When patients complain to their doctors about tiredness, irritability, memory loss, headaches, allergies, dizziness, heart palpitations, moodiness, food cravings and an inability to cope with stress, they may undergo a few lab tests, be told everything is normal, and receive a prescription for antidepressants. If the problem is adrenal fatigue, unnecessary medication can make things worse.
Why Would a Doctor Not Diagnose Adrenal Fatigue?
Addison's disease is an autoimmune disorder of the adrenal glands. Cushing's syndrome can be caused by overuse of steroid medications. The adrenal glands are a pair of triangular shaped organs that sit atop the kidneys. They secrete hormones that prepare the body to handle stress and regulate blood pressure and the metabolism of carbohydrates, which influences blood sugar control and balances fluid levels in tissues. Cortisol is one of these important hormones that is normally secreted in greater amounts in the morning and smaller amounts at night. Doctors can measure cortisol in blood, saliva, or urine. Generally if these levels are within a broad normal range, physicians assume adrenal function is adequate. After all, the tests rule out Addison's disease and Cushing's syndrome.
One of the tests doctors use is a 24-hour urine collection, in which samples are combined in one large container that is kept on ice. The measurement of cortisol in this large sample gives a total amount of cortisol secreted per day. If the total amount is normal, doctors may dismiss complaints as having nothing to do with adrenal function. The problem is that cortisol secretion may drop below normal during some hours of the day and more than double normal output at other times, which could indicate problems.
A Simple Self-Test for Adrenal Gland Function
Normal blood pressure is recorded in two numbers: the top, or systolic blood pressure, should be about ten points higher when standing up than when reclining. This is due to the effect of the adrenal glands when they are functioning properly. If adrenal glands are impaired, the standing systolic blood pressure may be lower than the systolic resting blood pressure.
To do the test, lie down and relax for at least five minutes. Take the blood pressure and record both numbers. 120 over 70, for example. Then stand and immediately take the blood pressure again. If the standing systolic blood pressure is less than 120 in our example, it indicates hypoadrenalism. The greater the difference, the more serious the impairment.
Other Medical Tests Can Be More Informative
When the adrenal glands are not functioning up to par, the pituitary releases ACTH, a hormone that stimulates adrenal function. An ACTH challenge test is more comprehensive than a single 24 hour urine collection. The test has two parts. A baseline cortisol level is measured before an injection of ACTH is given, and a second cortisol level is taken afterward.
Holistic Healthcare Practitioners Can Diagnose Subclinical Conditions
Naturopathic physicians base their evaluations on several separate saliva, urine or blood samples tested throughout the day to measure significant cortisol levels. While medical doctors consider anything less extreme than Addison's disease or Cushing's syndrome to be below the radar, patients can have very real symptoms related to chronic stress, poor diet and inefficient coping skills. Alternative practitioners recommend herbal medicine and are able to counsel nutritional and lifestyle changes that will help, possibly preventing disease development.
References:
Phyllis Balch, CNC, Prescription for Nutritional Healing, Avery, 2004
Medline Plus, Adrenal Gland Disorders, www.nlm.nih.gov/medlineplus/adrenalglanddisorders.html
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