by Andrew Pacholyk, MS, L.Ac.

Symptoms of Adrenal Fatigue include:
low energy levels
feeling tired even after you sleep
excessive fatigue
difficulty concentrating and feel overwhelmed
nonspecific symptoms people experience:
poor digestion
craving salty and/or sweet foods
food or environmental allergies
joint pain
low back pain in the area of the kidneys
sighing, yawning
impaired memory
reduced sex drive
anxiety and irritability
low immune function
recurrent infections
consistent low blood pressure
extreme sensitivity to cold
difficulties that develop premenstrual syndrome
difficulties that develop during menopause

The adrenal glands, of which you have two, are a part of the kidney system. These endocrine glands sit on top of the kidneys and are mainly responsible for releasing hormones in conjunction with stress through the synthesis of corticosteroids such as cortisol and catecholamines, such as epinephrine. Adrenal glands affect kidney function through the secretion of aldosterone, a hormone involved in regulating blood osmosis. The adrenals release three classes of hormones responsible for maintaining metabolic processes by managing blood sugar levels, regulating inflammation, regulating the balance of salt and water, controlling the “fight or flight” response to stress, maintaining pregnancy and initiating and controlling sexual maturation during childhood and puberty. The adrenal glands are also an important source of sex hormones such as estrogen and testosterone. The result of low blood sugar (hypoglycemia) result in:

blurry vision
rapid heartbeat
sudden mood changes
sudden nervousness
unexplained fatigue
pale skin
difficulty sleeping
skin tingling
trouble thinking clearly or concentrating

The cortex is the area surrounding the core and is responsible for fluid and electrolyte balance in the body using corticosteroids. These corticosteroids are responsible for the proper metabolism of fat, protein and carbohydrates.

The term “Adrenal Fatigue” is not considered an acceptable medical diagnosis. It is actually a term, coined by a doctor in the mid 90’s, to cover a group of non-specific symptoms people would experience when the adrenal aspect of their endocrine system was not functioning at optimum levels, resulting in many of the above symptoms. Western endocrinologists and conventional tests cannot diagnose adrenal fatigue because they are only able to diagnose extreme dysfunction in the adrenals, such as Addison’s disease, a potentially fatal condition where the adrenals essentially shut down.

The best way to establish a baseline diagnosis is with a saliva testing for cortisol levels and measurement of thyroid hormones in the blood in order to confirm the irregularities within the endocrine system. Simple boosting of cortisol levels or other hormones is not efficient enough in treating the balance of multiple organ systems. Finding the root cause of the disorder is essential.

It is also important to differentiate adrenal fatigue vs. chronic fatigue syndrome. CFS is typically a post-viral fatigue syndrome characterized by disabling fatigue occurring chronically, after minimal exertion, and with duration of at least six months. As adrenal fatigue affects a group of body systems, treatment is incomplete if it just targets individual symptoms.

The right nutrition for adrenal fatigue is essential. You must eat first thing in the morning. There is no compromise here. A low-glycemic (low-sugar) diet, consisting of sufficient protein and good fats, low-glycemic carbohydrates, eaten in smaller, more frequent portions throughout the day are the secret. Eat 6 – 8 servings of vegetables a day and some fruits (apples, mango, papaya, plums cherries and pears). Eat organic meats and dairy products in small portions. Water is your best choice. Other healthy choices are green tea, herbal teas, natural vegetable juices, goat’s milk, almond milk, rice milk and carob (a great substitute for chocolate beverages). A snack before lunch and after lunch is also essential as it helps maintain blood glucose levels, boost the immune system and keeps the adrenals on track.
Foods to Avoid

Non-organic meats and dairy products are loaded with preservatives, hormones and antibiotics.

Suffering from adrenal fatigue due to blood sugar issues, you should be careful about high sugar levels found in bananas, grapefruit, dates, figs, raisins and oranges and avoid them.

Although coffee, chocolate, alcohol and soft drinks give you an “energy rush” they should all be avoided, since the backlash is a severe drop in blood sugar levels as there affects run out and further deplete the adrenals.
Herbs and Supplements to Consider

It is best to visit a professional, certified herbalist who is savvy in both Western and Chinese herbs, supplements, mineral and vitamins and who understand the mechanisms behind how they work! Herbs for adrenal fatigue are best used in combination with vitamins and need to be individualized or tailored to each patient’s specific needs and contraindications. There is no “one size fits all” approach. This is difference between Western medicine and Naturopathic/Eastern medicine. Herbal treatment for adrenal fatigue should include herbs used to modulate adrenal secretion (or “Yin Tonic” formulations) as well as to increase the body’s ability to respond to stress (or “Adaptogen” formulations).

Herbs for adrenal health are best used in combination, and these combinations need to be individualized and tailored to each patient’s specific needs and contraindications. For simplicity’s sake, there are two ways to think about herbal treatment for adrenal fatigue: Herbs can be used to modulate adrenal secretion (i.e., a “tonic” approach) or to increase the body’s ability to respond to stress (an”adaptogenic” approach).

Adrenal Support Formula: combines the whole adrenal and adrenal cortex with a combination of herbs that nutritionally supports the adrenal glands. Panax ginseng and Eleutherococcus senticosus, or eleuthero, are used primarily as adaptogens, nontoxic substances which improve overall health of the body by a wide range of physical, chemical, and biochemical factors. This formula enhances both the effects and production of certain adrenal hormones and maintains a healthy immune response.

Astragalus (Astragalus membranaceus) also comes to the West through its long use in Chinese medicine. It is typically used in combination with other herbs, especially Rehmannia and Eleuthero. Astragalus is both a tonic and an adrenal support herb. Its key components are polysaccharide fractions, isoflavonoids, saponins, triterpenoids, and gaba-aminobutryic acid. These substances can affect growth hormone levels, blood glucose, general inflammation, blood pressure, blood flow, and water balance in the body. Astragalus can be combined with Eleuthero and Echinacea for patients who are “run down” and experiencing recurrent respiratory infections.

Ashwagandha (Withania somnifera) root comes from India’s Ayurvedic medicine tradition. It is particularly useful for stress induced sleeping problems especially when you take Ashwagandha immediately before bed. Recent East Indian trials showed that Ashwagandha improves both DHEAs (DHEA-sulfate) and testosterone levels.

B Vitamin Complex: is a multifunctional blend of the highly crucial vitamins including B-2, B-6, B-12, Niacin and Pantothenic acid to help maintain a sufficient daily intake. These vitamins are essential for normal formation of blood cells, and also support vision health, a healthy nervous system and energy metabolism.

Black Cohosh Root (Cimicifuga racemosa), as a long-term glandular tonic. It is used in North American Indian medicine for malaise, gynecological disorders, kidney disorders, malaria, rheumatism, and sore throat. It was also used for colds, cough, constipation, hives, and backache and to induce lactation. In 19th-century America, black cohosh was a home remedy used for rheumatism and fever, as a diuretic, and to bring on menstruation.

DHEA is a natural steroid hormone, one of the hormones produced by the adrenal glands. After being secreted by the adrenal glands, it circulates in the bloodstream as DHEA-sulfate (DHEAS) and is converted as needed into other hormones. DHEA is chemically similar to testosterone and estrogen and is easily converted into those hormones. DHEA production peaks in early adulthood and declines in production with age in both men and women. Therefore, many diseases which correlate with age also correlate with low levels of DHEA production.

Eleuthero (Eleutherococcus senticosus): is an adaptogen herb used to support cognition, alertness, immune function, and physical stress. The most recent research on adaptogens views them as stress adaptogens which act like mild stressors to the body, and the body’s protective response is what accounts for the therapeutic benefits.

Fo-Ti Root (Ho Shou Wu): a Chinese herb that’s broader and slower in action than but similar to ginseng, works very well on tonifying the kidneys.

Ginkgo (Ginkgo biloba) is a common herb well known for its ability to enhance peripheral circulation and for its neuroprotective effects. Often overlooked is the fact that Ginkgo can favorably affect stress levels. In one study, it lowered cortisol levels in healthy patients undergoing glucose tolerance testing.

Ginseng Root (Korean – Panax Ginseng): is traditionally used in western herbal medicine to remedy physical or mental exhaustion, lowered immunity and facilitate adaptation to stress. In Traditional Chinese Medicine (TCM) it is considered a key herb for reinforcing vital energy and longevity. Ginseng Root, (Siberian): along with astragalus for immune support are key tonics for the adrenal and endocrine systems.

Licorice (Glycyrrhiza glabra and G. uralensis) is a staple of Traditional Chinese Medicine (TCM) for adrenal insufficiency and ulcers. This herb contains triterpenoid saponins that influence cortisol-cortisone balance throughout the body. Glycyrrhizin is the main active compound in licorice. At higher amounts, however, it has a strong effect on the kidney and allows cortisol to interact with aldosterone receptors, which affects sodium/potassium balance and increases blood pressure. For this reason, patients taking higher amounts of licorice need to be monitored closely. That is why, in TCM, it is used to assist the other herbs in a formula and is not the main ingredient.

Mate: (pronounced, “mah-tay,”) is an herbal tea native to South America. Mate is considered more nutritious than black tea (or coffee), and though it also has some caffeine, it’s effects are energizing, rather than jittery.

Multivitamins for Women and Multivitamins for Men are an essential part of any balanced lifestyle plan. It provides adequate amounts of key vitamins and minerals for the adrenals and metabolic processess. Consider your multivitamin carefully, as often, the least expensive have the poorest amounts and proper ratios needed for daily intake. You can find a good list of what should be in your vitamins here.

Pregnenolone, (3-alpha-hydroxy-5-beta-pregnen-20-one): is a natural steroid hormone produced in the body from cholesterol. It has been described as the “Grandmother of all Steroid Hormones,” since all steroid hormones, over 150 of them, are derived from pregnenolone. Pregnenolone has been linked with positive support of the immune system, mood and memory. In the body, it takes one or two metabolic pathways, converting to DHEA and/or progesterone. It is likely that the body will convert pregnenolone appropriately, according to its needs. Studies show that the body makes 60% less of this hormone at age 75 than it does at age 35. Pregnenolone, a natural precursor to over 150 steroid hormones, helps support the immune system, mood and memory.

Rhodiola (Rhodiola rosea) is an adaptogen herb with a long history of traditional use. It also has a number of positive human trials in the areas of stress and fatigue management, enhancement of mental performance and treatmentof mild depression. Rhodiola exerts these beneficial effects by regulating key mediators of the stress response including cortisol, nitric oxide, molecular chaperones (HSP70) and stress activated protein kinases.

Triphala : an Ayurvedic remedy, has been used as a long term glandular tonic. This combination of three fruits is one of the best bowel formulas in the world! Assists natural internal cleansing, Gently maintains regularity, nourishes and rejuvenates the tissues, supports healthy digestion and absorption and is a natural antioxidant.

Exercise for Fatigue?

Absolutely. Consider exercises that are not overstimulating such as heavy lifting or aerobics. Do something more calming such as Pilates, restorative yoga or tai chi. Exercise gives you energy. Study after study supports those words, including one by the National Aeronautics and Space Administration. More than 200 federal employees were placed on a moderate, regular exercise program. The results: 90 percent said they had never felt better. Almost half said they felt less stress, and almost one-third reported they slept better.
Get Acupuncture

Acupuncture and Traditional Chinese Medicine (TCM) are the oldest, continually practiced, and professionally administered health care system in the world. It is a documented medical system spanning over 2,500 years based on comprehensive philosophies, rational theories, clinically tested and empirically verified by over 100 generations of highly educated practitioners. Chinese Medicine is a total system of internal medicine which is comprised of a diagnostic procedure based on signs, symptoms and treatment styles including acupuncture, herbal medicine, exercise, diet and meditation is one of the Studies have shown that acupuncture helps to regulate the HPA axis (hypothalamus pituitary adrenal axis) therefore, correcting problems that arise from adrenal hormone and neurotransmitter derangement like depression, anxiety, fatigue, and insomnia. Acupuncture can help suffers of adrenal fatigue by stimulating key points associated with the kidney. In some cases, acupressure may be done by massaging just inside the ankle between the medial malleolus and the Achilles tendon. Massage the area in a clockwise motion for five minutes on each side of the foot and repeat daily.

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