Dr. Wilson also delves into the types of people and personalities who are commonly afflicted with this syndrome. He explains how different professions can leave certain people vulnerable to the type of stress that can overload their adrenals and result in this syndrome. Included also are examinations of how certain diseases have an adrenal component that can lead to adrenal exhaustion.
Ideally, cortisol is released into the system only on an occasional basis, rather than in response to chronic stress. If cortisol levels become too high for too long, they may have undesirable side effects, including loss of bone density, muscle wasting, thinning of the skin, decreased ability to build protein, kidney damage, fluid retention, spiking blood sugar levels, weight gain, and increased vulnerability to bacteria, viruses, fungi, yeasts, allergies, parasites, and even cancer.

Dr James Wilson is the world’s authority on the stress syndrome known as adrenal fatigue. His book Adrenal Fatigue: the 21st Century Stress Syndrome is a commitment to the truth in defining and treating this well-known but poorly understood malady. Adrenal fatigue is not recognized by allopathic medicine or by the insurance or pharmaceutical industries in the United States. There is no International Classification of Diseases coding for adrenal fatigue. Some patients have a diagnosis of the extreme forms of adrenal stress known as Addison disease or Cushing disease. Where allopathic medicine falls short, naturopathic medicine steps up to the plate to shine, outweighing the possibilities for success: “there are no magic pills for adrenal fatigue but there are certainly key lifestyle changes and nutritional supplements that will greatly facilitate your recovery” (p 97).


While CFS and adrenal fatigue are not the same, adrenal function may play a role in it. Those with CFS are often found to produce a low amount of the hormone cortisol, which is produced by the adrenal glands. Furthermore, CFS is a malfunction of the pituitary, a pea-sized gland at the base of the skull, which regulates all our hormones. The pituitary, hypothalamus and adrenals all work together as part of the HPA axis to regulate our health and hormones. Analysis of the data in over 50 studies that assessed adrenal function in CFS and fibromyalgia patients demonstrates that the majority of these patients have abnormal adrenal function due to hypothalamic-pituitary dysfunction.
If you want to get your energy levels back to where they were, there are a few things that you need to do. Adopting an adrenal fatigue diet will give your adrenals and HPA axis the raw materials they need to recover. Removing sources of stress from your life will eliminate one of the causes of your adrenal exhaustion. And changing your lifestyle will have a measurable impact on your ability to handle stress.
After that, she offers the outline for how you can be healed from adrenal dysfunction. This includes advice on diet, blood sugar maintenance, meal plans, and addressing digestive issues. Lifestyle changes are also a big part of this process, with sleep, relaxation, and exercise being major components of the recovery plan. There is even a section on supplements and extracts.
Dr. Smith will likely order blood work, but in some cases salivary cortisol levels taken at four different times over the course of the day (a kit you take home) is a better option for a more detailed survey of adrenal function. Usually Dr. Smith will also assess some other adrenal hormones in her lab work such as DHEA. Both blood and salivary tests are equally sensitive when testing cortisol levels.
Addressing one stressor at a time is generally the best way to approach this. Identifying what makes you happy and what stresses you is the easy part, then begins the difficult part of making the changes that you need to make. This will often require a significant adjustment in outlook. For example, if a high-paying job is damaging your health, can you step off the corporate ladder and return to a simpler, more fulfilling life? And if a relationship has been causing you emotional stress for years, do you have the courage to pull the plug and start again? All these are issues that can hopefully be addressed with the support of family, friends and perhaps even a good therapist too.
The U.S. Food and Drug Administration (the government agency that oversees most food and medical products) does not oversee nutritional supplements and vitamins. This means there is no guarantee that what's on the label of a supplement is really what's inside the bottle. In some cases, supplements have very few, if any, active ingredients. In other cases, the dose of a particular ingredient may be too high. This is true if you purchase supplements from your local drug store or a specialty pharmacy (sometimes called a compounding pharmacy) where supplements are made directly by the pharmacist.
At some point in all of our lives we go through a period of feeling tired, run down or exhausted without being able to point to a readily identifiable reason. Whilst such symptoms could be attributed to a variety of factors – some lifestyle related and some related to identifiable medical conditions – some people take the view that a condition known as adrenal fatigue could be an underlying cause, and that this is an issue of increasing importance. Your adrenal glands are fundamental to a healthy body and mind – they produce a variety of key hormones, including those underpinning our “fight or flight” responses. Looking after the adrenal glands, and the wider endocrine support system is, therefore fundamental. This book explains why your adrenal glands and the hormones they produce are so important. The book then gives some analysis of why diet, exercise and stress levels are important in relation to the functioning of the adrenal glands – and what you might be able to do to develop a more robust system – also likely improving your overall general health in the process. The goal of this book is to give you the tools to help you understand the condition, consider whether or not you need to seek medical attention, and set yourself on a path to self-treatment and complete recovery. Even in broader terms, if you have ever felt that you may be somewhat low on energy, then we urge you to read this book, and put its advice into practical, daily use.
That discussion leads to a more in-depth explanation of how our understanding of the nature of stress has evolved in recent years, and then an explanation of how the adrenals work to provide the hormones we need for stress response. From there, she quickly moves to a discussion of the circadian rhythm, and how its dysregulation can impact sleep patterns and ultimately lead to a cascading series of system failures that put your health in jeopardy.
While adrenal fatigue may not exist, this doesn’t mean the symptoms people experience aren’t real. These same symptoms could be caused by true medical conditions such as sleep apnea, adrenal insufficiency, or depression. Accepting a fake disease diagnosis from an unqualified practitioner is arguably worse. Patients don’t receive a science-based evaluation of their symptoms, and they may be sold unnecessary treatments that are probably ineffective and potentially harmful. The Endocrine Society’s guidance is entirely appropriate:
I’m in my early 20’s and have severe adrenal fatigue. It’s so bad that it has caused weight gain in the belly area, fluid retention everywhere, and severe hypoglycemia. I don’t understand how I have adrenal fatigue this bad when I’m so young. I’ve been on a third shift sleep schedule for about 6 years (going to bed anywhere from 3am-6am) but despite doing that, I sleep in late so I still get plenty of sleep. But I know people who have worked third shift for decades. So I’m assuming it couldn’t have caused severe adrenal fatigue after just 6 years, especially considering I’m still getting plenty of sleep? I’m guessing there are other factors at play here?

Chronic infections play a critical role in some cases of adrenal exhaustion. Chronic infections may originate in infected teeth or gums, though they can be located anywhere in the body. They contribute greatly to the toxic load of the body. Infections also cause inflammation and stress that must be countered using the adrenal hormones such as cortisol and cortisone.
I also promote quality sleep by turning off the TV, computer, and smartphone a few hours before bed (they can overstimulate the brain, block melatonin production, and hurt your quality of sleep). And I often eat an ounce or two of clean protein like organic turkey and 2 tablespoons of coconut oil before bed to balance out my blood sugar throughout the night.
Addressing one stressor at a time is generally the best way to approach this. Identifying what makes you happy and what stresses you is the easy part, then begins the difficult part of making the changes that you need to make. This will often require a significant adjustment in outlook. For example, if a high-paying job is damaging your health, can you step off the corporate ladder and return to a simpler, more fulfilling life? And if a relationship has been causing you emotional stress for years, do you have the courage to pull the plug and start again? All these are issues that can hopefully be addressed with the support of family, friends and perhaps even a good therapist too.
Dr. John Tinterra, a medical doctor who specialized in low adrenal function, said in 1969 that he estimated that approximately 16% of the public could be classified as severe, but that if all indications of low cortisol were included, the percentage would be more like 66%. This was before the extreme stress of 21st century living, 9/11, and the severe economic recession we are experiencing.
Proponents of the adrenal fatigue diagnosis claim this is a mild form of adrenal insufficiency caused by chronic stress. The unproven theory behind adrenal fatigue is that your adrenal glands are unable to keep pace with the demands of perpetual fight-or-flight arousal. As a result, they can't produce quite enough of the hormones you need to feel good. Existing blood tests, according to this theory, aren't sensitive enough to detect such a small decline in adrenal function — but your body is.
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