About Adrenal Fatigue
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What is Adrenal Fatigue?

Adrenal insufficiency is a condition in which the adrenal glands, located above the kidneys, do not produce adequate
amounts of steroid hormones (chemicals produced by the body that regulate organ function), primarily cortisol, but may also
include impaired aldosterone production (a mineralocorticoid) which regulates sodium, potassium and water retention.
Craving for salt or salty foods due to the urinary losses of sodium is common.

Addison's disease and congenital adrenal hyperplasia can manifest as adrenal insufficiency. If not treated, adrenal
insufficiency may result in severe abdominal pains, diarrhea, vomiting, profound muscle weakness and fatigue, depression,
extremely low blood pressure (hypotension), weight loss, kidney failure, changes in mood and personality, and shock
(adrenal crisis). An adrenal crisis often occurs if the body is subjected to stress, such as an accident, injury, surgery, or
severe infection; death may quickly follow.

Adrenal insufficiency can also occur when the hypothalamus or the pituitary gland, both located at the base of the skull, does
not make adequate amounts of the hormones that assist in regulating adrenal function. This is called secondary adrenal
insufficiency and is caused by lack of production of ACTH in the pituitary or lack of CRH in the hypothalamus.

Causes

Causes of acute adrenal insufficiency are mainly Waterhouse-Friderichsen syndrome, sudden withdrawal of long-term
corticosteroid therapy and stress in patients with underlying chronic adrenal insufficiency. The latter is termed critical illness–
related corticosteroid insufficiency.

For chronic adrenal insufficiency, the major contributors are autoimmune adrenalitis, tuberculosis, AIDS and metastatic
disease. Minor causes of chronic adrenal insufficiency are systemic amyloidosis, fungal infections, hemochromatosis and
sarcoidosis.

Autoimmune adrenalitis may be part of Type 2 autoimmune polyglandular syndrome, which can include type 1 diabetes),
hyperthyroidism, autoimmune thyroid disease (also known as autoimmune thyroiditis, Hashimoto's thyroiditis and
Hashimoto's disease). Hypogonadism and pernicious anemia may also present with this syndrome.
Adrenoleukodystrophy can also cause adrenal insufficiency.

Adrenal Insufficiency can also be caused when a patient has a Craniopharyngioma which is a benign tumor that can
damage the Pituitary gland causing the Adrenal Glands not to function. This would be an example of Secondary Adrenal
Insufficiency Syndrome.

Signs and symptoms

Symptoms include: hypoglycemia, dehydration, weight loss, and disorientation. Symptoms may also include weakness,
tiredness, dizziness, low blood pressure that falls further when standing (orthostatic hypotension), muscle aches, nausea,
vomiting, and diarrhea. These problems may develop gradually and insidiously. Addison's can present with tanning of the
skin that may be patchy or even all over the body. Characteristic sites of tanning are skin creases (e.g. of the hands) and the
inside of the cheek (buccal mucosa). Goitre and vitiligo may also be present.

Western Medicine Treatment

  • Intravenous fluids
  • Intravenous steroid (Solu-Cortef/injectable hydrocortisone) later hydrocortisone, prednisone or methylpredisolone
    tablets
  • Rest
  • Cortisol deficiency (primary and secondary)
  • Hydrocortisone (Cortef)
  • Prednisone (Deltasone)
  • Prednisolone (Delta-Cortef)
  • Methylprednisolone (Medrol)
  • Dexamethasone (Decadron)
  • Mineralocorticoid deficiency (low aldosterone)
  • Fludrocortisone Acetate (To balance sodium, potassium and increase water retention)


Adopted from wikipedia.com