Adrenal fatigue? page 2

[sbhikes]

I've been eating a buttload of sugar lately mainly in the form of candy. It's that time of year.

[RichMahogany]

Chris Kresser keeps mentioning HPAD (Hypothalamic-Pituitary-Adrenal Dysfunction) in his RHR podcasts but never goes into as much detail as I'd like. I googled around with those search terms and found some stuff, maybe it can set you on the right track.

[Paleobird]

I guess the main symptom for me is that I am always in a state of DOMS and I notice that the pain goes away under stress or caffeine. If I rest or take days off and do absolutely nothing, I start to feel worse rather than better, like I'm falling apart.

Of course you have DOMS. You have recently taken up a serious weight lifting program. The pain goes away under stress because of the endogenous morphine (endorphins) the body produces in response to stress or trauma. The caffeine is a vaso-dialator which is why it is the main ingredient in Excedrine for headaches.

I would suggest backing off the intensity a bit (not necessarily the frequency). I know weight lifting can be addictive but you don't really have to stack all those plates on the bar today, build up more gradually.

[Rueben]

It's actually hydrocortisone - not hydrocortisol, and I would really hesitate in recommending someone take it for adrenal fatigue. Taking an exogenous source of cortisol (including any type of corticosteroids) will actually cause your adrenal glands to slow down their own natural production of cortisol and can cause an induced state of adrenal insufficiency which can be really serious!

To the original poster - the first thing to do would be to see your regular dr. Mention your symptoms and your thoughts that it is adrenal related and hopefully your dr. will check your cortisol, ACTH, aldosterone and renin levels to see how your adrenals are actually functioning - then go from there. Most regular dr's will not recognize adrenal fatigue as a medical condition, but I think it is important to rule out Addison's or secondary adrenal insufficiency before you try treating on your own.

According to Dr James Wilson who treats a lot of people with adrenal fatigue hydrocortisone only diminishes the adrenal function while taking it, it can give the adrenals a rest and is a therapy for severe adrenal fatigue if administered in physiological doses to emulate the natural daily secretion of cortisol.

The danger with synthetic corticosteroids is the massive dose people are given and the length of time they are on them. My doctor obviously is experienced with using hydrocortisone and adrenal cell extracts as well as supplements to strengthen adrenal function sobi feel comfortable with this decision as he informed me of the differences between synthetic, natural and cell extracts before he prescribed them.

The OP asked for people's experiences with finding a doctor who knew what they were talking about. I believe i have been lucky enough to find one after years of being offered antidepressants and anxiety medication by "pill pushing" GPS who don't look at the whole picture.

It comes back to hormonal balance and how the body can't function without them.

I would rather take what has been prescribed for 5 weeks than be on antidepressants for years. I'm sure there are depressed, chronically fatigued fibromyalgia patients who would agree with me and my fantastic doctor. That's the point, regular doctors only recognise Addison at one end of a bell curve and cushings on the other. This "does adrenal fatigue exist" question frustrates me a little as why cant you have Low cortisol before the adrenal give out totally whereby you then have Addison s? Surely there is a progression towards Addisons whereby people feel like crap but dont yet fit into the CW bell curve? Why is it so controversial to support and heal a part of the body to prevent illness? Maybe pharmaceuticals companies want to sell more steroids?

Oh the other thing I forgot to mention was my doctor gives presentations to other doftors on adrenal fatigue and thyroid function. He showed mehis power point presentation to illustrate what was going on. He drew pictures, he spent over an hour on me. But he also showed me a lady's results where her TSH was 9.5 and by purely treating her adrenal function her TSH went down to 2.0. Adrenal function has to be sorted before thyroid is treated and if you still feel like craps on thyroid medication this might be the part of the puzzle.

[Baba]

My doc is a disciple of Thierry Hertoghe. After a long series of questions, blood test and 24hrs urine lab, he gave me both Hydrocortisone and Aldosterone. I added Vitamin B5 and Rhodiola. After a year or so I weaned myself of the Hydrocortisone and after another year of the Aldosterone. I have also quit the above supplements (I have kept others). The treatment was spot-on and coming off the meds was easy.

[EyeOfRound]

I'm in the "it's not a real diagnosis" camp. Also, I'd be wary of anyone who thinks it's appropriate to diagnose a person with any sort of adrenal insufficiency without an ACTH stimulation test.

[Rueben]

I'm in the "it's not a real diagnosis" camp. Also, I'd be wary of anyone who thinks it's appropriate to diagnose a person with any sort of adrenal insufficiency without an ACTH stimulation test.

Can you tell us why you think it's not a real diagnosis? Why is no cortisol, addisons and people feel like death, but low cortisol is somehow nothing? When people feel like crap, but not as crap as those with addisons?

Is it a non diagnosis because you didn't learn about it at medical school?

[Mamame]

Can you tell us why you think it's not a real diagnosis? Why is no cortisol, addisons and people feel like death, but low cortisol is somehow nothing? When people feel like crap, but not as crap as those with addisons?

Addison's isn't NO cortisol. I was diagnosed with Addison's last year and my cortisol was nowhere near 0! You'd be dead before a diagnosis if that was the case.

There is a progression of Addison's (which is often why it takes a long time to be diagnosed, but the adrenal destruction is there from the beginning (tests would show the presence of anti-adrenal antibodies). When I was first diagnosed my cortisol was still in the *normal* range. But my ACTH was sky high and my ACTH stim test did not double or even get close to where it should have been.

I'm not saying that adrenal fatigue doesn't exist (I'm still on the fence about that one), what I am saying is that before deciding a person has adrenal fatigue they need to rule out something more serious and not try and self treat.

I also have to say I disagree with your doctor, Rueben - for most, the adrenals will not immediately start working again when you stop taking hydrocortisone. For most people there will (or at least should) be a very slow weaning (many people with steroid induced adrenal insufficency take about 2 YEARS to wean off their steroids and it is a very difficult journey). Failing to wean off slowly could lead to an adrenal crisis which can be fatal of not recongized as such and treated immediately! I'm not saying YOUR dr. isn't knowledgable and isn't treating YOUR case correctly, what I'm saying is that OTHERS need to seek out appropriate medical attention and make sure that whomever is treating them knows exactly what they are doing - this isn't something that should be treated on ones own.

[Owly]

Weaning off even a steroid inhaler sucked majorly for me, and that was nowhere near what someone experiences coming off oral steroids. I was miserable. On the other hand, that was better than continuing to live with the side effects of taking a steroid medication daily.

But anyhow, sbhikes, before you jump to adrenal fatigue (which I also question, not the possibility of it but the frequency with which it is diagnosed in questionable circumstances and the poor research out there supporting diagnosis and treatment), I'd suggest considering that you're simply pushing your body too hard too fast. Lifting weights is good, but I read about how long you are working out and how often, and I think you should consider reducing the training volume first.

Yes, you read in stuff like SS that one should lift several days a week, and you may be talking to women on your weightlifting board who say you should be able to train more. However, you should listen to your body's responses over a book written with young men as a primary audience. And the women in that group may be younger, more experienced at lifting, more adapted to recovery, or (shockingly!) even not entirely honest with others or themselves about how they're feeling. I know I have had times when I did not want to admit how crappy I felt with high training volumes because that would mean admitting it to myself and needing to change things too, and also feeling virtuously crappy can be addictive.

What is your average workout looking like currently?

[sbhikes]

The thing with the weights is previously I had been taking a group fitness class twice a week and I never could adapt to it. I was always sore for days afterwards, crippling soreness sometimes like not being able to roll over in bed or having trouble lowering myself to the toilet. I kept hoping that I'd get strong enough for this class eventually but it never happened.

I started that class a year ago because things like bending over to clean the tub or pull weeds would leave me similarly crippled. Since I don't clean my tub or pull weeds very often, I thought the class would help build enough resilience not to make housecleaning such a devastating occurrence for my body.

The class basically didn't help me and became its own problem, so I thought maybe a real strength training program would help me. It tends to leave me not quite as cripplingly sore as the class, the tub or the weeds. Instead it sort of wipes me out. Meanwhile, although supposedly I'm getting stronger, doing something other than weight training, such as sprinting or an extra long hike, still leaves me with incredible DOMS that lasts for days. I can't seem to adapt to anything and it's been a really long time that it's been like this.

How on earth did my obese, 80-year-old grandmother ever pull weeds and clean house up to her last days? Even my image of her in my mind is her big blue stretch pants bent over in the back yard.