So, what is 'adrenal fatigue' or 'mild adrenal insufficiency'?
Unaddressed, chronic adrenal fatigue can go on to âAddisonâs Diseaseâ, whereby the adrenal glands can no longer function to produce hormones and they begin to shut down. This is a very serious medical condition and the only one formally recognised as such by the medical establishment (the opposite of which is known as âCushingâs Diseaseâ).
The purpose of this post is two-fold:
1. To provide factual information, taken from studies and science that this condition DOES exist and is becoming a very serious concern for 21st century healthcare
2. To dispel the myths once and for all that because this condition (in all its forms) is not yet fully recognised by the medical establishment does NOT mean it doesnât exist. I wish to present historical evidence from well-known medical doctors which shows, that on this issue, the medical establishment is wrong.
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Â· You can be tested for âadrenal insufficiencyâ which correlates to Addisonâs Disease also known as Hypo-adrenia (whereby the adrenal glands do not produce sufficient hormones)
Â· Adrenal insufficiency can be diagnosed by blood tests and special stimulation tests that show inadequate levels of adrenal hormones.
Â· Usually, when adrenal insufficiency is suspected an 8am serum cortisol test will be ordered. If this is low, the patient will be given an ACTH stimulation test. Since ACTH (from the pituitary) stimulates cortisol (from the adrenals), the patient is given simulated ACTH to âtestâ how well the adrenals produce cortisol. Then, a second time lapse style test is given to differentiate whether the problem is originating in the pituitary or adrenals. This is often done in conjunction with full blood work and / or scans to determine cause of symptoms.
Â· Current mainstream medical literature does not recognise adrenal fatigue in any form (except Addisonâs or Cushingâs disease) as a medical condition.
Â· It has not yet been accepted by the medical establishment that ongoing, chronic stress and / or the prolonged use of stimulants have any effect on the adrenal glands in the human body.
Â· As far back as 1939, Dr Fuller Albright had already become famous as a pioneer investigator of adrenal function at the prestigious Harvard Service of the Massachusetts General Hospital, which is where the New England Journal of Medicine is published.
Â· A student of Dr Alrbright, named Dr. William Jeffries coducted a study which gave rise to the idea that there could be mild adrenal dysfunction, something in between the two extremes of the very low adrenal function called 'Addison's Disease' and the very high adrenal levels called 'Cushing's Disease'. This study conducted by Dr William Jeffries was backed by Dr Fuller Albright.
Â· The above study was published as "The present status of ACTH and cortisone in clinical medicine," and was published in the New England Journal of Medicine in 1955. It showed that the use of hydro cortisol treatments produced beneficial results in patients suffering from âmild adrenal insufficiencyâ.
Â· Dr. Jeffries then penned a more recent book called âSafe Uses of Cortisoneâ.
Â· The work of Dr Jeffries strongly influenced the work of Hans Seyle, author of âThe Stress of Lifeâ. It was, in fact, Selye who famously and painstakingly proved to the satisfaction of the vast majority of scientific opinion that that long-term mental, emotional, or physical stress drains the adrenal glands and causes many common symptoms.
Â· A recent statement made by Dr Richard Shames, a well-respected integrative physician and hormone expert, co-author of 'ThyroidPower' and 'Fat, Fuzzy & Frazzled' in 2010, regarding the position of the Endocrine Society that adrenal fatigue does not exist and is not recognised as a diagnosable medical condition: âI can assure you [and your readers] that the above-mentioned collections of adrenal research contradict and prove that the Endocrine Society is wrong in failing to accept the existence of adrenal fatigueâ.
Â· Some state that the saliva tests for this condition are not based on scientific evidence. To the contrary, the University of Colorado Health Sciences Center position on this was published by Gozansky in the equally well-respected and peer-reviewed Journal of Clinical Endocrinology, September 2005. The article title says it all: "Salivary cortisol as measured by immunoassay is preferable to serum (blood) cortisol for assessment of dynamic hypothalamic-pituitary-adrenal axis activity." In other words, saliva tests for adrenal fatigue ARE based on scientific facts, supported by good scientific studies.
Â· Additionally, Dr Richard Shames states: âEndocrine Society has refuted itself. I found one of their "Clinical Practice Guidelines for Doctors" that actually ADVISES physicians to use a late night saliva test for cortisol in an adrenal diagnostic situationâ. This shows that the Endocrine Society are advising the public one thing, being that adrenal fatigue does not exist and is not recognised as an illness and then advising medical practitioners something completely different, contradicting themselves in the process.
Â· Finally, Dr Richard Shames states that indeed, adrenal fatigue is a diagnosable illness however the name for the condition that is commonly used is not accurate. âI want patients to understand that adrenal fatigue is certainly a real illness, but not the accepted medical name for it. People are likely to obtain attention from practitioners and reimbursement from insurance companies simply by calling it "Mild Adrenal Insufficiency."
The above excerpts taken frominterview conducted in 2010 with Dr. Richard Shames who is a graduate of both Harvard and the University of Pennsylvania, and trained extensively with the National Institutes of Health.
Whilst there are yet to be sufficient 'controlled studies' performed to change the general 'opinion' on this matter (for opinion is all it is and the above information proves that) it does not mean that the condition does not exist. It merely means that medical science requires more information. It appears that a clear set of symptoms have yet to be identified by medical practitioners. It also appears that more accurate diagnostics are required and these are currently lacking.
Sadly, rather than address these shortfalls in current practices, the general consensus has been to simply ignore the condition in its entirety.
It seems that as more and more people present with symptoms or diagnosed cases (as done so by the more progressive and informed members of the medical establishment), resources appear from progressive medical experts from as far back as 1939 who have disagreeing with the general consensus all along.
Unfortunately, I can not turn the entire medical establishment opinion on this matter on its head in one article. I can, however, present all the evidence which is available from medical practitioners of good standing so that you can make informed decisions or insist upon better diagnostics from your Doctors. Knowledge is power.
Part Two of this series will address causes and treatments, including âmedicalâ treatments available.
The Eco Mum