The adrenal glands sit on top of the kidney and receive input from the pituitary. They are the main producers of adrenaline and cortisol, necessary for a healthy stress response. Unfortunately, over time, usually due to chronic stress, toxicity exposure and other factors, these glands can be become stressed, and either produce too much cortisol or too little.  This is often the cause of either unexplained weight gain or weight loss.

Adrenal dysfunction is often misdiagnosed by conventional medicine; and, as a result, often antidepressants, antianxiety medicine, and thyroid medicines are inappropriately prescribed. Unfortunately, these medicines either have no effect or they make the situation worse and the person may become either more anxious or fatigued. Dr. Lam MD summaries this process as well as the stages of adrenal fatigue here. Dr. Shallenberger, MD, who has been practicing Integrative Medicine for many years, has a great presentation as well. See the video below:

Diagnosis

Adrenal fatigue is usually dismissed by conventional medicine. Most doctors are taught about the extremes of cortisol dysfunction, such as in Addison's and/or Cushing's disease, and therefore often overlook more functional problems of low cortisol. Patients who complain of chronic fatigue are often dismissed as being lazy or depressed. The standard of care is to look for abnormal levels of cortisol and other parameters in a blood test. Unfortunately, this testing often misses what is known as chronic hypocortisolism (low cortisol).

Functional testing for abnormal cortisol looks at saliva over the course of 24 hours, which gives a more accurate representation of one's daily cortisol production. 24-hour urine testing, fasting blood cortisol, DHEA-s, and insulin levels are also good measurements and can determine if one is suffering from too high or too low cortisol.

Functional laboratory testing offers more simplified, inexpensive, and standalone adrenal stress testing. The DUTCH test combines saliva hormone and cortisol testing for a more advanced evaluation.

Treatment

Many of those who suffer from low cortisol need advanced nutritional and dietary support. Herbal and/or adrenal glandular supports are sometimes necessary to support adrenal health until the body becomes more balanced. If all else fails, sometimes low-dose hydrocortisone therapy is sometimes needed for a period of time to support adrenal function.

Those who have too high cortisol production may benefit from calming herbs at certain times of the day such as lavender and ashwagandha, as well as things like phosphatidylserine to lower cortisol levels.

If you suspect you have altered adrenal function, please contact our office for further evaluation and treatment.