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The adrenal is the small hormone producing gland that sits on top of each kidney. The autopsy of President John F. Kennedy was remarkable for a number of its findings, and missing items, but one thing was clear, the pathologists could not find his adrenal glands! That was because the President suffered from Addison’s disease, and required external steroid medication to stay alive. The exogenous steroids also had the effect of turning off pituitary stimulation of the adrenal, thus leading to what we call “atrophy” or shrinkage of the gland.

The adrenal produces a wide range of critically important hormones, absolutely essential to life, including the “fight and flight” hormone adrenaline, and cortisol, the stress hormone. Today stress is a fact of almost everyone’s life. The adrenal takes the brunt of the effects. Yes, we were built to cope and adapt, but not to the ongoing inescapable stress that drives experimental mice into illness, death, or psychosis.

Stress has seemingly been linked to almost every human disease, and in my experience is especially crucial in the causation of cardiovascular disease and cancer.

But the most common scenarios that I see in clinical practice are adrenal exhaustion (which none-the-less falls short of the severity of the near total shutdown of Addison's disease) with low adrenal hormones, and adrenal hyperfunction, which constitutes the opposite picture of excessive hormone levels and a different clinical picture entirely. The adrenal manufactures the precursor hormones DHEA and pregnenolone, the mineral controlling aldosterone, and the glucose controlling cortisol. Cortisol counters the action of insulin and produces elevation of blood sugar levels. When high levels become chronic, insulin levels must also rise to compensate, and the result is hyperinsulinemia and the associated ills that I have written about previously. That and the high cortisol levels themselves will promote fat storage which specifically will produce weight gain or difficulty losing weight out of proportion to caloric intake, thus a major source of over-weight problems.

Initially under chronic stress the adrenal goes through a hyper phase, and the patient may be restless, anxious, and insomnia. Later when the gland can no longer keep up, blood sugars drop, hypoglycemia and allergies set in, and fatigue is a major problem.

The majority of patients with chronic fatigue and allergies or asthma are found to have weak adrenals. Autoimmune diseases are also usually associated with this problem, as are recurrent infection, eczema, and herpes outbreaks (notoriously occur under stress).

How are these problems diagnosed? Most usually today a saliva test which takes 4 specimens throughout an average day will give us the answer. The diagnosis is often suspected by the history and clinical symptoms alone. The weak adrenal is by far the most common disorder shown by the tests. In the area of treatment, orthodox medicine again shows its inflexibility by refusing to recognize and treat any but the patients at the extreme high end of the exhaustion spectrum, those with Addison’s disease. Natural medicine doctors on the other hand know that “normal” and “abnormal” can be personally variable terms, and that glandular function and dysfunctions ride the spectrum from extremely low to extremely high, and everything in between.

I treat adrenal fatigue first with herbs and glandular products which contain no hormonal substances. If that’s not enough, safe and low dose identical to natural prescription cortisol can often prop up the failing adrenal long enough for the appropriate life style and stress management changes to be made. Supportive nutrition of a more general nature is also usually required. The outcome of treatment in most cases is excellent if the fact that many times hormone imbalances are multicentric, involving multiple endocrine glands at the same time, is kept in mind. For best results comprehensive thyroid, adrenal, precursor hormones, sex hormone, and growth hormone levels are checked at the same time.

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