This is Dr. Lam.
Adrenal Fatigue-related health conditions can be broadly classified into five main areas.
First, we have metabolic system imbalances.
Now, anybody with severe Adrenal Fatigue will be able to tell you that they have a problem
maintaining their blood sugar at a level that is very, very steady.
Part of the reason is because hypoglycemia is commonly associated with Adrenal Fatigue,
even though, if you measure the blood level of the sugar, it is considered normal and
not considered low.
This is normally due to a combination of low cortisol and a high insulin level when the
body is under stress.
The normal stress response by the adrenal gland is to increase the blood sugar level.
However, glucose release is slowed as the output of cortisol reduces during later stages
of Adrenal Fatigue, such as what happens in adrenal exhaustion.
Hypoglycemia itself is a significant stress on the entire body, especially on the adrenal,
so you have a vicious cycle that goes on.
While this can be overcome by sugar fixes initially, in mild Adrenal Fatigue – and
that’s why people take Coca-Cola, or Pepsi Cola, or pop drinks, as well as donuts or
juices to give themselves that little boost, this is only a quick fix, and usually the
symptoms will come back after only a short time, usually within one or two hours.
This cycle, if it continues, this will make the person more drained, and towards the end
of the day, the person will feel nearly exhausted, without having done anything.
Low blood sugar is usually most likely to occur, therefore, around 10 AM and 2 PM, as
well as from 3-4 PM.
Hypoglycemia is also related to the autonomic nervous system dysfunction, which we will
describe later.
Secondly, we have a musculoskeletal system breakdown.
Now, collagen and protein are broken down in a catabolic state of function during Adrenal
Fatigue.
This can lead to chronic pain syndromes, joint pain, chronic fatigue, and fibromyalgia.
It must be remembered that the glucocorticoids, primarily cortisol, are steroidal hormones
produced by the adrenal glands as a response to stress.
Cortisol output is high in stage 1 and stage 2, and then as the Adrenal Fatigue progresses,
the cortisol output often is pushed to the limit, and then finally goes down.
As cortisol goes up, one of the side effects of this hormone is the breakdown of protein,
resulting in an overall net catabolic state, meaning the amount of buildup of the muscle
is less than the amount of breakdown, so as a result, broken down muscles are not adequately
replaced.
Collagen is broken down without significant replenishment.
Outwardly, wrinkles start to develop as premature aging sets in.
Internally, organs and muscle breakdowns tends to lead to chronic muscle and joint pains
of unknown origin, especially after strenuous exercise or heavy lifting.
Adrenal Fatigue therefore is often associated with poor ability to digest protein, as well
as the gastrointestinal systems tend to slow down.
This will only add to the musculoskeletal pain and syndromes.
It should come, therefore, as no surprise that that secondary fibromyalgia and chronic
fatigue are commonly associated with adrenal exhaustion.
Third, we go into neurological system dysfunctions, and this can be divided into various categories.
Because Adrenal Fatigue can lead to insomnia, sleep disturbances, brain fog, anxiety and
depression if the central nervous system is involved.
Peripheral nervous system dysfunction is often associated with orthostatic hypertension,
dizziness, lightheadedness, temperature intolerance, fainting spells, tingling and numbness sensation
of extremities, as well as sweating disregulation.
First we talked about central nervous system imbalances.
When you have imbalances of the adrenal gland, then what starts to happen is you have sleep
disorders.
Both too high and too low nighttime cortisol level can cause sleep disturbances.
Waking up between 1-3 AM is a characteristic of low blood sugar during this time, as well
as cortisol imbalances.
Sometimes it is accompanied by nightmares, sudden onset of heart palpitations, anxiety
attacks, and cold sweats.
Chronic lack of sleep is strongly associated with decreased immunity, as well, and impaired
glucose intolerance, as well as the decreased alertness and concentration.
Cortisol, DHEA, testosterone, and estrogen are key hormones produced by the adrenals.
Decreased levels of each of these hormones can reduce adrenal function, and also has
been linked to depression, which is a part of the central nervous system dysfunction.
It comes as no surprise that those with advanced Adrenal Fatigue are strongly associate with
an increase in fear, anxiety, depression, as well as difficulty concentrating.
A lot of people also complain of brain fog, which is a mental state where the memory becomes
clouded or unclear.
The exact physiology is not clear, but it’s postulated that excessive metabolite buildup
in the brain over time, due to poor clearance is a major factor.
It brings up a point that many people try to do detoxification to get themselves better
from Adrenal Fatigue, but improper detoxification can make the body worse, and make brain fog
more decompensated, and also can even trigger a retoxification reaction, if not done carefully.
The peripheral nervous system imbalances is quite significant.
The sympathetic nervous system, as well as the parasympathetic system, comprises the
autonomic nervous system.
The autonomic nervous system is what keep the unconscious housekeeping functions of
the body going.
They regulate blood pressure, body temperature, forces of the heart beat, as well as heart
rate.
A combination of sympathetic overtone, which is oftentimes what happens during Adrenal
Fatigue, is what’s responsible for many of the common symptoms, including heart palpitations,
blood pressure irregularity, as well as sweating.
Oftentimes, a sympathetic nervous system is activated because the body feels that it’s
in the danger state, and therefore activate the autonomic nervous system to compensate,
and as an emergency measure.
Unfortunately, the adrenalin released from the stimulation of the autonomic nervous system
can lead to all these side effects that we mentioned earlier, including panic attacks,
heart palpitations, strong heartbeat, irritable bowel, being wired and tired, POTS, orthostatic
intolerance, orthostatic hypertension, and also contribute to hypoglycemia, as well as
temperature intolerance.
One can also have neurotransmitter dysfunctions, such as glutamate, GABA, dopamine, norepinephrine,
epinephrine, histamine, serotonin, melatonin, acetylcholine, and nitric oxide.
These are all neurotransmitters that work in the body to maintain homeostasis, and there’s
no wonder that if you have Adrenal Fatigue and neurotransmitter dysfunction, you’re
going to have problems sleeping, depression, as well as an increase in allergies from the
histamine imbalance, serotonin imbalance leads to depression, melatonin imbalance leads to
insomnia, acetylcholine dysfunction, as well as nitric oxide dysfunction that can also
lead to either physiological states.
In the early stages of Adrenal Fatigue, mainly stage 1 and stage 2, serotonin levels tend
to be weakened, epinephrine and norepinephrine is elevated, and GABA tend to increase to
compensate.
As Adrenal Fatigue progresses, the cortisol output will start to fall, thyroid-binding
globulin tend to rise, leading to reduce in the T4 and T3, with a corresponding rise in
TSH.
DHEA increase in the body is put on overdrive, serotonin falls as the dopamine and norepinephrine
continue to rise, as a sympathetic nervous system is activated.
Number four, we have hormonal system imbalances and overload, and this can be divided into
several categories, the first category being adrenaline and norepinephrine overload and
reactive sympathoadrenal response.
A rise in the absolute level of adrenaline in the body leads to an increase in heart
rate, increase in blood sugar, respiration, reduce in serum potassium, as well as constriction
of blood vessels.
Unfortunately, in people suffering from adrenal exhaustion, the excessive activation of the
sympathetic nervous system leads to a massive amount of adrenaline and more adrenaline being
released, and that can remain in circulation for a long period of time.
In layman’s terms, the body’s internal thermostat appears to be malfunctioning, and
the body goes through wild metabolic and hormonal internal gyrations, like a rollercoaster,
with a lot of adrenaline flooding the system.
Laboratory studies, unfortunately, continue to be sub-clinical, unless a clinician is
alert that this reactive state is often missed.
You can also have estrogen and progesterone imbalances leading to a continuum of estrogen
dominance, such as PMS, endometriosis, PCOS, fibrocystic breast disease, breast cancer,
as well as irregular menstrual cycles.
Hormone imbalances can also include thyroid imbalances, which are very common, as you
can see.
Adrenal Fatigue is commonly associated with secondary hyperthyroidism, where the thyroid
laboratory tests may be normal, but the person is clinically sub-functioning in terms of
high thyroid, and can be considered hypothyroid.
There can also be cortical hormone imbalances, such as aldosterone imbalances, leading to
irregular blood pressure, as well as salt and fluid retention problems.
Lastly, there could be androgen imbalances, including masculinization effects from testosterone,
with symptoms such as seborrhea, dermatitis, acne, hirsutism, as well as velvety light
brown to black markings, usually on the neck.
In men, a low libido is often associated.
Finally, we have immune system dysfunctions with symptoms such as allergies.
The weaker the adrenal, the stronger the effects of allergens because of the histamine release,
and the less the cortisol is being secreted.
Therefore, you have less anti-inflammatory response.
Number two, you also have autoimmune disease.
These become more prevalent, such as Hashimoto’s disease, as well as rheumatoid arthritis,
because of the cortisol effect.
Thirdly, infection can be more prominent, and people can have recurrent infections for
no reason, it seems.
In summary, metabolic, musculoskeletal, neurological, hormonal, as well as immune system dysfunction
can all be independent, or they can be associated with Adrenal Fatigue.
If you have any of these symptoms and have failed to get better, and conventional medicine
has failed to give you any insight, you may want to consider them as part of the overall
Adrenal Fatigue picture.
I hope this presentation has been helpful to you to understand how Adrenal Fatigue is
related to many, many health conditions.
This complete article can be viewed in my public education website at www.DrLam.com.
Look for the article called “Adrenal Fatigue Related Health Conditions.”
If after reading, you have some questions, feel free to write to me from the website,
or if you need personalized attention, you can call my office.