Adrenal Fatigue or not?

I've had CFS/ME for 20 years, symptoms including fatigue, tremors, vomiting, diahrea, brain fog, and sleep disturbances.

Like everyone else, I am not sure if this disease is viral, neurological, or something else.

I am wondering about treating the adrenal aspect of this disease.

The following symptoms might suggest an adrenal hypothesis:

• much more energy later in the day, especially after 5 pm
  
• stress can cause extreme flare-up of symptoms
• celibacy and abstinence from sex lead to large increase in energy reserves over time

Do any of these suggest an adrenal role, and what sort of supplements or treatments should I try to test whether this is an adrenal problem?

 

I would say anyone here sick with CFS or any other chronic illness will definitely have at least some level of adrenal fatigue/exhaustion...

I have had it pretty severely myself actually..

for myself I used herbal glandulars that help boost the HPA axis and start normal regulation feed back for adrenal function, alongside some high dose vitamin C and a good b vitamin complex with folate instead of folic acid.. this is considered the first type of intervention and usually the least likely of adverse side effects.

The herbs are called adaptocrine, but there is also another great one called Adrenotone, and another company which produces something called Gaia Herbs (adrenal health) which also works extremely well!

then its also important to keep very low stress levels, not push yourself too hard, get plenty of rest and avoid stimulants like coffee, and sugar. Basically the same type of stuff to recover from CFS.

There are other more high pharm grade interventions so to speak but you would need to get tested by an endocrine doctor and have your 24 hour cortisol levels tested with saliva, and maybe vitamin D levels checked...

They might prescribe bioidentical hormones like pregnenolone or DHEA, but you need to be under the care of a medical advisor to do that, you don't want to just try those things out on your own without experienced help!

Also if you get your test levels done get it through Biohealth Labs! Some people use Diagnos-Techs testing which is said to just be unreliable and to wacky with results.

 

A saliva test can show whether you are cortisol deficient.

 

Weighing in here, I would say that adrenal fatigue leans more toward the quack end of the medical spectrum. Obviously you're right to be doing your own investigations, but you might find this is a dead end.

 

Get saliva and blood better, DHEA, pregnenolone and cortisol. Those really are conclusive diagnostic tools for "Adrenal Fatigue".

The standard treatment is on the line of what Martial suggested. Sadly, if you go to forums with "adrenally fatigued" people you´ll see that those that stick around ("chronic" cases) normally need much more time and research to heal and the standard treatment often is not enough.

I am personally still trying to find the right protocol for me, the adrenal nutrients (b-complex, mag, cal, vit C, E, B5 etc) weren´t of much help (my sleep did not improve, which is no doubt my worst problem). The keys in my opinion for long term healing of "Adrenal Fatigue" are improving sleep, normalizing the stress response and healing the gut.

 

I don't want to get into a thing here, but although I won't argue with your advice given later in your reply, it's definitely misleading to say there are 'conclusive diagnostic tools' for adrenal fatigue.

 

I can agree with what you are saying about inadequate testing and the like, in some regards most people do not recognize adrenal fatigue as a real existing condition but rather an 21st century "internet disease"

some endocrinologists speak out about both adrenal fatigue and wilson's temperature disease.

http://articles.latimes.com/2010/sep/15/news/la-heb-internet-diseases-20100915


I for one do not have a ton of expertise on the subject but due to the fact that there is no toxicity or adverse side effects from adaptogenic herbs, b complex, and vitamin C use in moderation I don't see the harm in trying it as a protocol..

Whether or not it is an actual "disease" or not does not matter to me.. As long as I can take something to heal and control symptoms it can have whatever name it wants. lol

I would say I believe there can be HPA axis dysfunction in chronic illness and stress for sure though, definitely also with issues regarding blood flow.. In that regard I would put having someone go on DHEA and Preg to be on a bit of higher end risk.. But this is why you ALWAYS do something like that under the care of an endocrinologist specifically.

 

HPA axis hypofunction is real, but is not caused by the adrenal glands being fatigued. Hypocortisolism is common in ME/CFS. Saliva, blood and ACTH stim tests can help to diagnose the condition. Getting the HPA axis back to normal function is easier said that done, though. Rest or a few vitamins and herbs are unlikely to work. The HPA axis is under the control of the immune system, who is king of the household. Getting the immune system balanced is likely your best bet.

 

The correct terms for adrenal fatigue are HPA dysregulation and/or autonomic nervous system imbalance (actually a shift towards the sympathetic). These are recognized by the global medical/scientific community.

If you have high cortisol in blood, and low in urine and saliva consistently as I have, yeah, that is a solid clue that points out that your stress systems are screwed. Furthermore, I also have low DHEA-S in blood. Some of these tests were prescribed by allopaths by the way, so they are as "legit" as it can get.

I stand by my assertion, blood, urine and saliva cortisol,ACTH, DHEA and pregnenolone are conclusive if you want to know your adrenal/HPA axis status.

 

Yes, I don't see a problem with taking a safe protocol. However I have a bit of a bee in my bonnet about 'adrenal fatigue', especially when mentioned in the same breath as ME/CFS, because we have enough problems as it is with our own credence.

 

I think I had the same issues with HPA axis feedback but due to the lyme I am dealing with, so I wonder if this kind of thing occurs with most chronic ongoing infections,even outside the spectrum of pure M.E./C.F.S.

It definitely high jacked my immune system as well and did all kinds of strange things as a result, maybe thats what triggered it for me, or the brain inflammation hypo perfusion leading to issues of getting proper neuro transmitter feedback..

 

So have a bee in your bonnet about the "name", which as @Beyond pointed out, many of us also take issue with, and is totally different than having a concern about a medical condition that is well documented in the scientific literature both in ME/CFS and other immune deficient states.

I have a bee in my bonnet about people calling legitimate medical conditions quackery and thus discouraging people from seeking appropriate medical intervention for what can be very serious conditions. An adrenal crisis can be fatal.

A good place to start investigating your adrenal function is with an 8AM serum cortisol and ACTH test. A saliva test will inform you further about your circadian rhythm and how much free cortisol you have as opposed to that which is bound. These measures along with some good clinical guidance can go a long way towards helping you understand whether adrenal dysfunction is playing a part in your illness.

Getting your immune system balanced is surely the best option, but I'm not aware of a sure fire solution to that problem yet. In the meanwhile, replacing missing hormones can go a long way towards symptom relief.

I'm not sure I would say that the HPA axis is under the control of the immune system either. It certainly accepts inputs from the immune system but I think it is more of a complex reciprocal response. The HPA axis modulates the immune response in many cases.

 

Here is a good article on HPA axis and its relation to CFS.. http://chriskresser.com/chronic-fatigue-syndrome-and-stress-a-new-frontier-for-treatment

 

Doctors wont treat anything unless an overt condition, so in terms of adrenal fatigue or adrenal dysfunction or whatever name u want to call it, they will only treat conditions like addisons. The adrenal hormones cortisol and dhea are far from optimal in adrenal fatigue but then not low enough to be diagnosed with addisons. Adrenal function can be measured and is recognised testing, its just that the average doctors hasnt been shown how to treat it or look for other issues that could be causing it. So its far from quakery.

I have read where the na sayers say its just a list of symptoms, this is not true or else they wouldnt find low dhea and cortisol levels or irregular cortisol rthyms.

Why does it occur?? maybe its a protective reaction and or maybe this protective action is stuck, in that its producing low adrenal hormones.

I think there is enough people here who have tested low in adrenal hormones and rythms and treated these defiencies, found improvement, to realise that these issues are real.

those with cfs/me do have enough problems and this is one that many have. It makes sense that hormones will be dysfunctional especially since ME is a neurological condition and its the brain/hypothalamus that controls many hormones and functions.

The name adrenal fatigue isnt appropriate but it is so commonly used that i dont think its going to change anytime soon. Because its not an appropriate name doesnt mean it doesnt exist.