Adrenal Fatigue: A Generally Unrecognized But Pervasive Syndrome
James L. Wilson
Role of the Adrenal Glands
The purpose of the adrenal glands is to help the body cope with stress and survive. They secrete minute, yet precise and balanced, amounts of steroid hormones that have a considerable psychological and emotional impact, as well as significantly influencing the functioning of every tissue, organ, gland, and physiological process in the body. These hormones closely affect the utilization of carbohydrates and fats, the conversion of fats and proteins into energy (gluconeogenesis), the distribution of stored fat (especially around the waist and on the sides of the abdomen), the regulation of normal blood sugar, and the proper function of cardiovascular and gastrointestinal musculature. It is their anti-inflammatory and antioxidant protective activity that helps minimize allergic reactions to foods and the negative effects of alcohol and drugs. After mid-life (menopause in women), the adrenal glands gradually become the major source of the sex hormones circulating throughout the body in both men and women. These h ormones themselves have a whole host of physical, emotional and psychological effects, from the level of the sex drive to the tendency to gain weight. Every athlete knows that adrenal hormones, known as steroids, greatly influence muscular strength and stamina.
What is Adrenal Fatigue?
Because the adrenal glands are designed to be so very responsive to changes in ambient or internal environment, any number of factors can interfere with the finely tuned balance of adrenal hormones. Normally, this is not a problem, and the adrenals are able to respond appropriately to stresses from every possible source, ranging from injury and disease to work and relationship problems. However, if they are unable to adequately respond to the total amount of stress placed on the body, adrenal hormones (especially cortisol and aldosterone) fall instead of rise. This creates a state of maladaptation called hypoadrenia or adrenal fatigue. Although adrenal fatigue can result from a single stressor, more commonly it is the product of cumulative physical (thermal, chemical, biochemical, metabolic), emotional, and psychological stresses acting in concert.
The most extreme form of hypoadrenia, Addison’s disease, is the only form of adrenal fatigue officially recognized by modern medicine. It is often life threatening if untreated and commonly involves actual structural damage to the adrenal glands. People suffering from Addison’s disease usually have to take corticos-teroids for the remainder of their lives in order to function. Approximately 70% of Addison’s cases are autoimmune disease; the other 30% are termed idiopathic and stem from a variety of causes. John F. Kennedy suffered from this disease as a result of his PT boat being torpedoed during World War II. Luckily, Addison’s disease is the rarest form of adrenal fatigue, with an occurrence of only about 4 persons per 100,000.
Adrenal fatigue more commonly manifests itself within a broad spectrum of less serious, yet often debilitating, disorders that are only too familiar to most people. The lower end of this spectrum has been known by many names throughout the past century, such as non-Addison’s hypoadrenia, sub-clinical hypoadrenia, neurasthenia, adrenal neurasthenia, adrenal apathy, and adrenal fatigue. However, I prefer the name adrenal fatigue because it most aptly describes this common syndrome whose paramount symptom is fatigue. Adrenal fatigue affects millions of people around the world in many ways and for many reasons. Regardless of the fact that modern medicine does not recognize it as a distinct syndrome, it can wreak havoc with a person’s life.
Although fatigue is a universal symptom of low adrenal function, it is such a common complaint and occurs in so many other conditions, that today’s medical doctors rarely consider pursuing an adrenal-related diagnosis when someone complains of it. In fact, physicians 50 years ago were far more likely than their modern counterparts to correctly diagnose this ailment. Information about non-Addison’s hypoadrenia has been documented in medical literature for over a 100 years, but unfortunately this form of hypoadrenia is missed or misdiagnosed in doctors’ offices every day, even when the patient clearly presents its classic symptoms. Adrenal fatigue is all too often the cause of patients’ rundown feeling and inability to keep up with life’s daily demands. The fact that it usually remains undiagnosed does not diminish its debilitating effects People with adrenal fatigue often live with a general sense of unwellness or “gray” feelings. Their fatigue is most prevalent in the morning, especially upon rising, and so t hey often have to use coffee, colas, and other stimulants to get going in the morning and to keep going during the day. As their condition worsens, it lays the foundation for other seemingly unrelated conditions, such as hypoglycemia and associated blood glucose dyscrasias, more frequent respiratory infections, increased allergic reactions, increased propensity towards anaphylaxis, chemical and food sensitivities, exacerbation of autoimmune disorders, and a number of other health problems, such as fibromyalgia and chronic fatigue syndrome. Athletes suffer from poorer performance, increased recovery time, and less muscular strength. There is also a tendency to experience increased arthritic pain when there is decreased adrenal hormone output.
Low adrenal function can also negatively affect mental states, producing anxiety, depression, decreased tolerance, heightened frustration levels, a tendency toward increased fears and apprehensions, intervals of confusion, increased difficulties in concentrating, and less accurate memory recall. When the adrenals are not secreting the proper amount of hormones, insomnia is also a likely outcome.
If doctors were to suspect and pursue adrenal fatigue as the basis of their patients’ complaints soon after its onset, it is likely these more serious conditions could be avoided. Adrenal fatigue syndrome is fully recognizable and treatable with the use of safe natural substances along with dietary and lifestyle changes that decrease the stress load. In some cases, it is totally preventable.
Who Suffers from Adrenal Fatigue?
Anyone who does not get enough rest and relaxation to enjoy life, who drives him/herself constantly, who is never satisfied or is a perfectionist, who is under constant pressure (especially with few outlets for emotional release), who feels trapped or helpless, who feels overwhelmed by repeated or continuous difficulties, or who has experienced severe or chronic emotional or physical trauma or illness is probably already suffering from some degree of adrenal fatigue. People from every walk of life, every culture, and every age can suffer from adrenal fatigue. The political leader, the university student, the environmentalist, the farmer, the villager in a war-torn country, the Hollywood director, the factory worker on a swing shift, the over-extended physician, and the teenage mother on welfare all have the factors in their lives that can lead to adrenal dysfunction, even though they have very different life-styles.
The cost of adrenal fatigue is enormous in the loss of productive hours, creative ideas, sound business decisions, and other intangibles, such as happiness. Some professions are harder on the adrenal glands than others. If you look at actuarial tables for mortality rates, drug abuse, and number of sick days for different professionals, what you are seeing, barring physically dangerous jobs, is the amount of adrenal fatigue experienced in those jobs.
Signs and Symptoms of Adrenal Fatigue
Below is a list, excerpted from my book, Adrenal Fatigue, The 21st Century Stress Syndrome, of some of the most common symptoms of low adrenal function.’ Read through them, and I am sure you will recognize many of your patients or acquaintances.
* Continued fatigue not relieved by sleep: Despite a good night’s sleep, you still get tired when you wake up. Refreshed is a foreign word to people with adrenal fatigue.
* Craving for salt or salty foods: You find yourself eating the whole bag of chips or adding extra salt to foods.
* Lethargy: Everything seems like a chore, even the things you used to enjoy.
* Easily fatigued: Everything takes more effort. Walking a block sometimes feels like a marathon.
* Decreased sex drive: The hottest movie star could be waiting in your bedroom, and you would ask for a rain check. Sex is often the last thing on your mind when you hardly have the energy to keep your head up.
* Decreased ability to handle stress: Little things that never used to bother you get to you. Road rage, constant anxiety, yelling at your kids, compulsive eating, smoking, or drug use are some of the behaviors that let you know your adrenals are crying out for help.
* Increased recovery time from illness, injury or trauma: The cold you got in October is still hanging on in December. The cut on your finger takes weeks to heal. Two years after your father died you are still incapacitated by grief.
* Less enjoyment or happiness with life: Not much seems to interest you anymore. Work and relationships feel empty and you almost never do something just for fun.
* Mild depression: Why bother making an effort, it sometimes seems so pointless?
* Increased PMS: Bloated, tired, crabby, cramping and craving chocolate — does it get any worse than this?
* Symptoms increase if meals are skipped or inadequate: You have to drive yourself with snacks, colas and coffee just to keep from collapsing.
* Thoughts less focused, more fuzzy: You frequently lose track of your train of thought, and it is harder and harder to make decisions.
* Light-headed when standing up quickly: Sometimes you feel a little woozy or even like you are going to pass out when you get up too fast from the bed or chair.
* Memory less accurate: You’ve become so absentminded, you should be a professor.
* Decreased tolerance: People seem a lot more irritating than they used to.
* Difficulty getting up in the morning: Three alarms and you still don’t feel awake enough to lift your head off the pillow.
* Afternoon low between 3:00-4:00 pm: Around 3:00-3:30 in the afternoon you start to feel like you have been drugged.
* Feel better after evening meal: After 6:00 pm or your evening meal, you start to feel alive again.
* Decreased productivity: It takes you longer to complete tasks, and it is harder to stay on task.
* Increased effort to do every day tasks: Everything seems to require much more effort than it should.
* Hypoglycemia: If meals are skipped or delayed, the results can be disastrous.
No single one of these symptoms is pathognomonic for hypoadrenia, but taken collectively as a syndrome, they strongly suggest its presence. Although adrenal fatigue is so common these days we have come to accept it as normal, it is definitely not a normal state of health! These symptoms indicate defective adaptation of the adrenal glands to the stresses being experienced. Three or more of them indicate that the patient is likely suffering from adrenal fatigue. They are warnings that something needs to change.
Use of Adrenal Cortical Extracts to Improve Adrenal Function
The first, and still probably the most reliable, way of rebuilding the adrenals from adrenal fatigue is the use of extracts from liquid or powdered bovine adrenal glands. Adrenal extracts have been recommended and successfully used for a variety of conditions that involve low adrenal function, including asthenia, asthma, colds, burns, depletion from or increased recovery time from tuberculosis, pneumonia, bronchitis and other infectious respiratory illnesses, dyspepsia (atonic), early idiopathic Addison’s disease, hypotension, neurasthenia, light-headedness and vomiting during pregnancy.(2)
Historically and in many modern clinics, preparations using adrenal cell extracts have been used extensively and are considered to be the most important aspect of the therapy. The first physician to use an adrenal extract in this way was Sir William Osler. In 1898, he used a crude preparation of adrenal cells in an unsuccessful attempt to keep a person with Addison’s disease alive and functioning. Since adrenal cell extracts first became commercially available in 1918, they have been used successfully by thousands of medical doctors in the treatment of non-Addison’s type of hypoadrenia. By the mid-1930s, adrenal cell extracts were produced by several companies in liquid and tablet forms. As recently as 1968, they were being made by some of the leading pharmaceutical companies (Upjohn and Parke-Davis, among others).(6)
However, use of these cellular extracts declined in the early 1950s when synthetic cortisol became available. Because the initial effects produced by the synthetic hormone cortisone were so much more dramatic and immediate than the effects of adrenal extracts, many physicians switched to cortisone and its synthetic version to treat conditions they had previously treated with adrenal cell extracts. The profit margin of the synthetic corticoids was many times greater than that of the cell extracts. This quickly made the synthetics the unquestionable favorite of the pharmaceutical industry. Within a few short years, the many detrimental side effects of the synthetics started appearing, but the pharmaceutical industry had made its profitable choice and never turned back.
It is important to clarify the difference between adrenal cell extracts and the natural and synthetic corticosteroids. Corticosteroids are replacement hormones; they replace only the hormone they are fashioned after but do not function exactly the same as the natural hormone. Upon entering the body they suppress adrenal function, shutting down all hormones secreted by the adrenals. If used in excess, which is often done, the side effects can be many and far-reaching. The natural form of the hormone (hydrocortisone) is safer than the other corticosteroids, but even the natural hormone shuts down the adrenals while it is being used and for several weeks to months after it is discontinued.
The cell extracts are not replacement hormones, but contain all the components of the adrenal cell in the proportions in which they naturally occur. This means that they contain only a tiny amount of actual hormone. The liquid extracts include the complete cell constituents, fresh frozen after being sterilized by ultrafiltration. Their action supports, fortifies, and restores normal adrenal function, enhancing adrenal activity rather than suppressing it. These extracts rarely have side effects and have been used orally and as injectables since the end of WWI.
The usefulness of adrenal cell extracts in infectious disease states was dramatically illustrated during the flu epidemic of 1918. While this flu was debilitating, even killing, thousands around the world, a few hundred of its victims were given a formula containing liquid adrenal cell extracts combined with a small amount of thyroid and gonadal extracts. This formula was found to be unusually effective in overcoming many of the asthenic, hypotonic, and depleted states that were so common in those afflicted with this deadly flu. It also effectively reduced the serious sequelae that usually followed this particular infection. The quick and uneventful recovery experienced by those taking this adrenal extract contrasted to the long period of recuperation normally seen in this flu epidemic.
The fact that respiratory infections, such as the flu, are especially taxing on the adrenal glands was demonstrated by Lucke and his associates in 1919, when they found signs of adrenal exhaustion in 103 of 126 autopsied cases of mortality from the flu epidemic. In three other cases the adrenal glands had hemorrhaged and enlarged to twice their normal size. In other words, in 106 of 126 patients who died from influenza, the adrenals were actually damaged by the infections. It is not that the adrenal glands were infected per se, but that the effort the adrenals exerted to try to restore balance to the body led them to such exhaustion that it could be detected physically upon autopsy. (4)
This information and the benefits experienced by those taking this formula during the epidemic made many physicians aware of the possibility for recovery from less severe forms of hypoadrenia as well. There was a realization that although textbook cases of endocrine diseases, such as Addison’s disease, exemplify endocrine pathology very well, they are usually too extreme to provide promising opportunities for applying adrenal therapies. By 1919, it had become known that the less severe endocrine disorder of adrenal fatigue was infinitely more common and far more likely to respond to therapy than the full-blown adrenal failure seen in Addison’s disease. (2) By the late 1930s adrenal cell extracts, in their liquid and tablet forms, were being used successfully by tens of thousands of physicians. (3)
I have heard lectures by so-called authorities in medicine who claim that these glandular extracts have no value. The truth is that these physicians must not know how to use these substances correctly, or they would never make these claims. Most medical doctors are totally unaware of the existence of this type of therapy and do not know how to use it. Because it is a departure from their usual thinking and protocol, they are often reluctant to even explore it. If a patient asks about cell extracts, these physicians are typically negative about the subject. But as my friend, the late Dr. Leo Roy, the first holistic physician of Canada said, “Doctors are down on things they are not up on.” This is especially true of live cell substances, such as adrenal extracts, and their use.
Adrenal cell extracts are the cornerstone of effective therapy for adrenal fatigue. There are several brands available in both tablet and liquid form. The liquid is generally more powerful than the tablet; however, it is more costly. I usually use the liquid in moderate to severe cases, and tablets in the milder cases. Dosage for the adrenal cell extract tablets is 6-12 per day, depending upon severity, taken in three to four hour intervals throughout the day. Dosage for the liquid form is usually one vial under the tongue 2-3 times weekly. In severe cases, it may need to be more frequent. The most common liquids available in the United States come frozen and can be shipped to your door. Although both the tablets and the liquids are classified as dietary supplements, they must usually be purchased through a physician.
The doctors who are up on treating adrenal fatigue find significant value in adrenal extracts for alleviating most forms of adrenal fatigue. Today, by combining our knowledge of adrenal cell extracts with lifestyle modifications, dietary supplements, and herbal formulas, we can stabilize people with adrenal fatigue and accelerate their recovery more efficiently than ever before. Adrenal extracts are one of the fundamental treatment protocols used effectively for over 80 years, yet ignored by modern medicine.
Because adrenal fatigue is still a relatively unrecognized syndrome, it is my hope that articles like this one and my book, Adrenal Fatigue: The 21st Century Stress Syndrome, will make physicians more aware that many are unnecessarily suffering from adrenal fatigue and that there are a number of things we can do to help our patients recover from this common, but overlooked, illness.
About the Author
Dr. James Wilson holds a PhD in Human Nutrition from the University of Arizona, Tucson, and is a licensed Doctor of Chiropractic and Naturopathic Medicine. His doctorate studies at the University of Arizona include minors in pharmacology, toxicology, microbiology and immunology. In addition, he holds master’s degrees from two other American universities; one in bio/nutrition and the other in experimental psychology. He is listed in The International Who ‘s Who in Medicine (Cambridge, England).
Dr. Wilson has been in private practice since 1978 and now practices in Tucson, Arizona, where he also conducts private research in cellular immunology. In addition to his clinical interest in nutrition, immunology and natural approaches to wellness, he is a nationally known lecturer, author and talk show guest, as well as a respected nutritional formulator who has worked with nutritional companies to develop formulas presently available to health professionals. He encourages people to use every available avenue to achieve their own health and happiness.
If you would like to contact Dr. Wilson, you can write to him at P0 Box 12242, Tucson, AZ, 85732 or send him an email at email@example.com.
(1.) Wilson JL. Adrenal Fatigue: The 21st Century Stress Syndrome. Smart Publications, Santa Rosa, CA, 2001.
(2.) Harrower HR. An Endocrine Handbook. The Harrower Laboratory, Inc., Glendale, CA, 1939; 17-22.
(3.) Harrower HR. Endocrine Pointers. The Harrower Laboratory, Inc., Glendale, CA, 1933; 111.
(4.) Lucke B, et al. Archives of Internal Medicine, 1919; 23:154.
(5.) McNulty, J. New York Medical Journal, 1921; 93:288.
(6.) Roberts SE. Exhaustion Causes and Treatment: A New Approach to the Treatment of Allergy. Rodale Books, Inc., Emmas, PA, 1968; pg. 76.
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