Michael McEvoy, FDN, CNC, CMTA

Conventional medical diagnostics still fails to recognize adrenal fatigue as a real problem. Tell this to the millions of people who suffer from depleted adrenal function, chronic fatigue and symptoms of exhaustion and complications that are associated with these symptoms.

Dysfunction of the adrenal glands has become one of the most ubiquitous components of chronic illness. Adrenal fatigue can be the cause of and be caused by numerous complications and health issues. This is due to the fact that the hormones produced by the adrenals are involved in so many biological processes in the body. Take away or deplete the production of these critical steroid hormones and there will be a seemingly endless cascade of health issues.

The Complexities of Adrenal Function

The adrenal glands have been called the most powerful glands in the body. The hormones they produce, chiefly DHEA and Cortisol are involved in so many biological functions, it is hard to keep track. The roles these hormones are involved in include:

• Managing the body's stress responses
• Digestive functions
• Anti-inflammatory processes
• Fluid dynamics
• Thyroid Function
• Sodium retention
• Blood Sugar Regulation
• Musculo-skeletal health
• Immune Function
• Heavy Metal Detoxification Capacity
• Quality of Sleep
• Mood, Energy, Mental Clarity
• Mucosal Surface Integrity

Adrenals & Gut Function

While it is critical to identify adrenal insufficiency and support them, this is only a part of the picture. Depleted adrenal function can result in several serious problems including breakdown of gut function. The feedback loop can be a two-fold blocking factor also, because damaged gut function can cause the adrenals to breakdown as well.

Take for example a chronic digestive disease like Ulcerative Colitis or Crohn's Disease. These conditions result in devastating amounts of cellular breakdown (catabolic activity) in the gut. This breakdown of gut function demands a strong, anti-inflammatory response headed by the production and release of cortisol, an anti-inflammatory hormone produced by the adrenals. The continuous breakdown of digestive function associated with chronic diseases like Crohn's or UC, results in the depletion of adrenal hormones. Just ask someone with these diseases how stress effects their digestive function. They will very often tell you that external stressors make their symptoms worse!

It is extremely common that high levels of external stressors will cause an intensification of adrenal activity, and that cortisol/anti-inflammatory feedback loop will continue. Over time, this wears away at the adrenals, and their ability to continuously meet the internal and external stress demands.

Take another factor in gut function: food allergies and sensitivities. These factors can result in serious auto-immune processes, causing a breakdown of the delicate villi and mico-villi in the gut, and a loss or depletion of intestinal surface integrity and immunoglobulins. In these inflammatory states, not only is their loss of surface mucosal integrity, there are inflammatory mediators that get released such as cytokines, leukotrienes, prostaglandins and histamine. Once again, cortisol gets pumped out to respond to these processes, wearing away at adrenal function.

So what is needed here is a multi-pronged approach that identifies and supports ALL of the functions of the body that are affected when the adrenals shut down. So often people tell me they have adrenal fatigue. But what they need to understand is that this is only the tip of the iceberg. There are so many other problems that are either causing their adrenal dysfunction, or resulting from their adrenal dysfunction.

Immune Processes & the Adrenals

Any autoimmune process in the body has an impact upon adrenal function. Cortisol is involved in the response to inflammation. The ratio of Cortisol and DHEA have an influence upon Eicosanoid function. Eicosanoids regulate prostaglandin balance, which is hugely involved in the immune reaction to inflammation. De-regulated cortisol and DHEA levels will skew the eicosanoids, resulting in poor immune responses.

These issues are hugely involved with diseases like MS, Crohn's, Rheumatism, Osteoporosis and Arthritis, not to mention Haschimoto's and other auto-immune diseases.

Chronic infections such as H-Pylori, Giardia and parasites can all take their toll on the adrenals as well. Chronic infections can cause a depletion of HCL in the stomach, as well as damage to intestinal organs. Just like with any kind of inflammatory damage in the body, cortisol will be used up.

The Adrenals, Hypertension & Fluid Balance

The adrenals are hugely regulated by sodium and potassium levels. The adrenals produce a mineralcorticoid hormone called Aldosterone. Aldosterone's chief responsibility is to retain sodium. When there is adrenal hyperfunction (high amounts of cortisol), aldosterone causes excess sodium to be retained and potassium to be excreted. This is a major cause of hypertension, otherwise known as high blood pressure. Hypertension can result in congestive heart failure and heart disease, not to mention is associated with Diabetes.

When there is abnormal adrenal function, either hyper or hypo function, it is very common to see fluid retention issues. This is why one of the primary results of hypertension is fluid retention. Support adrenal function, and the fluid/electrolyte dynamics are better regulated because the proper balance of potassium and sodium are met.

The Adrenals & Thyroid

Abnormal amounts of cortisol will block the conversion of the Thyroid Hormones: T4 into T3. Cortisol is involved in a continuous feedback loop with the HPA (Hypothalamus, Pituitary Axis). Excess cortisol will feed back into the Hypothalamus and then the Hypothalamus produces CRH (cortico tropln-releasing hormone). High amount of CRH inhibits TSH (Thyroid Stimulating Hormone) production. This feedback loop goes on and on.

These processes described above are a key piece to the hypothyroid picture. It is no surprise that cortisol studies on patients with hypothyroidism involves adrenal fatigue and de-regulated cortisol and DHEA levels.

Supporting and restoring adrenal function helps to slow these potentially harmful processes. As mentioned earlier, the adrenals are strongly involved in the Thyroid autoimmune disease Haschimoto's.

Adrenal Fatigue: What to Do

Again it should be emphasized that because of the systemic involvement of the major adrenal hormones, the best course of action is to view the function of multiple systems in the body, not just the adrenals. Because of the various feedback loops in the body, adrenal function is only a part of the whole picture.

There are numerous laboratory tests that can look at adrenal function. The best way to get a picture of the adrenals is through a Saliva Hormone Biopsy. This will reveal 4 cortisol levels throughout the course of one day, as well as DHEA levels and 5 other steroid hormones. The best way to test the adrenal hormones is through the saliva, not the blood because only the saliva measures the "free-fractioned" hormone levels. Blood steroidal hormones are mostly bound to protein and do not represent the available levels of hormones to cell receptors.

A standard blood test can also detect relative adrenal function as indicated by sodium, potassium, chloride and Co2 values. Another effective way I have found is through HTMA (Hair Tissue Mineral Analysis). I have found that HTMA correlates well with both blood and saliva adrenal studies.

Understanding the intrinsic relationship the adrenals have with some many other systems, depending on the specific issues of each person, I may recommend several other biopsies including: Gut Function assessments, Intestinal Surface Immune testing, food sensitivity identification or other similar tests.

A complete, intelligent and Functional nutritional protocol that involves supporting adrenal function should also include:

• Identifying ALL blocking factors: Food Sensitivities, Heavy Metal Toxicity, GI/bacterial/parasitic infection
• Identifying Your Ideal Diet through your Metabolic Type
• Restoring/Repairing Gut Function
• Improving Liver Function
• Supporting digestion, elimination and hydration

Supporting & Restoring Adrenal Function

The following information is solely for educational purposes and is not intended as advice.

There are numerous ways to support adrenal function. i always like to recommend food as a priority, and this is why eating right for your type of metabolism can be so powerful. For example, calcium supplementation can be very important to maintain healthy adrenal function for some people but totally wrong for someone else. The best way to find this out is by understanding your Metabolic Type.

There are no "one size fits all" protocols for restoring adrenal function. In truth, individual assessments must be the baseline component for understanding what your own body needs. Therefore the following recommendations are only to be used as educational.

A key component of adrenal function is understanding the relationship of sodium and potassium. This critical balance of electrolytes has immense implications for adrenal function. Sodium and potassium activity can be assessed using blood chemistry as well as hair tissue mineral analysis. Therefore supporting adrenal function by using the correct concentrations of certain electrolytes can have tremendous healing potential for the adrenals. What appears to be adrenal fatigue could actually be an electrolyte imbalance.

What appears to be adrenal dysfunction may in fact be a pituitary or hypothalamus issue. This is because the Hypothalamus and Pituitary have a regulatory effect upon how much adrenal hormones are made. This is a complex issue that extends beyond this article.

I am a big fan of Adrenal Glandulars and other glandulars that support healthy endocrine function. I have seen them work wonderfully for numerous people. The dose should be determined by each person's individual needs.

Herbal therapies can have very positive effects on adrenal health and vitality. This may include herbs such as ashwagandha, rhemmania, eleuthero and schisandra. Licorice Root Extract is another excellent way to help improve adrenal function because Licorice root helps to maintain cortisol levels. This is contraindicated for people with hypertension, however.

Other nutrient supplements that may be beneficial for some but not for others include B complex, zinc and copper.

If there are fluid retention issues involved with adrenal fatigue, this needs to be dealt with. Understanding Electrolyte and Fluid Dynamics is critical for controlling and maintaining the intracellular sodium/potassium pump and healthy electrolyte and fluid levels.

Michael McEvoy has a private nutritional consulting practice. He works with clients nationally and internationally. Please contact him to learn more about his nutritional consulting services and programs.

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