When taken as a group, these signs and symptoms do form a specific syndrome or picture - that is of a person under stress. These signs and symptoms are the end result of acute severe or chronic excessive stress and the inability of the body to reduce such stress. Stress, once a "basket" term used by physicians to explain non-specific symptoms undetectable by conventional blood test, is of no mystery to the body at all. The ability to handle stress, physical or emotional, is a cornerstone to human survival. Our body has a complete set of stress modulation system in place, and the control center is the adrenal glands. When this gland becomes dysfunctional, our body's ability to handle stress reduces, and symptoms will arise.

Is adrenal fatigue related to other health conditions?
The processes that take place in any chronic disease, from arthritis to cancer, place demands on your adrenals. Therefore, as a general rule, if morning fatigue is a symptom of the chronic disease, the adrenals are likely fatigued so some degree. Also anytime a medical treatment includes the use of corticosteroids, diminished adrenal function is most likely. All corticosteroids are designed to initiate the actions of cortisol, a hormone secreted by the adrenal glands, and so the need for them rises primarily when the adrenals are not providing the required amount of cortisol.

 
What is cortisol and how does it effect my health?

The most important anti-stress hormone in the body is cortisol. Cortisol protects the body from excessive stress by:


Normalizes blood sugar - Cortisol increase blood sugar level in the body, thus providing the energy for the body to physically escape threat of injury  in order to survive. Cortisol works in tandem with insulin from the pancreas to provide adequate glucose to the cells for energy. More energy is required when the body is under stress from any source, and cortisol is the hormone that makes this happens. In adrenal fatigue, more cortisol is secreted during  the early stages. In later stages ( when the adrenal glands become exhausted), cortisol output is reduced, and blood sugar balance becomes a problem.

Anti-inflammation Response - Cortisol is a powerful anti-inflammatory agent.  When we have a minor injury or a muscle strain, our body's  inflammatory cascade is initiated, leading to swelling and redness commonly seen when a ankle is sprained or an insect bite. Cortisol is secreted as part of the anti-inflammatory response. It's objective  is to remove and prevent swelling and redness of nearly all tissues. These anti-inflammatory responses prevent mosquito bites from enlarging, bronchial tress and eyes from swelling shut from allergies, and swelling from being too intense.

Immune System Suppression - People with high cortisol levels are very much weaker from the immunological point of view. Cortisol influences most cells that participate in the immune reaction, especially white blood cells. Cortisol suppresses white blood cells, natural killer cells, monocytes, macrophages, and mast cells. It also suppresses  the auto-immune system response to foreign insult.

Vaso-constriction - Cortisol contracts mid-size arteries. People with low cortisol (as in advance stages of adrenal fatigue) have low blood pressure and reduced reactivity to other body agents that constrict blood vessels. Cortisol tends to increase blood pressure that is moderated by calcium and magnesium.

Physiology of Stress - People with adrenal fatigue cannot tolerate stress and will then succumb to severe stress. As their stress increases, progressively higher levels of cortisol are required. When the cortisol level cannot rise in response to stress, it is impossible to maintain the body in optimum stress response. In this respect,  we can conclude that stress does kill.

In summary, cortisol sustains life via two opposite but related kinds of regulatory actions: releasing and activating of existing defense mechanisms of the body and shutting down and modifying the same mechanisms to prevent them from overshooting and causing damage or cell death.



Cortisol Regulation

The adrenal glands are controlled via the hypothalamus-pituitary-adrenal (HPA) axis. There is an existing negative feedback loop that governs the amount of adrenal hormones secreted under normal circumstances. For example, the HPA axis adjusts cortisol levels according to the body's need via a hormone called Adrenal Corticotrophic Hormone (ACTH) that is secreted from the pituitary gland in response to signals from the hypothalamus. When the ACTH binds to the walls of the adrenal cells, a chain reaction occurs within the cell. This leads to the release of cholesterol where it is manufactured into pregnenolone, the first hormone in the adrenal cascade. After this, cortisol is released into the blood stream where it travels in the circulatory system to all parts of the body and back to the hypothalamus, where it is measured. This completes the negative feedback loop.

Cortisol and ACTH are not secreted uniformly throughout the day. They follow a diurnal pattern, with the highest level secreted at around 8:00 a.m. in the morning after which there is a gradual decline throughout the day. Episodic spikes during the day can also occur when the body is stressed or when certain foods are taken. The cortisol level is lowest between midnight and 4:00 a.m.


Does Adrenal Fatigue affect the Thyroid Gland?
Approximately 80% of the people suffering from adrenal fatigue also suffer some form of decreased thyroid function. People shown to be low in thyroid but unresponsive to thyroid therapy are most likely suffering from adrenal fatigue as well. For these people to get well, the adrenals must be supported in addition to the thyroid.


Are presription drugs necessary to treat Adrenal Fatigue?
NO, most cases are remedied without prescription drugs. Natural dietary supplements and lifestyle changes are the most effective form of adrenal fatigue treatment. These supplements are natural, relatively inexpensive and very effective.


How does Adrenal Fatigue progress? Can it get worse?
Diseases progresses through stages normally as the body decompensates. Let us take a closer look:

          

ADRENAL FATIGUE PROGRESSION

Stage 1: Alarm Reaction (Flight or Fight response)

In this stage, the body is alarmed by the stressors and  mounts an aggressive anti-stress response to reduce stress levels. Some doctors called this the Early Fatigue stage.
Typically, there is an increased ACTH from the pituitary gland that stimulates the adrenal glands into full gear to mount an retaliation response. The adrenal medulla is stimulated to secrete more epinephrine, and the total cortisol output from the adrenal cortex  is increased from the excitatory stimulus. There is a corresponding reduction in DHEA production. During this period, the  body needs cortisol to overcome stress, and production of cortisol is therefore  increased. After some time, the adrenals will experience difficulties in meeting the body's ever increasing demand for cortisol.

Stage 2: Resistance Response

With chronic or severe stress, the adrenals eventually are unable to keep up with the body's demand for cortisol.  As such , the  cortisol output  will start to decline from a high back to a normal level,  while the ACTH remains  high. With protracted ACTH and adrenal fatigue, less cortisol is produced due to the adrenal becoming exhausted. While the morning, noon, or afternoon cortisol levels are often low, the nighttime cortisol level is usually normal.

A phenomenon  called pregnenolone steal (also called cortisol shunt) sets in. Cortisol production becomes the predominant pathway of hormone production as the body favors the production of this hormone. Other hormones such as pregnenolone, DHEA, testosterone and estrogen are less favored and their production will decline. As a result, total pregnenolone output is reduced but total cortisol output continues to be maintained at a normal level. Careful analysis of the daily diurnal cycle of cortisol shows a dysfunctional pattern of abnormally low cortisol in the morning. This is  a time when cortisol is needed the most. Nighttime cortisol is usually still normal.

Stage 3: Exhaustion

Despite rising ACTH, the adrenals are no longer able to keep up the increased demand for cortisol production. This may happen over a few  years. Total cortisol output is therefore reduced, and DHEA falls far below average. The nighttime cortisol level is usually reduced as the hypothalamic-pituitary-adrenal axis "crash" and the body is unable to maintain homeostasis. Severe sex hormonal imbalances (estrogen, progesterone, and androgens) are common and a precursor to adrenal failure.

Stage 4: Failure

Eventually, the adrenals are totally exhausted. Patients at this stage have a high chance of cardiovascular collapse and death.
 

Does Adrenal Fatigue effect women differently than men?

Yes, the adrenal glands contribute about 35 percent of female hormones pre-menopausal and almost 50 percent post-menopausally. Furthermore, without the proper functioning of the adrenal glands, pregnancy cannot occur.

Estrogen Dominance.  Today, women often have exhausted adrenal glands by the time they reach their mid-thirties or early forties due to a stressful lifestyle.  Stress is regulated by our adrenal glands primarily. In  early stages  of adrenal fatigue, cortisol output is high as the body attempts to neutralize the stress by producing more of it. However, when too much cortisol is produced, it will have multiple undesirable effects. For example, cortisol blocks progesterone receptors, making them less responsive to progesterone.   Progesterone normally produced by the adrenals comes to a halt in favor of cortisol. Insufficient progesterone production leads to an imbalance of estrogen to progesterone.  With reduced  progesterone to offset estrogen, the body may experience estrogen dominance and a host of undesirable side effects associated with excessive estrogen. This leads to a condition known as estrogen dominance. It is no coincidence that we see a proliferation of conditions associated with excessive estrogen such as PMS, fibroids, and pre-menopausal syndrome when a women reaches their mid thirties and early forties.

Adrenal normalization should precede hormone modulation. The adrenal glands deal with the daily stresses of life. A woman must normalize her adrenal glands in order to have a total body hormonal balance. In fact, replacement of deficient hormones alone without addressing the overall health of the adrenal gland is a band-aid approach and often ineffective in the long run. The normalization process can begin with investigating and eliminating stressors. Stressors are often chronic in nature, and can be related to lifestyle, dietary, mental, and inflammatory causes.