Weak Adrenals

Writ­ten by Vale­rie Tay­lor, thy­roid patient and mode­ra­tor of the NTH ADRENALS group.

The adre­nal glands are two small glands that sit on top of the kid­neys. They pro­duce some of the most impor­tant hor­mo­nes for the pro­per func­tio­ning of your body. Without them you can­not live without repla­cing the hor­mo­nes they produce.

When our bodies are hypothy­roid for long periods of time, the adre­nal glands can become fati­gued from trying to pro­duce enough cor­ti­sol to com­pen­sate. Hypothy­roid lifesty­les often put MORE strain on the adre­nals as we try to cope with our lives with less than opti­mal energy. Dea­ling with the stress of a job, and just trying to keep a house clean can some­ti­mes be the straw that breaks the adrenals.

There seems to be quite a bit of con­tro­versy over how MUCH cor­ti­sol the body needs to func­tion. My theory on this is that it is as indi­vi­dual as we are, with some nee­ding 20-30MG a day and others may need up to 40MG a day (accor­ding to Dr. Peat­field) and that is on a nor­mal, uns­tress­ful healthy day. When we are under stress, or ill, these needs may become dou­bled or even tri­pled in a mat­ter of minu­tes. Weak adrea­nals simply can’t pro­duce enough to do this.

Most every thy­roid presc­ri­bing infor­ma­tion I have read sta­tes that adre­nal func­tion should be tes­ted before presc­ri­bing. Why is it then that MOST doc­tors never check this? Many do not believe that adre­nal fati­gue is pos­si­ble. The tests they do, when they bother at all, are ina­de­quate as they only show Cushings (extre­mely too much Cor­ti­sol) or Addison’s ( NO cor­ti­sol) disea­ses. The only tests that seem to be fairly accu­rate are saliva tests for 24 hour cor­ti­sol as these show the dif­fe­rent levels that should be pre­sent for a nor­mal cir­ca­dian rythym. These show 4 dif­fe­rent times in the day when, for exam­ple, first thing in the mor­ning we should have our highest levels of cor­tis­dol, and at mid­night, when they should be lowest. A total cor­ti­sol is inac­cu­rate as you could be high at night, ina­pro­pria­tely, which cau­ses wake­ful­ness in the middle of the night, and low in the mor­ning when it should be high to pro­vide the energy nee­ded for your day. Cor­ti­sol is neces­sary for thy­roid to get into your cells to work.

There are at-home tests you can do for adre­nal fati­gue but they are falli­ble. A nega­tive from this tes­ting does not mean you defi­ni­tely do not have adre­nal fati­gue, but a posi­tive cer­tainly points to it. One of the most accu­rate tests for adre­nal fati­gue you can do at home is a tem­pe­ra­ture test. Follow the ins­truc­tions and use the charts from www.drrind.com and the fluc­tua­tions in your temp will tell you when you need to raise or lower your adre­nal sup­port meds. I firmly believe that ALL tes­ting should be used as a gui­de­line only. As adre­nal fati­gue and weak­ness are NEW con­cepts in medi­cine, they are not an exact science. The very way that the adre­nals func­tion when wor­king pro­perly makes their func­tio­ning dif­fi­cult to assess and monitor.

In sta­ges of adre­nal fati­gue, the first stage, cor­ti­sol may be high at inap­pro­priate times. Doing a 24 hour cor­ti­sol saliva test you may see the late after­noon and mid­night levels higher than the mor­ning and noon levels. This hap­pens when your adre­nals are almost deple­ted and they are sti­mu­la­ted all day but just can’t pro­duce enough cor­ti­sol for your needs, but they dump out excess at night as they are still in a state of sti­mu­la­tion due to low day­time levels. This is follo­wed by total adre­nal fati­gue where the levels are too low all the time, or maybe just the mid­night level is too high.

When inter­pre­ting a 24 hour saliva cor­ti­sol test, I look for top-of-the-range levels for the first two tests; the third test in the after­noon I feel should be middle-of-the-range and the mid­night one mid-to-low range. These are the levels I shoot for when peo­ple ask what infor­ma­tion to give to their doc­tors. I have seen many results for this test and when peo­ple are on medi­ca­tion for it, they can even be over range on the first two and feel well. This is my own per­so­nal inter­pre­ta­tion from loo­king at many of these and com­pa­ring it to when the symp­toms of adre­nal fati­gue go away.

What medi­ca­tions are used to treat adre­nal dys­func­tion? The ones I most com­monly see GOOD results from are Hydro­cor­ti­sone (Cor­tef) or Iso­cort. Iso­cort is an OTC medi­cine that pro­bably con­tains less than the 2.5MG of Cor­ti­sol per pellet, and can be found from many sour­ces by doing a Goo­gle search. Most the her­bal reme­dies I would not recom­mend simply as they are not regu­la­ted and we have no way of kno­wing how much cor­ti­sol is in each tablet or cap­sule. Lico­rice has been recom­men­ded, but again it works in such a way as to pre­vent the body losing cor­ti­sol nor­mally, not in any way repla­cing what is nee­ded WHEN it is needed.

Most peo­ple with weak adre­nals will need to learn to adjust their medi­ca­tion by how they feel. My per­so­nal expe­rience was to start at 5 MG first thing in the mor­ning, then four hours later (cor­ti­sol only stays in your sys­tem 4 hours) another 5 MG. I did this for a week then added a third 5MG four hours after the last one. Another week I added 5MG to my first dose to bring me to 20MG a day. This must be held for a while to deter­mine the body’s res­ponse to it. Often this is a great main­te­nance dosage for most peo­ple. The experts in this field seem to agree that it can take from 2 months to 2 years for adre­nals to heal. I also feel the thy­roid levels MUST be opti­mal for this hea­ling to happen.