DO YOU SUFFER FROM ADRENAL FATIGUE?
__ Do you need to take sleep aids to get a good night's sleep?
__ During the night do you often wake up and are unable to get back to sleep?
__ Are carbonated drinks and coffee necessary for you to “make it through the day?”
__ Do you suffer from skin rashes, pimples, allergies, frequent illness or asthma?
__ After eating do you feel nauseated or unable to digest your meal?
__ No matter how hard you try to eat right, diet, and exercise do you continue to gain weight?
__ Do you experience anxiety at the end of the day? Feel irked by small things? Feel pessimistic or have excessive sensitivity to stress?
__ Frequent joint and muscle aches?
__ Dark circles under your eyes that require a concealer to cover them up?
__ Do you have a "buffalo hump" on your back?
__ Crave salt or sugar?
__ Have difficulty becoming aroused for sex?
__ Have difficulty concentrating or finishing a task?
__ Pre or Post menopausal?
__ Have you been prescribed Synthroid for low thyroid values?
If you have answered yes to several of these questions, you are suffering from Adrenal Fatigue, much like the majority of adult Americans. Because the sex hormones, adrenal glands, and thyroid are intimately involved, testing should be performed yearly for all of these functions. Today, most patients are also hypothyroid, so a complete thyroid panel including Total T3, T4, and TSH should be performed. Many practitioners today are making millions of dollars testing free T3 and T4. This is all well and good, but unless the T3 is bound to gobulin and the T4 is bound to protein, no thyroid hormone has been produced. A total T3, T4, and TSH should provide the practitioner with adequate information to balance thyroid values.
“The adrenal glands lie at the superior poles of each of the two kidneys. Each gland is composed of two distinct parts, the adrenal medulla and adrenal cortex."¹ For our purposes, we will focus on cortisol, which is the principle glucocorticoid produced by the adrenal cortex. "Glucocorticoids stimulate the formation of carbohydrates from proteins by the liver."²
Cortisol increases all enzymes required to convert amino acids into glucose in liver cells. Amino acids are the primary building block for energy in the body. When there is a lack of cortisol, all metabolic processes are impaired, including the ability of the liver to have sufficient enzymes for optimal liver function.
Adrenal function can become impaired by trauma of any type; infection, surgery, ongoing stress situations, chronic lack of sleep, food choices, pharmaceutical drugs, and severe emotional distress. Cortisol is light sensitive, so when the sun comes up, the body begins its production. In optimal circumstances, the adrenal gland modulates cortisol production throughout the day and night, to handle the stressors we all encounter.
When sundown approaches, the adrenal glands ideally should slow production to allow us to prepare for sleep. The reality is that today by sundown, adrenal production increases, and the patient is "sleepless in Seattle." Cortisol is light sensitive, so years ago before the invention of the electric light, people went to sleep when the sun went down. This was the optimal situation for adrenal gland function. They also arose with the sun, and the adrenal gland began its correct function: to help us modulate the production of cortisol throughout the day. Today, because of shift work and lifestyle changes, the adrenal gland has decreased function.
Actuarials have proven shift workers live an average of seven years less than those who work during the day. The disruption of the circadian rhythm or sleep cycle is extremely detrimental to total body health. Usually, the upside down adrenal process begins again the next day. This is why no one who begins taking Ambien, Lunesta, or Excederin P.M. ever stops taking these sleep aids.
For those persons whose adrenal gland is fatigued, the gland is not able to catch up to the body's needs for cortisol until early evening. The result of this situation is that these people are unable to sleep, and must take sleep aids to get a good night's rest. Even with the supplementation of sleep aids, most hypo adrenal patients do ever not receive a "good night's sleep". Only thyroid, sex hormone replacement, and adrenal supplementation can remedy the situation.
Life style changes that would help "the Sleepless in Seattle situation" would be to get to bed by 9:30 pm or 10:00 pm at the latest. If the patient is not experiencing Rapid Eye Motion (REM) sleep between 2 and 5 am, the body will not be able to complete its repair of the immune system. Sleep space should be dark, cool, clean, have no night light, and no noise from a television. Electronic gadgets such as alarm clocks, phone chargers, and clock radios should not be kept in the sleep space. EMFs or Electro-magnetic frequencies are emitted from these appliances, and can cause severe immune and adrenal system dysfunction. The television should be at least 12 feet away from the bed.
Patients should stop or modify abusing caffeine, sugar, and fast food. All humans should drink minimum of one half body weight in ounces daily of filtered water. Our bodies have not chemically evolved in millions of years, so hydration only occurs when water is consumed. The body does not recognize ice tea, coffee, or soft drinks as hydration, with the exception of green or white tea.
For hydration purposes, if a person weighs 100 pounds, the minimal amount of water the person should consume daily would be 50 ounces. This amount is sufficient as a minimum, if no physical exertion is performed during the day. It is helpful to purchase water bottles and set the needed amount out each morning as a goal for the day. Plastic bottles should never be placed in the dishwasher, as the hot water releases plasticides into the water. Warm water and soap is the preferred method to clean plastic bottles. Even more environmentally friendly are non-disposable water containers.
Stress is measured by saliva cortisol testing. Cortisol, the product of the adrenal gland is measured four times during the day and evening to determine the level of cortisol the patient has at each particular time of the day. After testing, natural adrenal supplements can be prescribed at the correct time of day to give the patient optimal adrenal function. If a patient has low cortisol, at certain times of the day, or hypoadrenal, we prescribe a compounded product called "Cortisol", which is compounded from natural sources. Before the patient's cortisol falls, Cortisol is given two hours before the adrenal function plummets.
Sometimes, we have patients whose testing reveals hypo-adrenal at certain times of the day, and hyper-adrenal at other times of the day; meaning they have too little or too much cortisol production at certain times or the day or the night. For those patients who are also hyper-adrenal, we prescribe Pregnenalone.
"Pregnendlone is the memory hormone. In animal studies, it improves memory one hundred times more than DHEA."3Pregnenalone allows the adrenal gland to modulate its output of cortisol throughout the day and night. In the adrenal cascade, Pregnenalone is the first hormone to be made from cholesterol. Pregnenalone allows the body to choose which other hormones it will make according to its needs of the body. In todays upside down world, most people over 50 years old would benefit from 25mg of Pregnenalone given two times daily.
Because the body needs cholesterol to make Pregnenalone, many people are classically Pregnenalone deficient. Millions of Americans are dutifully destroying the cholesterol our body needs to function by taking statin drugs such as Lipitor, Zocor, and Crestor. If patients have a total cholesterol below 150, no thyroid, adrenal, or sex hormones can be made. A certain part of cardiac health is controlled by cholesterol.
For patients who have excess total above 250 cholesterol, only 30% of patients experience cardiac arrest. The majority of cardiac issues can be laid squarely at the door of inflammation. And what is cholesterol after all? It is inflammation. Tests for inflammation for patients taking statin drugs are fibrinogen, highly sensitive C - reactive protein, and Homocysteine. If any of these cardiac risk factors are elevated, natural supplements can be given.
In fact, millions of Americans are adrenal and sex hormone deficient, because of over prescription of statin drugs. Many patients have reported to us their physician said their cholesterol "could never be too low." The opposite is the truth. The first fact we learned from graduate study as nutritionists is the body's necessity for a certain amount of cholesterol.
Optimal values from cholesterol should be 170, or even up to 200 and above, as long as HDL is high. Cholesterol forms a protective barrier against invading pathogens. Too much cholesterol is detrimental, no question about it, but too little is harmful as well. The doctors and the pharmaceuticals are well aware of this fact, but choose to ignore it; in pursuit of profit from illness.
Red Rice Yeast is a natural supplement that reduces cholesterol. It is a "natural statin," and has the same side effect as pharmaceutical statins, including the same possible muscle aches and pains. 1,200mg should be taken after each meal. If a patient is taking Red Rice Yeast, 100 milligrams of CO-Q10 should be added to replace the enzyme in the heart depleted by the Red Rice Yeast and pharmaceutical statins.
Canadian pharmaceutical companies warn patients taking statin drugs to supplement with 100 milligrams CO Q10. CO Q10 is a natural enzyme produced by the heart. Unfortunately, our law allow millions of American patients to take statin drugs with no warning of the danger of lack of CO Q10. Yet, if a choice between a synthetic chemical statin and a "natural statin" was presented, the natural version would usually win with the patient. Unfortunately most patients are never offered the option.
Testing for adrenal function is performed by saliva testing at home. The results are mailed to ZRT labs. We test sex hormones in addition to adrenal function; they are Estradiol, Estriol, Progesterone, Testosterone and DHEA. Women produce Estriol which is the "protective" estrogen. Estriol and Estradiol are prescribed in all estrogen prescriptions. This bio-identical formulation is called Biest. Biest and all other hormones we prescribe originate from Yam sources. The formulation is 20% Estradiol and 80% Estriol. This is exactly the same estrogen percentage found in the body.
In addition, all patients are tested with a fifty value blood test including microscopic urinalysis. Four thyroid values are evaluated as well. It is optimal to test hormone, adrenal, and thyroid function; they are all aspects of endocrine function. If you fix one endocrine value, and not the other, the patient will not achieve an acceptable state of wellness. It is similar to a performance of the "Three Musketeers", and only one or two appearing on stage. It would certainly not make for a satisfying performance.
The information in this article may seem disturbing to many of you. Some may have the knee jerk reaction to go to your primary care physician to talk about bioidentical sex hormones, adrenal glands, thyroid dysfunction, and cholesterol. When you have your five or ten minutes with your practitioner, you may show him this article, and you will be told that this information is just "not proven". The reality is that standard medicine operates within a rigid timeline. If the practitioner spends anymore than 5 to 10 minutes with the patient, they are losing money. Most physicians simply will not allow patient health to overrule their financial interests.
The "expected values" for each chemistry on a lab report were designed 50 years ago to alert a doctor of disease in progress, when the values fell outside of the limits. The authors of these textbooks could not have guessed the severe symptoms of endocrine and exocrine dysfunction in our society in the year 2014.
In addition, many doctors one hundred years ago were advocates of homeopathy in combination with allopathy. Those doctors could never imagine the death grip the pharmaceuticals now exert over the patients and doctors of the world today. Nor could they dream of the impairment of adrenal, hormone, and thyroid function caused by overuse of pharmaceutical drugs, altered lifestyles, antibiotics in food sources, consumption of fast and GMO foods, and disruption of the sleep cycle in 21st century.
Many of our patients report they dutifully made the annual physical appointment with their primary care physician as their insurance instructs them to. The patients often ask for testing for hormone and thyroid functions. Frequently, females are offered an anti-depressant or a synthetic hormone, usually in the form of a "convenient patch". The hormone symptoms women suffer are night sweats, crying for no reason, menstrual cycles lasting for fourteen days, lack of interest in sex, dry skin, and weight gain.
The synthetic hormone estrogen/progesterone combination is usually given without testing to determine what the patient's need for hormones might be. Remember, significant money cannot be made from testing within the standard of care insurance model". The luxury of our practice that there is no knock on the door. We are able to devote as much time as we need for each patient. Tests should include adrenal/hormone function, review of lab results, formulation of a natural hormone replacement, consultation with the patient, and sending Rx for the bioidentical blend to a compounding pharmacy for formulation. Most medical doctors have no idea how to test or write a protocol for adrenal/hormone replacement. Natural medicine left the standard of care in 1910. Rockefeller decided his interests would be better served by pharmaceutical medicine. He funded 6 medical schools.
Adrenal testing routinely does not occur in insurance fueled medicine, unless a severe disease state exists in the adrenal gland. Blood testing is usually the only modality used to determine hormone status in standard of care medicine. Saliva hormone testing is preferable to blood testing because saliva testing will indicate free hormone status and blood testing will only indicate total hormone status. How can a practitioner accurately determine what dose to give if the hormone is bound to albumin and globulin?
For more information about us and our protocol visit us at:
Dr. Frank McGehee, M.D., C.C.N.
Vivienne McGehee, B.A. C.N.
Call 936-291-3351 or e-mail: email@example.com
1909 22nd Street, Huntsville, Texas 77340, U.S.A
1 Arch Intern Med 2008 April 28:168 (8) in 855-60.
2 "The Textbook of Medical Physiology." Arthur Guyton MD and John Hall Ph.D. 1996. ISBN 0-7216-5944-6 p.957.
3 "Breakthrough" Suzanne Somers. Copyright 2008 ISBN 978-1-4000-5327.8. p.11