ADRENAL FATIGUE part-2

ADRENAL GLANDS BASICS

The adrenal glands are two small glands situated on top of the kidneys. Their purpose is to help the body to cope with stress and help it to survival. Each adrenal gland has two compartments.
Ø Inner or Adrenal Medulla modulates the sympathetic nervous system through secretion and regulation of two hormones called Epinephrine and Nor-epinephrine that are responsible for the “fight or flight response”.
Ø Outer Adrenal Cortex comprises 80 % of the adrenal gland and is responsible for producing over 50 different types of hormones in three major classes –

1) Glucocorticoids - most important glucocorticoid is CORTISOL. When this is lowered, the body will be unable to deal with stress as in the case of adrenal fatigue.

2) Mineralcorticoids - most important is ALDOSTERONE which modulates the delicate balance of minerals in the cell, especially sodium and potassium. It therefore regulates blood pressure. Stress increases the release of aldosterone, causing sodium retention (leading to water retention and high blood pressure) and loss of potassium and magnesium. When the body lacks magnesium, it will suffer from a variety of pathological conditions such as cardiac arrhythmias, uterine fibroids and osteoporosis.

3) Androgens - the adrenal cortex is also responsible for producing all sex hormones, although in small amounts. One exception is DHEA, a weak androgenic hormone that is made in large amounts in both sexes. DHEA, together with testosterone and estrogen, are made from Pregnenolone, which in turn comes from cholesterol. Pregnenolone also leads to the production of progesterone and as one of the intermediary steps in the making of cortisol. Pregnenolone is therefore one of the most important intermediate hormones being produced in the hormonal cascade. Prolonged deficiencies in Pregnenolone as that in adrenal fatigue will lead to reduction of both glucocortico-steroids and mineralcorticoids such as cortisol and aldosterone respectively.

Cortisol

The most important anti-stress hormone in the body is cortisol. Cortisol protects the body from excessive stress and adrenal fatigue by:
· Normalizes blood sugar - Cortisol increase blood sugar level in the body, thus providing the energy for the body to physically escape threat of injury in order to survive. Cortisol works in tandem with insulin from the pancreas to provide adequate glucose to the cells for energy. More energy is required when the most important anti-stress hormone in the body is cortisol.
· Anti-inflammation Response - Cortisol is a powerful anti-inflammatory agent. Cortisol is secreted as part of the anti-inflammatory response. It's objective is to remove and prevent swelling and redness of nearly all tissues. The cortisol response may be blunted in adrenal fatigue.



· Immune System Suppression - People with high cortisol levels are very much weaker from the immunological point of view. Cortisol influences most cells that participate in the immune reaction, especially white blood cells. Cortisol suppresses white blood cells, natural killer cells, monocytes, macrophages, and mast cells. It also suppresses the auto-immune system response to foreign insult. The immune response can be blunted in adrenal fatigue.

· Vasoconstriction - Cortisol contracts mid-size arteries. People with low cortisol (as in advance stages of adrenal fatigue) have low blood pressure and reduced reactivity to other body agents that constrict blood vessels. Cortisol tends to increase blood pressure that is moderated by calcium and magnesium.

· Physiology of Stress - People with adrenal fatigue cannot tolerate stress and will then succumb to severe stress. As their stress increases, progressively higher levels of cortisol are required. When the cortisol level cannot rise in response to stress, it is impossible to maintain the body in optimum stress response.

In summary, cortisol sustains life via two opposite but related kinds of regulatory actions:

Ø releasing and activating of existing defense mechanisms of the body, and
Ø shutting down and modifying the same mechanisms to prevent them from overshooting and causing damage or cell death.



Cortisol Regulation

The adrenal glands are controlled via the hypothalamus-pituitary-adrenal (HPA) axis. There is an existing negative feedback loop that governs the amount of adrenal hormones secreted under normal circumstances in people with adrenal fatigue.

Cortisol and Adreno-Cortico Trophic Hormone (ACTH) are not secreted uniformly throughout the day. They follow a diurnal pattern, with the highest level secreted at around 8:00 a.m. in the morning after which there is a gradual decline throughout the day. Episodic spikes during the day can also occur when the body is stressed or when certain foods are taken. The cortisol level is at its lowest between midnight and 4:00 a.m.

COMMON CAUSES OF ADRENAL FATIGUE

Chronic stress is very common in the western society. The most common causes of stress are work pressure, death of a love one, moving house, changing jobs, illness and marital disruptions. Adrenal fatigue occurs when the amount of stress overextends the capacity of the body to compensate and recover from stress.

Stressors that can lead to adrenal fatigue include:
· Anger
· Chronic fatigue
· Chronic illness
· Chronic infection
· Chronic pain
· Depression
· Excessive exercise
· Fear and guilt
· Gluten intolerance
· Low blood sugar
· Mal-absorption
· Mal-digestion
· Toxic exposure
· Severe or chronic stress
· Surgery
· Late hours
· Sleep deprivation
· Excessive Exercise
· Excessive sugar in diet
· Excessive caffeine intake from coffee and tea
One of the most commonly overlooked causes of adrenal fatigue is chronic or severe infection that gives rise to an inflammatory response. Such infection can occur sub-clinically with no obvious signs at all. Parasitic and bacterial infections including Giardia lamblia and H. pylori are often the main culprits.