Adrenal Fatigue: A Generally Unrecognized But Pervasive Syndrome

Original Internist, Dec, 2001 by James L. Wilson

Role of the Adrenal Glands

The purpose of the adrenal glands is to help the body cope with stress and survive. They secrete minute, yet precise and balanced, amounts of steroid hormones that have a considerable psychological and emotional impact, as well as significantly influencing the functioning of every tissue, organ, gland, and physiological process in the body. These hormones closely affect the utilization of carbohydrates and fats, the conversion of fats and proteins into energy (gluconeogenesis), the distribution of stored fat (especially around the waist and on the sides of the abdomen), the regulation of normal blood sugar, and the proper function of cardiovascular and gastrointestinal musculature. It is their anti-inflammatory and antioxidant protective activity that helps minimize allergic reactions to foods and the negative effects of alcohol and drugs. After mid-life (menopause in women), the adrenal glands gradually become the major source of the sex hormones circulating throughout the body in both men and women. These h ormones themselves have a whole host of physical, emotional and psychological effects, from the level of the sex drive to the tendency to gain weight. Every athlete knows that adrenal hormones, known as steroids, greatly influence muscular strength and stamina.

What is Adrenal Fatigue?

Because the adrenal glands are designed to be so very responsive to changes in ambient or internal environment, any number of factors can interfere with the finely tuned balance of adrenal hormones. Normally, this is not a problem, and the adrenals are able to respond appropriately to stresses from every possible source, ranging from injury and disease to work and relationship problems. However, if they are unable to adequately respond to the total amount of stress placed on the body, adrenal hormones (especially cortisol and aldosterone) fall instead of rise. This creates a state of maladaptation called hypoadrenia or adrenal fatigue. Although adrenal fatigue can result from a single stressor, more commonly it is the product of cumulative physical (thermal, chemical, biochemical, metabolic), emotional, and psychological stresses acting in concert.

The most extreme form of hypoadrenia, Addison's disease, is the only form of adrenal fatigue officially recognized by modern medicine. It is often life threatening if untreated and commonly involves actual structural damage to the adrenal glands. People suffering from Addison's disease usually have to take corticos-teroids for the remainder of their lives in order to function. Approximately 70% of Addison's cases are autoimmune disease; the other 30% are termed idiopathic and stem from a variety of causes. John F. Kennedy suffered from this disease as a result of his PT boat being torpedoed during World War II. Luckily, Addison's disease is the rarest form of adrenal fatigue, with an occurrence of only about 4 persons per 100,000.

Adrenal fatigue more commonly manifests itself within a broad spectrum of less serious, yet often debilitating, disorders that are only too familiar to most people. The lower end of this spectrum has been known by many names throughout the past century, such as non-Addison's hypoadrenia, sub-clinical hypoadrenia, neurasthenia, adrenal neurasthenia, adrenal apathy, and adrenal fatigue. However, I prefer the name adrenal fatigue because it most aptly describes this common syndrome whose paramount symptom is fatigue. Adrenal fatigue affects millions of people around the world in many ways and for many reasons. Regardless of the fact that modern medicine does not recognize it as a distinct syndrome, it can wreak havoc with a person's life.

Although fatigue is a universal symptom of low adrenal function, it is such a common complaint and occurs in so many other conditions, that today's medical doctors rarely consider pursuing an adrenal-related diagnosis when someone complains of it. In fact, physicians 50 years ago were far more likely than their modern counterparts to correctly diagnose this ailment. Information about non-Addison's hypoadrenia has been documented in medical literature for over a 100 years, but unfortunately this form of hypoadrenia is missed or misdiagnosed in doctors' offices every day, even when the patient clearly presents its classic symptoms. Adrenal fatigue is all too often the cause of patients' rundown feeling and inability to keep up with life's daily demands. The fact that it usually remains undiagnosed does not diminish its debilitating effects People with adrenal fatigue often live with a general sense of unwellness or "gray" feelings. Their fatigue is most prevalent in the morning, especially upon rising, and so t hey often have to use coffee, colas, and other stimulants to get going in the morning and to keep going during the day. As their condition worsens, it lays the foundation for other seemingly unrelated conditions, such as hypoglycemia and associated blood glucose dyscrasias, more frequent respiratory infections, increased allergic reactions, increased propensity towards anaphylaxis, chemical and food sensitivities, exacerbation of autoimmune disorders, and a number of other health problems, such as fibromyalgia and chronic fatigue syndrome. Athletes suffer from poorer performance, increased recovery time, and less muscular strength. There is also a tendency to experience increased arthritic pain when there is decreased adrenal hormone output.