Adrenal Clinic
Adrenal fatigue has been dubbed ‘The 21st Century Stress Syndrome.’ Some doctors don’t even think it exists, but I have found it in epidemic proportions and sometimes feel I’m running an adrenal clinic!
In fact, adrenal fatigue is why I became a nutritionist in the first place. I suffered from terrible chronic fatigue and was found to be adrenally exhausted. It was only by correcting the hormone output of the adrenals I recovered – to this day, I still need to watch it if I am under stress! This personal experience inspired me to train and want to help others with this horrible crushing tiredness feeling.
If someone comes in with chronic fatigue, I automatically think about what the adrenals might be up to and test if needed. People often think that their thyroid might be a bit sluggish and causing their fatigue, but not many people know much about the adrenal glands, and the thyroid and adrenals are linked so much that one can often affect the other. In fact, sometimes people are just what I would term ‘glandularly weak’ and glands like the pituitary, pancreas, thyroid and adrenals tend to be a bit sluggish.
I thought it might be useful for you to learn more about what the adrenals are and about this subject so here is some info supplied by Nutri-Link, a fab supplier of mine which tends to specialise in glandular issues like these.
Following this intro, you’ll find the Adrenal Plan, my 123 page ebook on how to test and treat adrenal fatigue. I hope it helps.
What are the Adrenal Glands?
The Adrenal Glands are two triangle-shaped glands that sit atop the kidneys. Their primary function is in regulating the release of energy, especially in periods of stress.
The Adrenal Glands are responsible for producing sudden bursts of energy during emergencies, also known as the ‘Fight-or-Flight’ response. This response is a valuable tool in human survival since it enables the body to perform at increased strength, energy, and levels of awareness during moments of possible danger.
In addition to emergency response, the Adrenal Glands are also vital in the body’s reaction to stress. The body reacts to minor stressors in the same way it does to large stressors, just to a smaller degree.
Today we are often subject to an almost endless number of daily stressors, from emotional stressors: children, money, marital issues; to physical stressors: fatigue, diet, lack of exercise. Whenever the body is stressed, it reacts in order to adjust to the stimuli. In the case of stress, the body releases cortisol, a stress hormone that allows the body to cope with stress and attempts to eliminate it.
As the Adrenal Glands are responsible for the production of Cortisol, they are also key in the production and regulation of various other hormones, including dopamine, epinephrine, norepinephrine, aldosterone, and dehydroepiandrosterone (DHEA).
What is Adrenal Fatigue?
Adrenal Fatigue is the state at which the Adrenal Glands may be unable to perform at their optimal levels of hormone and steroidal production.
When the Adrenal Glands are continuously taxed from overuse of stimulants, lack of sleep, poor diet, lack of exercise, stress, and other lifestyle factors, the glands are forced to work harder to keep up with the levels that you are demanding.
As your Adrenal Glands continue to work in ‘overdrive’, the Adrenal system is eventually unable to maintain fully functional at such a demanding pace; the result is an uneven hormonal balance. Since the Adrenal hormones are vital for many of the body’s processes, Adrenal Fatigue is generally accompanied by persistent fatigue, feelings of depression, cravings for sugar or salty foods, and sleep problems.
Here is a quick video of a news report in Australia about adrenal fatigue showing a doctor saying it doesn’t exist and a woman suffering from chronic fatigue and anxiety who certainly knows it does!
What are the Warning Signs of Adrenal Fatigue?
- Morning fatigue. Not seeming to “wake up” until 10 am even though you’ve been up for 3 hours.
- Middle of the afternoon “Low”. Sluggishness and clouded thinking in the middle of the day.
- Burst of energy around 6 pm.
- Sleepiness around 9pm, but a “Second Energy Burst” around 11 pm till 1 am.
- Mild depression, decreased sex drive, lack of energy and lack of focus/concentration
- Muscular weakness and declining endurance
- Weight gain (especially around the midsection), with extreme difficulty in losing it
- Unrelaxing or unfulfilling sleep
There are also quite a few relatively unrecognised signs of adrenal fatigue, especially when it is chronic and been going on for a long time. Have a look at this, albeit quite technical, article from Dr Lam:
Adrenal Fatigue Related Conditions Beyond Excessive Tiredness
You’ll understand why we also try and test the thyroid, neurotransmitters and hormones as well as the cortisol and DHEA levels to get a fuller picture! You can see the hormone and neurotransmitter tests if you need them on the shop.
What Causes Adrenal Fatigue?
Adrenal Fatigue typically results from the combination of several lifestyle factors and stressors, each of which requires the body to work longer and harder. As a result of these lifestyle factors, the Adrenal Glands become ‘exhausted’ and may be unable to function properly. When the Adrenal system is unable to function properly, the body’s natural energy levels decline, mood often declines or is unstable, sleep disorders may arise, and other problems can be typical.
The most common factors that contribute to Adrenal Fatigue are stress (physical and emotional), stimulant use, nicotine, poor diet, lack of exercise or too much of it, insufficient sleep, and a lack of relaxation. Most people will not have every one of these factors present in their daily life; each of these can cause unbalance in the body, which leads to Adrenal Fatigue.
For instance, it is possible to exhaust your Adrenal Glands without the use of stimulants or even without excessive stress. A combination of multiple factors will accelerate the rate at which the Adrenal Glands are fatigued. An overabundance of stress along with lack of sleep and relaxation is enough in itself to cause fatigue issues.
How can Adrenal Fatigue be Reversed?
Adrenal Fatigue may be overcome when healthy choices are made in lifestyle, diet, exercise, and stress avoidance. Depending on the severity of your Adrenal Fatigue, restoring your Adrenal health can take anywhere from a few months to over a year.
With lifestyle changes, most people can restore their energy levels within a short period of time. While natural energy production might return within a short period of time, it can take significantly longer for the Adrenal System to function properly, produce normal hormone levels, restore natural function, and repair Adrenal damage.
The most important thing aspect to take into consideration is your lifestyle. Stress, stimulants, lack of sleep, improper diet and exercise, and stressors all place a significant toll on your Adrenal Glands. By reducing the number of stressors in your life and reducing the amount of stimulants (ie coffee, nicotine, cola’s, etc) that you ingest, you will allow your Adrenal Glands to operate at more healthy levels.
Other than that, depending on what stage adrenal output you are at, there are protocols to follow to boost adrenal function. This is dependent on having the right level of the right nutrients in the right place just at the right time. You can use different supplements to help and these might include tyrosine, ginseng, calcium pantothenate, so-called glandular products that act like little spark plugs or myriad other things depending on your case.
I have now written down the full clinic Adrenal protocol for you to follow. This is what I have used successfully in-clinic for over a decade.
Adrenal Testing Summary
Use the Genova Adrenal Test, which is nice and simple but effective; I’ve used it for years. If you want a more detailed look at how you are metabolising cortisol and other hormones, use the DUTCH test. If you need to look at CAR, waking cortisol and need 6 cortisol samples, use the Labrix Comprehensive Adrenal test.
You can read a lot more about adrenal testing and see my video on the DUTCH test here. You can see the Adrenal Plan and Hormone Results Guide, including adrenals here.
Most people want to see what their cortisol and DHEA are up to during the day. You can do that using the Genova Adrenal Stress test which measures 4 salivary cortisols and total DHEA samples. This gives you the info you need to see what’s most likely going on, where issues in the day might be and when to take boosters or calmers etc.
The Cortisol Awakening Response (CAR)
In some cases, you can see an adrenal problem developing before it shows in the normal testing scores by measuring the CAR, cortisol awakening response, so it can be worth including that. The CAR essentially is the spike we experience on waking and within the first 30 minutes. If your CAR is below 50%, it shows you are not able to mount a wakening response and there is an adrenal issue, even if it isn’t showing on the main test parameters. You can add CAR onto the standard adrenal test if you wish.
Secretory IgA (SIgA)
SIgA is extremely useful and not enough people check it. You can read my SIgA factsheet here, but essentially it is the marker for gut and mucosal immunity and it ‘tags’ food as ‘safe’ or not. If you don’t have enough, it can explain why you can’t get rid of infections or chronic symptoms and is an answer to why you are developing ever more food and chemical sensitivities. If it’s too high, it suggests inflammation or acute reaction somewhere to, eg. a parasite or allergen. SO useful. You can usually add SIgA onto the standard adrenal test if you wish.
The DUTCH Test
The DUTCH test stands for Dried Urine Test for Complete Hormones.
Rather than the normal salivary test, they measure adrenal function using dried urine samples and include several metabolites which can give you more information, for example, on more hidden adrenal issues. The simplest is the DUTCH Complete.
You can read a blog post I wrote about the DUTCH tests here. You can see more info including collection instructions etc on DUTCH tests here.
The Adrenal Plan
The Adrenal Plan is based around the Genova tests and shows you what to do with your results, the protocols to use etc. In over a decade of use in-clinic, I have found this a very useful test and the Plan sorts most people out. There are two versions of the Adrenal Plan: one normal and one TrulyGlutenFree version, which contains grain and dairy free supplement protocols.
https://shop.purehealthclinic.co.uk/Adrenal-Plan-p48202844
https://shop.purehealthclinic.co.uk/TGF-Adrenal-Plan-p48202849
Don’t put up with that horrible feeling any longer. Get the Adrenal Plan and start sorting it out! Most people feel much better after 3-4 months on adrenal recovery in my clinical experience, so don’t put up with that horrid feeling any longer, download it straightaway here.
Just a quick note to say I really think this is excellent – well done. I had a passing dream of you being able to educate GPs with this document – how to make this happen…?
Well done Micki! For being very thorough, and explaining everything in simple terms! I think your writing style is fluent and readable, and you draw the reader through the entire subject in a logical and convincing way. I also really liked the supplement contents lists, and links to be able to source things.
Testing Tips…
Steroids like the pill, inhalers , creams etc and any adrenal or thyroid-boosting supplements might affect results. The lab advises you stop them 48 hours before taking the test unless monitoring yourself on them. Please be advised by your health professional before stopping anything.
Long term steroids may also affect cortisol levels and they can show artificially high. If you are on long term steroids, you may not get reliable results. If stopping a steroid medication (via your doctor), you are advised to wait 2 months before adrenal testing to allow them to come out of your system.
Always follow what the lab notes in your test kit tell you to do re avoidance of stuff before testing. There is a useful run-down of adrenal-affecting meds and foods etc here on STTM which might be useful too.
If you are on hormones or DHEA/& Keto-Zyme, ZRT have some useful instructions here for salivary adrenal testing: https://www.zrtlab.com/media/1144/saliva-testing-instructions.pdf.
Freezing time. Genova advises that frozen saliva samples are stable at room temperature for 3 days and frozen for 1 month. In other words, you can freeze your samples for a good few days if you have to hang on a bit before sending.
CAR: With CAR we want to get the measurement from when you naturally wake, so if you wake up at 4am, for example, take the samples then and 30 minutes later. The best is to wake naturally at your normal time, not measure an ‘odd’ day where you wake early or something.
Children: DUTCH do not have reference ranges for children. You wouldn’t test certainly before they’ve gone through puberty and a bit beyond.
Good luck!