Adrenal Fatigue
(what the heck is that?)
Adapted from Stop the Thyroid Madness, a great resource for Hypothyroid and Adrenal Fatigue information.
The adrenals are what handle the stress or "Fight or Flight" response in the body. Meaning, we experience stress, adrenaline kicks in and gives our body an energy boost. As cave women, it was great for fighting the occasional tiger (or running from said tiger) which we only had to do on occasion. But in the modern world we can experience stress every day from work, family, money, poor diets, and illness/disease which means continually draining the adrenal system.
We risk burning out the adrenals, resulting in a "crash" (which over time can lead to Low Cortisol). You know that feeling after a big family holiday ends you just want to lie on the couch for days? Or you've finished a big work deadline and either you get sick, or simply can't do anything for a few days? That's the adrenal crash from stress. When you say "you burned yourself out" that's totally true! You did, you fought that tiger, and you won, sister! But now you're paying.
With Adrenal Fatigue the body burns itself out trying to produce Cortisol and eventually gives up, resulting in Low Cortisol (see the symptom list below). If you've had a poorly functioning thyroid, the body considers this a kind of stress which could then drain the adrenal system. Another important detail is that Cortisol helps move the thyroid hormone from the blood to the cells. So while you might be taking Thyroid Medicine it may not be making into the cells, shocking! In short, treating Hypothyroid also means looking at Adrenal Fatigue.
Here are some of the signs and symptoms of Adrenal Fatigue, which happen to overlap with Hypothyroidism so its possible to have one condition but not the other, and important to explore treating both:
- Generally feeling fatigued or low energy
- Feeling tired even with plenty of sleep (like more than 8 hours)
- Insomnia/difficulty getting to sleep or staying asleep
- Weight gain
- Depression
- Feel emotionally off kilter
- Hair loss
- Acne
- Caffeine addict
- Craving carbohydrates and sugars
- Craving for salt
- Getting sick or run down a lot
- Sensitive or intolerant to cold temperatures
- Continuing hypo symptoms with a high free T3
- Shaky hands; shakiness
- Diarrhea
- Heart palps
- Feeling of panic under stress
- Physically weak
- Difficulty interacting with others
- Rage or sudden angry outbursts
- Emotionally hyper sensitive
- Overreacting or Defensive
- Feeling paranoid about people or things
- Impatient or easily irritated
- Hypoglycemia
- Nausea and shakiness in the face of stress
- Poor recovery from even minor stress, including stresses like a dental visit
- Flu-like symptoms
- Headache
- All over body ache
- Super-sensitive skin
- Scalp ache/tingle
- Jittery, hyper feeling
- Clumsy
- Confused/Cloudy Thinking
- Suddenly feel extremely hungry
- Low back pain
- Muscle weakness, less strength or endurance than others
- dizziness or light headedness (especially when going from laying down to standing, or sitting to standing)
- Motion sickness
- Being able to sleep after coffee, or requiring a lot of caffeine to even stay awake
- Vomiting even running up the slightest incline
- Dark circles under the eyes
- Frequent urination
- IBS symptoms
- Worsening allergies
Test Option 1: Above Symptoms
If you answered yes to at least half the symptoms above, in particular the symptoms related to low energy and poor sleep that's a good first indicator of Adrenal Problems.
Test Option 2: The Pupil Test
This is a free test you can try at home, right now. This primarily tests your levels of aldosterone, another adrenal hormone but will give you some quick insight about whether there might be an adrenal problem.
- Go to a darkened room with a mirror.
- Angle a flashlight from the side (not the front), and shine the light toward your pupils.
- Hold it for about a minute.
- Carefully observe the pupil.
- If the pupil stays constricted the entire time that is normal.
- With adrenal fatigue, the pupil will get small at first but within 30 seconds or so it enlarge again, or flutters large and small in its attempt to stay constricted. This happens because adrenal insufficiency can also result in low aldosterone, which causes a lack of proper amounts of sodium and an abundance of potassium. This imbalance causes the sphincter muscles of your eye to be weak and to dilate in response to light.
Test Option 3: 24 Hour Saliva Test
These are typically not covered by insurance and cost about $120-150 out of pocket, but they are more accurate than blood or urine tests which are covered by insurance. Once you have a good doctor discuss ordering a 24 Hour Saliva Test or order it yourself directly from labs such as:
A low dose of Hydrocortisone in pill form (20-30mg/day) is often prescribed for Low Cortisol. Hydrocortisone is a steroid, I know, I know, that sounds scary but your body is already creating it naturally (or at least it was until it got burned out). Long-term high doses of steroids (say 80 + mg a day) would be a concern, but under 30mg a day is considered safe. According to my doctor, if you take the Hydrocortisone and don't notice a difference you probably didn't need it. In my case, within hours of starting the Hydrocortisone I felt amazing. And over time I have noticed improvements in all the issues noted above, specifically my ability to exercise and have energy throughout the day.
[Update: I am not sure if Hydrocortisone is good for a long-term treatment (more than a few months). Especially if stress-dosing too high, and for long periods. I found my hair was thinner during the time I was on Hydrocortisone (about 3 years) and is growing thicker now that I am off Hydrocortisone. However, I very much needed Hydrocortisone in the beginning to help strengthen my adrenals.]
Hydrocortisone only stays in the body for about 3-6 hours, so its taken throughout the day and should be taken consistently. Cortisol is highest in the morning and tapers throughout the day (with a big drop usually around 3pm which explains why we all want naps at that time!).
Dose-wise for me the Hydrocortisone lasts about 3.5 hours (everyone is different). I take more in the morning and taper accordingly. So first thing in the morning I take 10mg, 7.5mg at lunch, 5 mid-afternoon and 2.5 after dinner.
In times of stress like sickness, holidays, travel, a fight with someone, or work stress I will "stress dose" which means I take an extra 10 mg (and more as needed). This helps in those "fight the tiger" moments. I will explain more about this later because its pretty important.
Stress Found to Weaken Resistance to Illness
