress and the adrenal glands persistently secrete cortisol we get into a potentially pathological state. At first the cortisol stays high all the time in order to stimulate the liver to put out sugar for fuel so the person can “fight or flight.” The high sugar levels stimulate the pancreas to put out insulin constantly to push the sugar into the cells via the cells receptors, which let the sugar enter the cells. There are a few sequels to this scenario. First the cells cannot use all the sugar that the cortisol-liver (sugar)-insulin axis delivers continuously, so it pushes it into storage as fat [triglycerides]. This gets deposited in women in the thighs and buttocks and then the abdomen. In men it is usually first deposited in the abdomen and then the other areas. Another thing that can happen to some people is the insulin surge may drop the blood sugar too much so they get what is called a reactive hypoglycemia ( This is not a true hypoglycemia). This makes the person hungry, lethargic, angry-aggressive and sleepy. This hypoglycemia is an added stress to the already ongoing stress. More stress! If stress continues to stimulate the adrenal glands and therefore high cortisol levels the adrenal gland fatigues out and produces low levels of cortisol or none. Now we have true adrenal fatigue. Also the receptors on the cells for insulin get tired of being consistently hit with insulin and develop a resistance to the insulin. The sugar stays in the blood causing high blood sugar. So the pancreas puts out more insulin to push the perceived needed sugar into the cells. This vicious cycle continues causing more cell receptor resistance evolving which we call Insulin Resistance. This is the first step to diabetes melitus (Diabetes II) and the Metabolic Syndrome [once called Syndrome X]. This fact is so important that I wrote a chapter in my book dedicated to diabetes and the metabolic syndrome.

This constant outpouring of cortisol can lead to numerous other problems that are not being addressed in the conventional medical world. One is the problem of osteopenia and osteoporosis. It is known that high night cortisol levels lead to bone absorption. For example, there is a warning that is posted on corticosteroid medications [ex. Prednisone]. It states that people on cortisol-like medications producing high cortisol levels can develop osteopenia, osteoporosis and stomach-intestinal ulcers.  Instead of investigating a stress causation and therefore high cortisol levels for why the person has osteopenia or osteoporosis the physician puts them on calcium, vitamin D and sometimes synthetic hormones.

If he/she does nothing to alleviate the stress situation eventually more breakdowns in the body occur. First the pancreas cannot keep putting out insulin constantly so it just runs dry and one has full-blown diabetes II. Similarly, the adrenal gland cannot keep putting out cortisol and it runs dry, so no more cortisol. And not mentioned yet is that while the adrenal gland is putting out cortisol it cannot at the same time put out DHEA (dihydroepiandrosterone) which cells need as an anabolic [building] hormone. Cortisol is a catabolic [breaking down] hormone. DHEA hormone is also a backup for making testosterone and estrogen when a person cannot produce it due to other problems such as aging. This lack of production of DHEA is very important as another body builder and energy stimulant. It is also an adjunct in the production of testosterone and estrogen especially in peri-menopausal and menopausal females.

In summary: cortisol when being abnormally secreted from the adrenal gland constantly due to stress is known as the death hormone. This is because it was created for the periodic fleeting flight or fight encounter. To enhance this response a lot of the other hormones are diminished by the cortisol since they are not needed to run or fight. These hormones include, estrogen, testosterone, progesterone, aldosterone (BP control) and thyroid hormone. Cortisol also shuts down the non-essential digestive system, raises blood pressure and heart rate. Prescription corticosteroids are used for allergies since they block the immune  response. Well so does high cortisol levels do to stress leaving the person without a good immune system and therefore illnesses to microbe infections. Just think of the illnesses that can occur without well functioning hormones,  digestive system and immune system. Another blog coming will soon give more functions and the symptoms and signs of Adrenal Fatigue Syndrome.

No wonder a person feels terrible and starts getting different illnesses when under stress. All these hormones are necessary for ones well being and anti-aging and they need to be in a state of homeostasis (balanced). In fact, sometimes the person believes that the prescribed hormone by the physician is not working; in reality it is, but it is the person that is still not doing anything about their stress. Therefore, they are counteracting a lot of the good affects of the prescribed hormone solution whether it is one of the sex hormones or thyroid or insulin by resisting seeing a counselor for stress. (See the blog on “Stress and your well-being”).

I believe in testing ones cortisol levels by a saliva test. Testing this way is for several reasons. Cortisol by nature changes its day-night production output (diurnal production). It is high in the AM and then by noon it is dropping and by evening it is down and even lower at midnight. It starts to go up again about 5-6 AM so that it can wake one up with a sugar spurt. A blood test would tell you the cortisol level at one particular time and not give the healer the knowledge of this diurnal trend which is needed in the diagnosis of one of the two stages of adrenal fatigue- too high or too low. Having blood drawn for some people is a stress and theoretically can cause an elevation of the cortisol level. Also with the right saliva test you get a calculation of the DHEA levels which is important in the adrenal fatigue diagnosis. It is important to know the DHEA level and compare this to the cortisol in order to really help the client.