Adrenal Fatigue, Adrenal Exhaustion and the Thyroid

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One common condition that frequently accompanies thyroid problems is adrenal exhaustion, also known as adrenal fatigue, or adrenal insufficiency.

About the Adrenal Glands

Your two adrenal glands are small, triangular-shaped endocrine glands located on the top of each kidney. Each adrenal gland is approximately 3 inches wide, and a half inch high.

Each gland is divided into an outer cortex and an inner medulla.

The cortex and medulla of the adrenal gland secrete different hormones. The adrenal cortex is essential to life, but the medulla may be removed with no life-threatening effects.

Hormones of the Adrenal Cortex

The adrenal cortex consists of three different regions, with each region producing a different group or type of hormones. Chemically, all the cortical hormones are considered steroids.

Mineralocorticoids are secreted by the outermost region of the adrenal cortex. The principal mineralocorticoid is aldosterone, which acts to conserve sodium ions and water in the body.

Glucocorticoids are secreted by the middle region of the adrenal cortex. The principal glucocorticoid is cortisol, which increases blood glucose levels.

The third group of steroids secreted by the adrenal cortex is the gonadocorticoids, or sex hormones. These are secreted by the innermost region. Male hormones, androgens, and female hormones, estrogens, are secreted in minimal amounts in both sexes by the adrenal cortex, but their effect is usually masked by the hormones from the testes and ovaries.

In females, the masculinization effect of androgen secretion may become evident after menopause, when estrogen levels from the ovaries decrease.

Hormones of the Adrenal Medulla

The adrenal medulla develops from neural tissue and secretes two hormones, epinephrine and norepinephrine. These two hormones are secreted in response to stimulation by sympathetic nerve, particularly during stressful situations.

A lack of hormones from the adrenal medulla produces no significant effects. Hypersecretion, usually from a tumor, causes prolonged or continual sympathetic responses.

Do You Have Adrenal Fatigue? The Symptoms of Adrenal Fatigue

When the adrenal glands are not functioning optimally, you can have a condition that is known as adrenal fatigue, or adrenal exhaustion. Adrenal fatigue often develops after periods of intense or lengthy physical or emotional stress, when overstimulation if the glands leave them unable to meet your body's needs.

Some other names for the syndrome include non-Addison's hypoadrenia, sub-clinical hypoadrenia, hypoadrenalism, and neurasthenia.

Symptoms include:

  • excessive fatigue and exhaustion
  • non-refreshing sleep (you get sufficient hours of sleep, but wake fatigued)
  • overwhelmed by or unable to cope with stressors
  • feeling rundown or overwhelmed
  • craving salty and sweet foods
  • you feel most energetic in the evening
  • a feeling of not being restored after a full night's sleep or having sleep disturbances
  • low stamina, slow to recover from exercise
  • slow to recover from injury, illness or stress
  • difficulty concentrating, brain fog
  • poor digestion
  • low immune function
  • food or environmental allergies
  • premenstrual syndrome or difficulties that develop during menopause
  • consistent low blood pressure
  • extreme sensitivity to cold

The adrenals produce hormones that help to balance your blood sugar, which helps your body to manage your daily ebbs and flows of energy. When blood sugar drops, the adrenals release hormones that cause the blood sugar to rise, and increases energy. The adrenals also release hormones when we're under stress, releasing energy. It's the "fight or flight" response from the days when we needed to run away from wild animals, which now kicks in for everyday stressors, such as traffic jams, arguments, and work pressures.

But being consistently under stress takes a toll on the adrenal glands, and eventually, they run out of steam, and stop producing sufficient hormones.

The concept of adrenal fatigue is somewhat controversial, and many conventional endocrinologists will simply not consider the diagnosis unless there is very extreme dysfunction in the adrenals, such as Addison's disease, a potentially fatal condition where the adrenals essentially shut down.

An integrative or complementary practitioner can do a 24-hour saliva cortisol/DHEA test to evaluate your adrenal function to diagnose more subtle dysfunctions in your adrenal glands.

If you are suffering from adrenal fatigue, what can you do? Here are a few tips that can help.

Physiologic Replacement Dose of Hydorcortisone

Some people with adrenal fatigue or unresponsive hypothyroidism have found that low-dose hydrocortisone at physiologic doses can help their immune system, and resolve many symptoms of adrenal fatigue. You will need a more open-minded, aware doctor to obtain this sort of treatment. Consider finding an integrative physician with expertise in diagnosing adrenal fatigue, providing supplement, nutrition and lifestyle support, and prescribing hydrocortisone when necessary.

Avoid Stimulants

As much as you may want them, stimulants are the equivalent of giving too much gas and "flooding the engine" in a car. It puts further stress on the adrenals to work harder and produce more energy, and ends up further depleting the adrenal glands. Things to avoid include: caffeine, ephedra, guarana, kola nut, and prescription stimulants.

Balance Your Blood Sugar With Your Diet

To minimize stress on the adrenal system, and ensure maximum energy, you should consider a low-glycemic (low-sugar) diet, consisting of sufficient protein and fat, low-glycemic carbohydrates, eaten in smaller, more frequent meals throughout the day. Sugar and simple carbohydrates put stress on the adrenal glands due by rapidly shifting blood sugar levels. By switching to vegetables and proteins, blood sugar remains more stable, providing less strain on the adrenal glands.

Use Adaptogenic Herbs for Energy

In the book Living Well With Hypothyroidism, herbal and aromatherapy expert Mindy Green of the Herbal Research Foundation offered some interesting recommendations about the use of herbs for energy, stimulation or adrenal support:

We live in a society that runs on stimulation -- whether it's coffee, or violence on television -- things that make us live on that edge. So while there are some excellent herbs and essential oils for adrenal support, people need to take care not to try these products along with other stimulants. When you're trying to tone your adrenals, you don't want to drink caffeine, or watch horror movies or violent news stories, for example. Instead of the simulating effect of aerobics, do something more calming, like yoga or tai chi. It's almost as if you need to train your body to run more on internal energy than outside energy and stimulation.

The way Mindy described it was that taking excessive stimulants when your endocrine or adrenal systems are depleted is like "like kicking a dead horse."

From an herbal standpoint, Mindy recommends Siberian ginseng, as opposed to regular ginseng, and astragalus, which is also good for immune support, as key tonics for the adrenal and endocrine systems.

In their book Herbal Defense, herbalists Robyn Landis and K.P. Khalsa discusses the benefits of Siberian Ginseng and astragalus, and also recommend several other herbs for thyroid support:

  • Fo-ti root (Ho Shou Wu) a Chinese herb that's broader and slower in action than -- but similar to -- ginseng
  • The Ayurvedic remedy Triphala, as a long-term glandular tonic
  • Black cohosh root, as a long-term glandular tonic

 

Herbal Teas and Mate -- NOT Coffee

The Herb Research Foundation's Mindy Green recommends the tea forms of several herbs, including chamomile, and melissa, which is also known as lemon balm, as relaxing herbal tonics. Mindy recommends that an easy way for a beginner with a relaxing tea is to get something like "Sleepytime Tea," by Celestial Seasonings. She also recommends mate, pronounced, "mah-tay," an herbal tea native to South America. Mate is considered far more nutritious than black tea or coffee, and though it also has some caffeine, it's effects are energizing, rather than making people jittery. On the scale of bad to good, coffee should be your last choice, followed by black tea, then green tea, with mate being the best option.

Other Supplements

Basic Multivitamin/ B Complex -- You will want to take a strong, balanced formula that provides decent amounts of key factors for adrenal and metabolic health. One formula I personally recommend is Jacob Teitelbaum’s “Daily Energy Revitalization" from Enzymatic Therapies, which replaces 30 different pills with one powder that you can mix into a drink.

Adrenal Glandulars -- Desiccated adrenal gland can be helpful to some people in supporting the gland, and replacing some missing adrenal hormones. Be sure to get a reputable brand from a reputable supplier, to ensure quality, potency and safety. These should only be taken under the guidance of a practitioner.

Pregnenolone, DHEA -- Pregnenolone and DHEA are hormones that can help resolve adrenal fatigue. Use of over-the-counter hormones is recommended only under the guidance of your practitioner.

This is by no means a comprehensive list of supplements or solutions. Your best option is to work with a practitioner to diagnose your adrenal fatigue, and to develop a customized treatment program that will help resolve this condition.

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