Adrenal Fatigue

A Primer on Effects and Dangers

I never learned the term "adrenal fatigue" in medical school. You cannot find it in medical textbooks nor will you hear it discussed on clinical rounds.

Conventional medicine is not exactly cutting edge when it comes to hormone balance, saying healthy or anti-aging. "Adrenal fatigue" is a term for people who are trying to be healthy and correct problems that are not diagnosable as illnesses by conventional means.

"Adrenal fatigue" is a label or diagnosis specific to alternative and integrative medicine. The term often springs up when a patient presents with an exhaustive list of symptoms and no one in conventional medicine can figure out what is wrong with the patient. As a result these patients, who refuse to accept a pat on the back or an antidepressant as a consolation prize, move on to integrative medicine and alternative medicine doctors and eventually may find themselves with the diagnosis of "adrenal fatigue".

The symptoms include but are not limited to the following: exhaustion, weight gain around the waist, mental fogginess, sleep disturbances, bloating, depression, anxiety, palpitations, night sweats, loss of libido, muscle and joint pains, etc.

The list of symptoms is so long that you can probably add anything you may experience that no physician is helping you with. "Adrenal fatigue" is now what Chronic Fatigue Syndrome was in the 1990s.

I must admit that I felt uncomfortable making that diagnosis in the 1990s and thus I find it a bit worrisome to throw my patients into the "adrenal fatigue" bin in the 2000s. Just like its predecessors, CFS, fibromyalgia, leaky gut syndrome, chronic EB virus and other diagnosis of exclusion, "adrenal fatigue" is a diagnosis that both integrative physicians and patients cling onto in hope of solving serious lifestyle, diet, exercise and hormone problems not resolved with other methods of help.

The problem with adrenal fatigue is that there is no way to diagnose it. There is no road map, no protocols established by experienced scientists or clinicians. All we really know about "adrenal fatigue" is that before you really get sick enough to carry a conventionally acceptable diagnosis, after you have been totally disappointed by the conventional system, many integrative physicians use "adrenal fatigue" as a working diagnosis to try to get you back on your feet. For the past 12 years I have been working with hormones and successfully helping women and men get healthy and stay healthy away from the conventional medical mindset, I have found it important to configure the adrenals in the mix of hormones, treatments and areas to cover.

Initially, since I am a conventionally trained physician, I could only deal with one diagnosis at a time. Estrogen, progesterone and testosterone deficiencies I treated with bioidentical hormones with great results. I was encouraged and continued the treatments. I even developed protocols that are now in use with other conventional physicians with the same great results. In time I realized that unless I addressed the thyroid gland and its deficiencies, my great results would be limited. So I developed expertise in thyroid and now add the thyroid to the treatments.

Diet, exercise, lifestyle, stress management and sleep are key to keeping us alive, healthy and well for as long as possible. Early on I started addressing them too. The results my patients experienced got better all the time.

Last year I finally approached the adrenals. My knowledge was limited to adrenal diseases. They are few, poorly understood and even more poorly treated by conventional medicine. No need to even go over them, they are so distant from what you think of when you think "adrenal fatigue". Finally, I started to look at my patients with an eye out for adrenal issues. I learned the treatments from alternative and integrative doctors who specialize in the area and only found the need to integrate those treatments with the other little pieces of the puzzle of our lives I now deal with in every patient I see. "Adrenal fatigue" is not yet another answer to your prayers for solutions to your feeling crummy. It is another piece of the puzzle.

If you are not honestly addressing your diet, exercise, sleep, relationships, thyroid, estrogen, progesterone, testosterone, supplements, air you breathe, etc. treating your adrenals for a supposed diagnosis of "adrenal fatigue" will not make things better.

In my practice, I work with the whole patient and when we treat adrenal issues, I look at as many parameters as possible before starting adrenal supplementation with adrenal extract (Isocort) or DHEA. These are medications I add when the patient and I have worked through as many of the other variables as possible and the results still leave something to be desired.

I don't want to discourage you from following the "adrenal fatigue" trail. I just want you to be clear that the only way to stay healthy and get better is to make little, smart changes in as many areas of your life as possible.

Read on to find out more about stress management