Adrenal Glands and Stress Disease and Fatigue

What are the Adrenal glands?

These are triangular shaped glands that sit superior to or on top of the kidneys like a hat around the 11th and 12th thoracic vertebrae.  These are known as the endocrine glands and are actually two different glands in one. The cortex and the medulla are encapsulated inside each other.  They secrete hormones such as mineralocorticoids, glucocorticoids, cortisol and androgens.

What is the major function of the Adrenal gland?


  • Release Adrenaline (epinephrine) – fight or flight response function, increase blood pressure and insulin resistance
  • Release Noradrenaline norepinephrine) – Vigilant concentration, increases contraction of the heart


  • Glucocorticoids, hydrocortisone (cortisol) – Weakness, fatigue, anorexia nausea, trouble sleeping
  • Testosterone, Androgens – Weakness, fatigue, lack of sex drive
  • Mineralcorticoids, aldosterone – Hypertension

What happens when this gland is dysfunctional?

One can experience hypo function of the adrenal gland itself and hyper function of specific hormones of the adrenal gland. Adrenal insufficiency is less serious but can cause major lifestyle dysfunction.

Hypo Function

  • Addison’s Disease – a failure of the adrenal cortex which can be caused by external triggers, infection, trauma, toxic chemical exposure and psychological stress (considered autoimmune)
    • Symptoms:  hyperpigmentation (mouth, areolae, perineum), weight loss, depression, postural hypotension causing vertigo and Azotemia (kidney failure and urea)
      • Test:  Serum cortisol, 24 hour free cortisol and ACTH stimulation test, standard electrolytes may be imbalanced potassium and depressed sodium
      • Adrenal Insufficiency Syndrome – caused in Western culture due to psychological stress and poor nutrition which depletes adrenal reserve
        • Symptoms:  Excessive fatigue, PMS, irritability, salt craving, confusion, poor memory, weakness, palpitations, insomnia, constipation or diarrhea
          • Tests:  Saliva or Urinary Cortisol usually done in 4 saliva tests or a 24-hour urine sample.  Also Test Testosterone, DHEA-S, Glucose, Serum Na, Serum K, BUN high normal or elevated

Hyper function

  • Cushing’s Disease – Excessive adrenocortical hormone production.  Adrenocortical production increases when a stressor occurs and then cortisol is released usually, cortisol is released until the stressor goes away, but in Cushings disease release of hormone is excessive and constant.  Some suffer from a low level of Cushing’s called hypercortisolism.  It is thus triggered by stress.
    • Symptoms in full blown cases:  Redistribution of the fat on the face and truncal (chest area) area (moon faces), hypertension, osteoporosis, weak connective tissue, insulin resistance, decreased immunity, mood disorders, poor wound healing, virilism (secondary male characteristics) in women.
      • Tests:  24-hour cortisol test, EKG, Elevated Na levels, K levels, Eosinophil levels low
      • Primary Aldosteronism (Conn’s Syndrome) – Excessive aldosterone is produced by the adrenal gland.  Most commonly caused by stress and seen in the majority of hypertensive patients.  Can occur secondarily to renal artery stenosis and thus a build up of a product called rennin or a begin tumor called an adenoma.
        • Symptoms:  Hypertension, women in 30-50 years old, heart palpations, weakness, muscle cramping, headaches, parasthesia, polydipsia and polyuria
          • Tests:  Potassium serum testing, blood pressure measurement, ECG, Serum aldosterone, urinary aldosterone, CT Abdominal, plasma renin levels
          • Pheochromocytoma – Tumor of the adrenal medulla that secretes high levels of norepinephrine, epinephrine and dopamine.  It is relatively rare.
            • Symptoms:  Headaches, diaphoresis, palpitation and hypertension
              • Tests:  Urinary measurement of Neuropinephrine and Epinephrine, CT scan Abdomen

How would I determine if I have Adrenal Insufficiency?

Adrenal insufficiency is a common diagnosis heavily related to everyday function and is especially prevalent in individuals with Thyroid conditions.  It is often under diagnosed since it is generally not recognized in conventional medicine.

Testing is done either through serum blood or saliva. Saliva testing is preferable because you can do it easily at home taking four separate samples throughout the day allowing you to see a daily rhythm. This is important as this gives us clinical knowledge to see if, and at what point in time, your cortisol level needs support or supplementation.

Sample of what a normal healthy cortisol level should look like.









What is the treatment for Adrenal Insufficiency?

The treatment is usually some lifestyle modifications coupled with a group of herbs called adaptogens.  A doctor will determine what types of adaptogens are needed based on your lab results and symptoms.  Lifestyle modifications include diet, sleep habits and stress reduction techniques.

What happens if I don’t treat Adrenal issues?

Since they are largely caused by autoimmune and stress response, people who are left untreated can face the following problems:

  • Hypertension
  • Thyroid issues start or become worse
  • Sleep issues
  • Hormone imbalances
  • Increased cancer risk

Our clinic prides ourselves on helping manage your health. It is our passion and it should be your goal.  You can fill out the hormone checklist on our website and email it to for scoring to see what risk factors you may have.  We do cortisol and hormone testing in office and even offer 10-minute free phone consults to determine if we are a right fit for you.

Don’t Let Sleep Issues Keep You Up At Night!


How well are you sleeping?  Your sleep is an important health indicator so it’s important to determine if a disruption in sleep patterns is an isolated incident or a symptom of something more serious.


In today’s busy world, most people believe that feeling tired is just part of life and something they have to deal with.   After all, there are lots of reasons to be tired; sick kids, challenging job, late-night television, holiday demands, and we all know that the list goes on.  But if you are constantly in need of coffee or find yourself falling asleep the moment you sit down, you may need something as simple as a few more hour of sleep to recover.  However, it’s important to rule out a more serious condition as the offender.


According to the National Sleep Foundation’s 2009 Sleep in America Poll, we get only about six hours of shut-eye on weeknights.  This increases to seven hours on weekends.  However, most adults need seven to nine hours nightly to ensure good health.  So before you blame your busy life for lack of sleep, take a careful look at these typical “Sleep Offenders”.


Offender:  Vitamin and/or Mineral Deficiency

Having low levels of B vitamins will cause anxiousness, fatigue and weakness since it helps nourish the nerves and tissue.  Vitamin D deficiency will also cause fatigue and lowered immune function.  Low levels of Calcium and Magnesium can cause leg and muscle cramping that will make it difficult to relax and go to sleep.


Our complete Vitamin and Mineral testing will give us all the information we need to develop a supplement regimen to address your needs.


Offender:  Your Adrenal Glands

Many of us live in a constant state of stress resulting in what is known as the fight or flight response.  This response should last only seconds to a couple of minutes.  However, if this response continues, the adrenal gland that sits above your kidney will get over-worked and the hormone levels will drop putting you into a constant state of adrenal fatigue. The adrenal hormone, known as Cortisol, becomes so low that you feel tired constantly or wake in the morning only to feel un-refreshed.  If you wake at 3 a.m., +/- an hour, at least every other night and get sleepy or cranky if you don’t eat regular meals, this could be the culprit.


We are able to treat this very successfully with a combination of supplements and stress reduction techniques. A simple saliva test can determine your cortisol levels as well as your hormone levels.  The test is done at four different times during the day so that we can see your rhythm over the whole daily cycle.


Offender:  The Blues

People with depression may be more likely to experience fatigue.  If your blues occur more in the wintertime you may have Seasonal Affective Disorders (SAD).




Using a full spectrum bulb and turning it on each morning can be very helpful.  In many cases getting 30 minutes of moderate aerobic exercise can minimize the blues and get your sleep patterns back on track.  If neither of these solutions is effective, we can refer you to the appropriate professional.


Offender:  Food

Food-sensitivity isn’t just a trendy buzzword.  Many people are suffering significant symptoms from eating foods that their body reacts to.  This means by simply avoiding certain foods you can bring the body back into harmony and feel better.


Testing is done with a simple blood test that is often covered by insurance.


Offender: Caffeine

Kicking the caffeine habit is your first line of defense. That afternoon pick-me-up may actually make you sleepier as it dehydrates cells and tissue causing fatigue.


Increase your water intake. Sample the wonderful selection of herbal teas that are now available. Our favorites are peppermint or pomegranate to give you the pick-me-up you may need in the mid afternoon.


Offender:  Underlining illness

Viral illnesses that basic blood work may not pick up, such as Lyme’s disease, can cause chronic fatigue.  Estrogen dominance, otherwise known as low progesterone, can also result in fatigue. Sleep apnea may be something that is going undiagnosed and can easily be determined with a sleep study.  Chronic Fatigue Syndrome can be a combination of multiple health issues.


If you have tried all the above techniques we can refer you to the appropriate health care professional to help you determine your exact condition.