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| Adrenal Fatigue: Information for PAs and NPs |
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by Dani Williamson CNM, NP - February 14, 2011
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Are you hitting the snooze alarm continually, feel sluggish until mid-morning, wiped out when you get home in the evening or possibly get a burst of energy when it is time to go to sleep? You could be adrenally fatigued. A condition that is treatable with the proper lifestyle modifications, supplements, nutrients and herbal adaptogens.
I have patients on a daily basis that are experiencing high levels of emotional, mental, family and work stressors on a continual basis. Some have “burned the candle at both ends” for way too many years, and some have simply been under chronic stress for a multitude of reasons. They come to our office oftentimes after having sought help from various practitioners, simply to be told that their “lab tests are normal” and they just need to exercise more, lose weight and/or “start saying no” to commitments!
It has been my experience that most people have never heard of adrenal fatigue, much less know where their adrenal glands are located or exactly what their function is in our lives! Adrenal glands secrete cortisol in times of stress, exercise, low blood sugar (we will address low blood sugar and cortisol later)! Cortisol is your “fight or flight” hormone. Adrenal glands become compromised and sluggish when stress is not well managed and the adrenals are constantly pumping out cortisol. Eventually, they simply “poop out” and cortisol is unable to rise to meet our daily needs. Therefore, causing fatigue, sluggishness, anxiety, craving for sweets, allergies, reduced tolerance for stress the “tired but wired” feeling, sleep disturbances that many of us are experiencing.
At CSFM we can help you overcome adrenal fatigue by evaluating your cortisol levels with saliva testing that test 4x during the day (cortisol should be the highest it will be in a 24 hour period when we wake up). Cortisol slowly declines as the day progresses, it is low cortisol that allows us to go to sleep at night. I see all levels of adrenal fatigue weekly.
Adrenal fatigue is best treated with lifestyle modifications such as:
1. At least 8 hours of sleep a night (sleep beginning before midnight is a must). The bed is for sleep and sex only….if you aren’t sleeping or having sex, get out of the bed!
2. Meals at least every 4 hours with adequate protein and complex carbohydrates.
3. Exercise at least 4-5 days a week of 20-30 minutes. No strenuous exercise: preferably yoga, stretching, breath work.
Nutrients: Supplements
1. High doses of vitamin C 2-3 times daily
2. Vitamins B5 and B6
3. Vitamin E
Adrenal adaptogens:
1. Ashwaghanda
2. Holy Basil
3. Licorice (used cautiously for elevated cortisol)
4. Rhodiola
5. Ginseng (used cautiously for elevated cortisol)
Adrenal Cortex or Cortisol is reserved for the most severe of cases.
For a complete saliva testing evaluation make an appointment at Cool Springs Family Medicine to see Dr. Kalb or Dani.
PS: The good news is that adrenal glands are easily treated, but can take months to a year or more to recover completely….be patient and consistent in your journey to better health!
Dani Williamson is just beginning a new career as a Certified Nurse Midwife/ Family Nurse Practitioner. She is a single mom of two teenagers, and she loves her first job in a practice that mixes traditional and integrative medicine. See this and other blogs by Dani at http://npdani.blogspot.com/.
The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.
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| Bronwyn Lewis, MS, FNP (VA) |
on 02 Mar 2011 at 8:34 am |
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I can't tell you how excited I was to see your article. I have wondered for yrs if there were other NPs/PAs who think along the lines of "why" things happen rather than just band-aiding.
I would highly recommend, for anyone reading this, to look up Apex Energetics and The Institute for Functional Medicine. Both places will provide a plethora of classes, information and resources for healing all the ills that we see today in medicine. Seriphos is a great product and using a variety of PPS is essential for repairing sleep. Apex has the best products, i have found, for healing adrenals and for the ever present reactive hypoglycemia that eventually leads to insulin resistance. They also have some amazing, in depth classes on endocrinology that beat anything I have ever taken or read anywhere is "traditional' literature.
What we are dealing with is immune dysregulation, gut imbalances, chronic inflammation and these lead to adrenal collapse which ultimately flows into auto immunity diseases.
It is time to completely boycott Monsanto, GMOs, the USDA and unhealthy food practices and start eating organic, local, fresh, seasonal foods. Our diets are killing us as are our lifestyle practices of thinking that we need to be the biggest, the best, the first to do everything. Our adrenals are forcing us to slow down, take the back roads, reevaluate ourselves and how we live...Thank goodness.
Thank you Dani for writing.
Peace
Bronwyn |
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| Beth (Sag Harbor New York) |
on 25 Feb 2011 at 9:53 am |
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| I agree with Leslie Satz's comment above. The American Endocrine Society has issued a position statement against the fad of "adrenal fatigue", giving it little to no credibility as a medical dx. Similar to the position statement issued by NAMS (N. Am. Menop. Soc.) re: "bioidentical hormones". Suzanne Somers is getting rich from these theories, as are "labs" that have popped up across the US offering saliva testing. I would like to see the studies, done with the gold standard of double blind, placebo. |
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| Floy Haschke MS APN CANP (Illinois) |
on 24 Feb 2011 at 10:12 am |
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| Thank you so much for the above info! I was diagnosed with adrenal fatique 4 yrs ago and have had severe chronic hypoglycemia for 15 yrs. I eat 4-5 meals per day with protein, complex carbs and a fat source such as cheese or eggs, olive oil.The hypoglycemia symptoms are worse with stress and activity. Travel is extremely challenging. I'm already on Adren-All, which includes adrenal , licorice rhodiola, & MVI, B complex, Vit C & E. I will try to add Ashwaghanda, Holy Basil. Ubiquinol, PPQ and Seriphos. Any other suggestions? I would greatly appreciate any advice! |
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| NICK (COLORADO) |
on 23 Feb 2011 at 12:07 am |
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| Very informative Article. My story and condition appears can be helped by your article and response. Did 22 yrs in Armed Forces, 10 yrs as PA. eXPERIENCED sTRESS, CHRONIC FATIGUE, Fibromyalgia early S&Sx 3 Ps, Asthma, Allergies. VA has denied Serv Connection. Other than elevated lipids Tested neg for DM. 8 yrs post retirement Dx Metabolic Syndrome, HTN, TYPE II DM, HYPERLIPIDEMIA. W/U FOR aDRENAL INSUFFICIENCY NEGATIVE. Attempted diet life style change minimal effective. Than in 09 hit by car vs ped. Converted to Type I, b/p nml w/ Beta blocker, Ace inhib, sugar control, cymbalta for anxiety, mild depression and mild RSD sxs. Extremely fatigue, probably 2nd to Firomyalgia, and 3 severe TBIs. Also using Licithin & Fish oil, multi-vit. Will look for suggested adaptogens. I also have hypopotasium whensalt intake is high. Residual Cognitive and memory slowness, but passed 6 yr PANRE NCCPA., post injury. DO YOU AGREE that I should add supplements. |
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| Dani Williamson (Nashville, TN) |
on 16 Feb 2011 at 8:13 pm |
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Thank you for the great information!! I use PS for my patients with elevated nighttime cortisol levels. I am learning everyday the importance of balancing the adrenals, sex hormones and thyroid!! If one is out of balance, they can all be affected!
Great information! Thank you for sharing. Check out our website and let me know what you think:
http://www.csfmed.net |
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| Leslie Satz |
on 16 Feb 2011 at 7:06 pm |
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| Interesting article. It is important to cite peer reviewed evidence based support of these statements to keep the professional level high. |
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| ROSS (SAN ANTONIO) |
on 15 Feb 2011 at 11:43 am |
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IMPORTANT ARTICLE; WIDESPREAD PROBLEM MOSTLY UNRECOGNIZED AND MOSTLY MISTREATED SYMPTOMATICALLY
UNDERLYING THE DEVASTATING EPIDEMIC OF HYPOTHYROIDISM, ETC. WHICH IN TURN UNDERLIES THE EPIDEMIC OF CARDIOVASCULAR , PSYCHOLOGICAL AND RESPIRATORY/IMMUNE FAILURES.
ALL EXCELLENT RECOMMENDATIONS ABOVE EXCEPT PROBABLY THE BEST THERAPEUTIC TOOL AVAILABLE WHICH IS "SERIPHOS"
OR PHOSPHORYLATED SERINE A RELATED COMPOUND OF "PS" OR PHOSPHATIDYL SERINE USED FOR MEMORY AND OTHER COGNITIVE FUNCTIONS.
SERIPHOS IS MANY TIMES MORE EFFECTIVE AND 1/2 TO 1/3 THE COST AND OF COURSE WITHOUT SIDE EFFECTS.
IT REPAIRS THE WASTED ADRENAL/PITUITARY/HYPOTHALAMIC
AXIS WHICH DETERMINES THE STRESS QUOTIENT WE CAN HANDLE. IT REMYELINATES NEURO-HORMONAL PATHWAYS.
IDEALLY TAKE 4 CAPSULES AM 20-30 MINUTES BEFORE BREAKFAST. I USUALLY FIND IT AT AMAZON.COM ABOUT 1/3 RD. CHEAPER THAN ELSEWHERE. FEW IF ANY HEALTHFOOD STORES CARRY IT AND EVEN FEWER NATURAL CARE DOCTORS OR AWARE OF IT. THOSE WHO DO BIOIDENTICAL HORMONAL REPLACEMENT THERAPY USE IT FOR ITS EFFICACY.
GOGGLE IT OF COURSE FOR INITIAL COLLABORATION AND REALIZE THAT ADRENAL DEPLETION SELDOM EXHIBITS ALONE AND SIMULTANEOUS TREATMENT OF OTHER HORMONAL/NEUROTX DEFICIENCIES CAN GREATLY INCREASE THE CHANCE AND SPEED OF RECOVEREY.
MUCUNA PRURIENS AS A NATURAL SOURCE OF L-DOPA TO PRODUCE CONCOMITANT DOPAMINE NEUROTRANSMITTER DEFICIENCIES INSTEAD OF "LYRICA" TYPE DRUGS FOR THE FIBROMYALGIA LIKE PROBLEMS, AND THE CHRONIC FATIGUE SYNDROME AND ASSOCIATED METABOLIC X SYNDROME., ETC. ONE SOURCE BEING "DOPA MUCUNA" FROM "NOW PRODUCTS" AVAILABLE IN SOME STORE AND THE INTERNET
EQUALLY IMPORTANT DO NOT NEGLECT THE IMPORTANCE OF RESTORING MITOCHONDRIAL INEFFICIENCY AND DEPLETION IN THE CELLS NOW BEING RECOGNIZED AS THE THE OVERWHELMING EFFECT OF ALL OF THE ABOVE AND A RESULT OF THE INSANE, DASTARDLY USE OF STATIN DRUGS TO LOWER BLOOD LIPIDS CAUSED MUCH MORE BY THYROID PROBLEMS OFTEN CAUSED BY THE ADRENAL DEFICIENCY TO BEGIN WITH. IT OF COURSE IS A NATURAL RESULT OF AGING, AND PREMATURE AGING WHICH IS NOT NATURAL. PRUDENT THERAPY IS NOT ONLY THE MANDATORY USE OF CO-Q10 AS UBIQUINONE AND UBIQINOL PAST 40 YOA; BUT SUCH AS ACETYL -L- CARNITINE, AND NOW THE NEWLY AVAILABLE
"PPQ" OR PYRROLOQUINOLINE WHICH EVEN GOOGLING DOESN'T EXPRESS A LOT OF ENTHUSIASM. I RECOMMEND ALL REFER TO "LIFEEXTENSION.COM" A RETAILER OF THE PRODUCT FOR THEIR TAKE ON ITS VAST POTENTIAL FOR THERAPY.
MEDICAL SCIENCE SHOULD BE THE READILY AVAILABLE SOURCE OF SUCH THERAPEUTIC INFO BUT OF COURSE MARKET SCIENCE HAS CORRUPTED ITS AVAILABILITY AND REPLACED ITS TRUTH WITH THE 'WORSHIP OF MAMMON" |
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