Adrenal Fatigue Part 1

I have been at least half way around the world in the last two and a half weeks with meetings as far as Hong Kong and Kuala Lumpur. During the middle of my trip, I began to experience fatigue, loss of appetite, muscle weakness and some depression. The fatigue became more and more pronounced and four days went by without my eating anything substantial. I slept the entire flight back to Rome and began to recover slowly. As I write this, I am on board a British Airways flight from London to Dulles Airport in DC feeling more “normal” than I have felt in the last two weeks. There was never any fever involved and no nausea, vomiting or diarrhea. I experienced only fatigue, weakness and appetite suppression which did cause weight loss. Now, as a physician, common sense tells me that the stress of travel, especially into varying time zones in such a short period, could predispose one to flu like symptoms which would resolve on their own. Uncommon sense however also makes me wonder whether the additive stresses of my schedule the two weeks before I departed, the stresses of international travel and the daily stresses of worrying about the clinic while I am gone resulted in a full blown adrenal fatigue syndrome. And that, dear friends, is the long winded introduction to ADRENAL FATIGUE, one of the most pervasive, yet under diagnosed health conditions affecting people today.

Decrease in optimal adrenal function has become a common occurrence in modern society with far reaching implications for most organs and systems. It includes all ages, occupations, races, social and economic groups. In older individuals it contributes to the combined processes of aging. Adrenal Fatigue occurs as both a distinct clinical disorder and as a contributing factor to many chronic illnesses. Primary care physicians see Adrenal Fatigue sufferers in their offices every day under the guises of weakness, fatigue, chronic fatigue, depression and an inability or unwillingness to participate in activities of daily living. Yet, it is seldom detected by most practicing health care professionals because it is not looked for, it is not properly diagnosed when the signs and symptoms are present, and it is seldom properly treated even if recognized. The patient is left to wander from doctor to doctor wondering if help will ever come.

I realize that I have not addressed the adrenal glands per se but I will get to that. The preeminent role of the adrenal glands in stress came into prominence with Hans Selye’s series of experiments and his GENERAL ADAPTATION TO STRESS theory. Stress affects the part of the adrenal gland known as the adrenal cortex and occurs in three phases. The initial reaction or ALARM phase consists of an increased secretion of cortisol, the adrenal stress hormone, followed by a decreased secretion, increased incidence of stomach ulceration, decreased white blood cells, increased blood glucose, decreased body weight and less resistance to added stress. The stage of RESISTANCE, or second phase, shows a chronically increased concentration of cortisol to combat the stressors and an ability to withstand stress. Body weight returns to normal and may increase. The final phase, the STAGE OF EXHAUSTION results from decreased cortisol levels. The brain has finally said ” enough is enough” and shuts down cortisol production in the adrenal glands. This results in a very decreased ability to withstand stress and a tendency toward premature aging.

In the next blog, I will address the adrenal glands themselves to foster a better understanding. of why these tiny anatomical structures are just so important for survival. As always, thanks for listening!

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