ADRENAL
INSUFFICIENCY

www.fms-help.com
Below is a fascinating article
found at http://www.chronicfatigue.org/History.html. It explains the sometimes baffling symptoms we experience,
such as feeling overexcited when we need to rest and sleep, but tired and weak
when we need to function. This is the "signature" of a condition called
hypoadrenia. - Dominie
Stress And You:
Hypoadrenalism,
Chronic Fatigue Syndrome,
Environmental
Disease
When we first published It's Only Natural, more
than twenty years ago,
Chronic Fatigue Syndrome, Fibromyalgia, Candida
infections, Epstein-Barr infections
and the various Environmental Diseases
were all unheard of. Patients with
these conditions were considered to be
malingerers or neurotics by the vast
majority of physicians. We were
considered a "quack" to even intimate that
there might really be something
wrong with these patients. All this has now
changed. Not that we have been
given any credit or respect for our
pioneering work (that would be asking too
much), but at least these patients are no
longer considered to be neurotic
hypochondriacs.
In the original edition of this work I used the name
functional hypoadrenia
to describe these patients. Since there is no evidence
that this is not the
underlying cause of these various conditions I will
retain this nomenclature
in this chapter.
To further the cause of
individuals with these conditions I later wrote two
separate books entirely
devoted to this subject. They were Adrenal Syndrome
and Chronic Fatigue
Unmasked. The latter of these works is still available
and is recommended for
all those who see themselves or someone they love in the
type of patient
presented here.
Many years ago, Dr. Hans Selye presented
papers on the adverse effects of
stress and what he called the general
adaptation syndrome (GAS). This
research showed that when the human body is
placed in a situation that produces a
degree of pressure greater than can be
handled by its normal homeostatic
organ functioning, a series of chemical and
glandular changes are produced that he
called the General Adaptation
Syndrome.
------------------------------------------------------------------------
One
of the most important factors in the GAS was found to be a previously
often
neglected gland, the adrenal. This small gland, which weighs about as
much as
a nickel and sits like a Bishop's cap on top of each kidney, is
now
recognized as one of our most important endocrine glands (glands
that
produce hormone-like substances discharged directly into the
bloodstream).
The adrenal glands are composed of two parts--the medulla
(inner portion)
and the cortex (outer surrounding portion). The adrenal
glands produce many
substances, the most noteworthy of which are epinephrine,
(previously known
as adrenalin), which is produced by the medulla; and the
various sterols such
as cortisone and aldosterone, produced by the
cortex.
Many observers believe that in hormonal responses to stress the
adrenal
medulla is the primary agent. According to this view, stress on the
body
stimulates (probably by way of the sympathetic nervous system) the
adrenal
medulla to increased epinephrine production. This hormone increases
the
secretion of adrenocorticotrophin (ACTH) by the pituitary, which in
turn
activates the adrenal cortex to a greater production of corticoids such
as
cortisone.
Cortisone and its related sterols have been used for
years in treating all
forms of inflammatory reactions, from extremely severe
diseases to mild skin
conditions. Inflammatory conditions usually respond
quite rapidly to
cortisone therapy. Unfortunately, in chronic disorders
cortisone usually doesn't bring
about a cure but only temporary relief. The
reason for this is simple. The
production of cortisone and allied sterols
represents only one step in the
general adaptation syndrome (GAS). These
sterols rid the condition of
inflammation but they don't resolve other
problematic aspects of the
condition. This must be done by other agents of
the GAS activity. If the
endocrine gland system is weak and not able to carry
on these activities,
the condition will revert to its inflammatory stage as
soon as cortisone is
withdrawn. Because cortisone is notorious for its side
effects when given
for any length of time, every physician tries to withdraw
it as soon as
possible, if at all feasible. Although sterols are useful in
serious cases and
undoubtedly have relieved much suffering, they are
definitely not the answer
to a balanced glandular system. It is in the search
for this balance that
this chapter is devoted.
So What
Does This Mean to Me?
About this time, you may be asking
yourself, "Very interesting, but what
does all this have to do with me?" It
concerns you in this way. The General
Adaptation Syndrome is reacting in your
body every moment of the day. As
long as it functions well, you should be
healthy and contented. If it functions
poorly, you undoubtedly will be vexed
with problems that often tend to cause
consternation among orthodox
physicians. In fact, at the Beverly Hall
Corporation Healing Research Center
our experience shows that most of the
misdiagnosed, neglected, and rejected
patients who come to our doors are
victims of a malfunctioning General
Adaptation Syndrome. Most of these
exhibit hypoadrenalism (also called
hypoadrenia)--functional (non-disease-caused)
adrenal insufficiency. The
adrenal glands of these patients, through
exhaustion, have ceased to function
as well as they should, and they aren't
capable of putting out the normal
complement of the substances required for
proper body function. Interesting
in many of these patients they are
overexcited when they should rest and
sleep and tired and weak when they
need to function. This seeming paradox is
the "signature" of this condition.
There has been much research,
particularly by Dr. John W. Tintera, relating
this condition to another
common metabolic defect--hyperinsulinism (low
blood sugar). A great deal has
been written in recent years about this connection.
The nutritionalist
authors--Carlton Fredericks, E. M. Abrahamson, and Allan
Nittler--have all
presented in great detail the symptoms, the methodology,
and the basic
nutritional and supplemental care for these patients. Although I
agree with
Tintera and others that many cases of hypoglycemia are caused
by
malfunctioning adrenal glands, it's been my experience that patients
can
have functional hypoadrenalism and all its symptoms without necessarily
having
the hyperinsulinism of the low blood sugar syndrome. And hypoglycemic
patients
do not always have lowered adrenal functioning, but many
do.
Many patients come to our Center with typical symptoms of low blood
sugar
who have had one, two, or even more normal glucose tolerance tests.
Often, as an
empirical treatment, these patients had been placed on the
low-blood-sugar
diet by their previous physician, but to little avail. Upon
examination, we
usually find these patients suffering from adrenal
exhaustion, which has not
yet manifested as hypoglycemia. Under treatment,
these patients usually
respond well; almost without exception, they have been
able to return to a
normal, productive life.
Functional adrenal
exhaustion is poorly understood by most physicians, and
very little has been
written for the general public on this condition.
Surprisingly, the earlier
investigators in hormones and hormone therapy knew
it well. The reason it has
been so ignored is difficult to explain. I
personally think this apathy has
been produced by the general vagueness of
its character, the seeming neurotic
symptoms of its victims, and the slowness of
its correction, even with the
most advanced therapy. In our Center, I always
meet the newly diagnosed
hypoadrenal patient with mixed feelings. I am, on
the one hand, very pleased
to know that we have a patient who will once again
become useful and
productive instead of being only half-functioning. On the
other hand, I
always groan a little bit inside when I think of all the care,
time, and
constant loving support necessary to carry this patient through
the seemingly
nonproductive early stages of treatment. With perseverance,
however, they all
respond. In the end, they prove to be among our most appreciative
patients,
which gives the physician a great sense of accomplishment. (While
this
paragraph was written over twenty years ago it is still as true today
as it
was then.)
I mentioned earlier that the hypoadrenal syndrome has been
known for some
time. To verify this statement I want to quote from one of the
great early
investigators in glandular therapy, Dr. Henry R. Harrower, M.D.,
F.R.S.M.
(London). In his book Practical Organic Therapy, the Internal
Secretions in
General Practice, Harrower had this to say:
"Since the
adrenals are so extremely susceptible to so many outside
influences, it is
likely that they would be easily worn out, and as a matter
of fact,
functional hypoadrenia is as common a condition as any
endocrine
manifestation. From a practical standpoint, this is an extremely
important
symptom complex." Remember this was written just a short time after
World
War I. Harrower goes on: "It is quite some years since Sajous began to
emphasize
the importance of this condition, and while his opinions were
scouted, and
some of his ideas declared visionary, it must be admitted that
our present
knowledge of this subject is very much in harmony with the
following
quotation from Sajous' monumental work: 'Functional hypoadrenia is
the symptom complex
of deficient activity of the adrenals due to inadequate
development,
exhaustion by fatigue, senile degeneration, or any other factor
which
without provoking of organic lesions in the organs of their nerve
paths, is capable
of reducing their secretory activity. Asthenia,
sensitiveness to cold and cold
extremities, hypotension, weak cardiac action
and pulse and anorexia,
anemia, slow metabolism, constipation, psychoasthenia
are the main symptoms of this
condition.' "
Therefore we see that this
condition was not only known in the early 1920s,
when Harrower wrote, but
Harrower himself quotes Dr. Charles Sajous an even
more famous
endocrinologist, who discussed it at a still earlier time.
Harrower goes
on to say that "Hypoadrenia is a complication of all the
serious acute
infectious fevers, since the adrenals are so intimately connected with
the
driving of the body and are so susceptible to toxemia, that the
ultimate
reduction of the accustomed adrenal stimuli is responsible for a
slowing
down of many of the sympathetic controlled functions of the organism.
Too often
this sympathetic asthenia is the actual cause of death from disease
of this
character."
In such cases Harrower stated that, "Asthenia is
the rule and muscular tone
(both striped and unstriped muscle) is poor.
Exertion is difficult, if not
impossible, and the fatigue syndrome is
prominent. The intestinal
musculature is inactive. Stasis, a common cause of
hypoadrenalism, is also a usual
result of it. Mental exertion, even the
simplest exertion, often causes so much
weariness and exhaustion as to be
prohibitive. Mental elasticity is lost,
and there is both mental and physical
depression with the fear that the
individual now can not accomplish his
accustomed good mental work; and the story that
he 'has lost his nerve.' With
this, one frequently notes a fearfulness of
making wrong decisions and
vacillating and indecisive frame of mind. This is the
most usual form of
adrenal insufficiency. It is chronic both in origin and in
its
course."
Another section in Harrower's book is entitled
"Neurasthenia as an adrenal
syndrome." The word neurasthenia isn't used as
much as it once was, nor is
it well-understood by the general public as it
was at one time. Neurasthenia
means weak nerves. Although they may not have
heard of neurasthenia, we
frequently hear people speak of their weak or
sensitive nerves and upset
nervous system. I personally still find
neurasthenia an acceptable term and
an exact description of many patients we
see daily.
Again, Harrower's report is so lucid that I am presenting the
entire section
on neurasthenia:
Neurasthenia as an Adrenal
Syndrome
"The minor form of functional hypoadrenia is more
common than some have
appreciated, and the fact that there is a psychic
origin as well as the
other physiologic causes already considered, allies it
to the fashionable
neurasthenia of today. In fact, some have stated that what
is improperly
called 'neurasthenia' is not a disease per se, but really a
symptom complex
of ductless glandular origin and that the adrenals are
probably the most
important factors in its causation. Campbell Smith,
Osborne, Williams and
others, including the writer, have directed attention
to the importance of
the adrenal origin of neurasthenia (though a
pluralglandular dyscrasia is
practically always discoverable), but so far
this is not understood as well
as its frequency and importance
warrant.
"A few quotations from the literature will firmly establish the
importance
of this angle from which to study this common and annoying symptom
complex.
Quoting from the Journal A.M.A. (Dec. 18, 1915): 'The typical
neurotic
generally has, if not always, disturbance of the thyroid gland. The
typical
neurasthenic probably generally has disturbance of the suprarenal
glands on
the side of insufficiency. The blood pressure in these neurasthenic
patients
is almost always low for the individuals and their circulation is
poor. A
vasomotor paralysis, often present, allows chilling, flushing, cold
or
burning hands and feet, drowsiness when the patient is up, wakefulness on
lying down
and hence insomnia. There may be more or less tingling or numbness
of the
extremities.'
"Again, Kinnier Wilson in his monographs on The
Central Importance of the
Sympathetic Nervous System, makes the following
pertinent remarks: 'Many of
the common symptoms of neurasthenia and hysteria
are patently of sympathetic
origin. Who of us has not seen the typical
irregular blotches appear on the
skin of the neck and face as the
neurasthenic patient 'works himself up into
a state'? The clammy hand,
flushed or pallid features, dilated pupils, the
innumerable paresthesias
(tinglings), the unwanted sensations in head or
body, are surely of
sympathetic parentage. In not a few cases of neurasthenia,
symptoms of this
class are the chief or only manifestations of the disease.
Here then, is a
condition of defective sympatheticotonus; may it not have
been caused by
impairment of function of the chromophil system? [Adrenal System]
..... There
does not appear to me any tenable distinction between the
asthenia of
Addison's Disease and the asthenia of neurasthenia. Cases of the former
are
not infrequently diagnosed as ordinary neurasthenia at first. It is
difficult
to avoid the conclusion that defect of glandular function is responsible
for
much of the Central picture of neurasthenia.'
"Later this same
author makes the following apothegm: 'Sympathetic tone is
dependent on
adrenal support, and until the glandular equilibrium is once
more attained,
sympathetic symptoms are likely to occur.' "
Interestingly, this
quotation from the Journal of the American Medical
Association of 1915
postulates a relationship between neurasthenia and low
adrenal function. Yet
to this day, such a relationship is rarely considered
in medical treatment.
At the Beverly Hall Corporation Healing Research Center,
we consider such a
cause and effect very common, and we treat accordingly. We
have become
internationally known for our treatment of the weakened
nervous
system.
Our treatment methods aren't so original or
revolutionary; it's just that we
are willing to get down to causes and accept
as facts the postulates of
Harrower, Sajous, and the many other brilliant
investigators of those
earlier days. Their work showed that many emotional
states have glandular causes. We
believe our duty as physicians is to find
these causes and correct them
whenever possible. The path to follow has been
shown. Harrower established
the basic treatment more than fifty years ago;
yet today, not one physician in a
thousand is familiar with this malady even
though his office may be jammed
with patients suffering from it. (This was
true twenty years ago but not
now. These patients are now beginning to be
recognized. The only problem is that
most physicians still have no idea of
how to treat them or of the underlying
glandular weaknesses. Maybe in another
twenty years?)
How Can One Tell if He Has Adrenal
Insufficiency (Hypoadrenalism--Chronic
Fatigue Syndrome-Environmental
Disease)?
Usually the first and most obvious symptom is
tiredness, apparent laziness,
or lack of ambition. A young person often feels
as if he has some serious
wasting disease. The young hypoadrenal patient
usually is by nature a go-getter,
smart in school, and extremely
conscientious. With hypoadrenalism, he finds it
more and more difficult to
concentrate. The harder he tries to work, the more
tired he becomes. Parents
and friends become alarmed, and the patient is usually
taken to a variety of
physicians to correct the enigmatic condition.
In middle age, the
hypoadrenal person usually feels he is just slowing down,
or that he is
beginning to grow old prematurely. Again, he tends to push
himself to added
effort. Sometimes he takes special exercises or courses to
stimulate mental
activity. As in the younger person, the harder he tries,
the less he is able
to accomplish. The situation can become so bad that the
hypoadrenal person
may even become dizzy or have fainting spells, which
usually brings him to a
physician.
In the elderly, this condition is blamed on old age. It is
believed that Mom
or Dad is finally wearing out. But the symptoms of senility
and of
hypoadrenalism are not the same; usually the difference can be
discovered by
a physician reasonably versed in the latter disorder.
If
hypoadrenalism is not diagnosed and treated in the early stages, the
patient
will start to manifest symptoms that he takes as signs of
mental
deterioration. He becomes more and more forgetful; he begins to have
small
blacking-out incidents, and dizziness is particularly prevalent,
especially
that which occurs on arising from a seated or reclining position.
He begins
to fear that he has a brain tumor or perhaps cancer of some vital
organ. The
most common fear however is fear of a mental disorder. This is the
point at which
he is driven to seek medical attention.
Let's take a
look at this picture. We have a person who is tired, much more
than he should
be, has occasional dizzy spells, and has disturbing mental
aberrations--all
contrary to his usual physical and emotional status. This
person had always
been bright, overconscientious, a perfectionist by nature,
had an
overabundance of energy, and had been able to drive himself
constantly to
accomplish what he would with his life. Now this whole pattern
is
reversed--not that his desires are gone, but the physical and
mental
entities are no longer able to carry out the dictates of his will.
This is most
frightening to any intelligent person, and is the sad story he
pours out to
his physician.
Now let's put ourselves in the position of
his physician and listen to his
story. You find before you a patient who is
obviously intelligent, able to
present his symptoms with great lucidity, and
yet whose symptoms don't seem
to fit any disease that you're familiar with.
You find the patient excitable,
agitated, and apparently overly concerned.
Although you aren't one to pass
snap judgments, your first thought is that he
is becoming neurotic because
of the pressures in his life. You are, however,
very thorough so you give him a
complete physical examination, a reasonably
complete blood chemistry
examination, a urinalysis, and all the other things
any physician should do
to discover a known pathologic condition that may
cause such symptoms.
The tests all are within the normal range. The
physical examination is
unremarkable. The patient's blood pressure might be
slightly lower than
normal, but not seriously so, and of course it's only
high blood pressure to
be worried about anyway. Slightly lower pressure just
means that the man
will live longer.
Your examination confirms that
you have before you a strong, healthy person
with symptoms that obviously are
of a neurotic nature. He is probably just
overworked. So you talk to him. You
recommend that he slow down, that he
find himself a hobby, or that he take a
vacation.
You give him a mild tranquilizer, and if he feels depressed,
you give him a
gentle antidepressant (Today Prozac is the fashion). Because
he doesn't
sleep too well at night (insomnia being one of the symptoms of the
second stage of
hypoadrenalism), you give him a mild sedative. You send him
home with a
comforting pat on the back, reassuring him that there's nothing
really wrong
with him, he's just been working too hard, and he's to settle
down a bit,
keep on his medication, and try to get some enjoyment out of
life.
This, in a nutshell, is the therapy most patients with
hypoadrenalism
received twenty years ago. It was very professional and was
usually given with the
best of intentions. Unfortunately, not only was it
insufficient, but it also was
usually detrimental, because the various drugs
put a greater strain on an
already overloaded glandular system. And so more
problems are heaped on
those that already exist.
Today a few
knowledgeable physicians will prescribe a more rational
treatment
program, but even today, if our patients are any indication, the majority
of
physicians are still treating this condition as they did in
1975.
Many patients, not realizing they have organic problems, continue
with this
archaic treatment. Unless certain changes occur in their life that
remove
much of the stress originally causing the condition, they will
continue to go
downhill as they become more and more dependent on their drug
therapy. The
drugs don't help the basic condition at all; the imbalances are
all still
there. The drugs simply mask the patient's ability to be affected
by the
symptoms.
If this condition goes unabated in some persons, it
can in time lead to
mental institutionalization. Knowledgeable investigators
frequently have found both
hypoadrenal patients and hypoglycemic patients in
mental institutions. Many
of these patients are willing to admit themselves
to mental institutions
because they have been told very clearly that they
have no physical condition that
could cause their symptoms; yet these
symptoms are so severe the patient no
longer feels capable of coping with
society. This is a sad commentary on a
condition whose cause and treatment
have been known for more than
seventy-five years.
When we first wrote
about these patients we were seeing most of them in the
early stages of this
condition. That is not true today. The majority of our
new adrenal patients
today are in the second or third stage of the GAS as
outlined in the diagram
of Dr. Selye. Rather than exhaustion being their
major complaint,
nervousness, panic attacks and insomnia take first place with
fatigue being
there but it is these other symptoms that bother them the
most.
What is happening is, as outlined in Dr.
Selye's chart, that their body is
overstressing the gland and nervous system
to keep them going despite the
serious glandular weakness. They are running
on vital reserve energy and
when this runs out total collapse may well ensue
(Again see Dr. Selye's chart).
We now run a test called the Adrenal
Stress Index (ASI) test on all
suspected adrenal patients. This test can
pinpoint exactly where the individual
patient is in the Selye sequence. Once
this is known, then the correct treatment
plan can be implemented. Without
this knowledge it is entirely possible to worsen
the condition if the first
stage treatment is given to a second stage
patient and vice
versa.
II Corinthians
1: 4 - "[God] Who comforteth us in all our tribulation, that we may be able to comfort
them which are in any trouble, by the comfort wherewith we ourselves are
comforted of God." Visit Dominie's FMS/CFIDS Homepage at
www.fms-help.com for Fibromyalgia and Chronic Fatigue Syndrome sufferers and their
families.
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