I recently had the pleasure of hearing Dr. James Wilson talk on the subject of his book, ADRENAL FATIGUE—The 21st Century Stress Syndrome?, Smart Publications, Petaluma, Ca 94555, 2001, 2002, $14.95.
Essentially, he lists 13 major predisposing factors. 31 significant symptoms, 13 energy patterns, 22 frequently observed events, 9 food patterns, 10 aggravating factors and 5 relieving factors, all sub-categorized into past and present and graded on a 0 to 3+ scale. The only clinical sign he notes is a drop in blood pressure when you stand after lying 10 minutes (blood pressure should rise 10 to 20 points). Incidentally, I have found that pulse rises of 20 or more beats per minute may be just as reliable. I also believe that many children with so-called ADHD have adrenal fatigue, as well as hypothalamic-pituitary-adrenal dysregulation.
Dr. Wilson emphasizes that lifestyle is the primary cause of adrenal fatigue:
Lack of sleep, a poor diet, food or drink stimulants, positions of powerlessness, perfectionism, remaining in no-win situations, inadequate R & R. Major illnesses/accidents, mental/emotional crises, grief, and major financial crises are also contributors.
The poor diet contribution is actually the typical American diet! Processed, pre-prepared and ”fast” foods are generally all junk! Use NO hydrogenated fats, deep fried foods, white flour or sugar!! A good diet includes a meal before 10 AM!! His recommendations are a wide variety of real foods, including 30 to 40% whole grains, 30 to40% vegetables (half of these raw), 5 to 10% low glycemic factor fruits, 10 to 20% animal foods, and 10 to 15% beans, nuts and seeds. One of his most important recommendations is to chew every mouthful 30 times – in other words eat slowly! Drink only green or non-caffeinated herbal and non-caffeinated tea, non-chlorinated water, and nut or rice milk. Avoid caffeine and alcohol.
Dr. Wilson recommends salivary hormonal tests as the best indictor of adrenal fatigue. He says these represent the amount of hormone inside cells, while blood tests measure only the amount circulating and urine represents only the spill over. Interestingly, he recommends salivary cortisol levels taken 4 times during the day correlated with their major symptoms at the time of the salivary sample, especially fatigue. Normally cortisol levels are highest within one hour of awakening (if you have a normal sleep pattern of rising between 6 and 8 AM). He may also use DHEA-S which is consistently low in adrenal fatigue. Incidentally, I believe that a FREE DHEA level below 50% of the ”normal” range, measured in the blood by Nichols Lab in Capistrano, California, is also diagnostic of adrenal fatigue. His recommendations for treatment:
- Vitamin C, as ascorbate, with bioflavinoids, magnesium and pantothenic acid. This will range from 2000 to 20,000 mg of vitamin C! Read the book to learn how to judge this—p.194
- Vitamin E, 800 units, mixed tocopherols
- Pantothenic acid, 1500 mg
- Niacin 25 to 50 mg
- B 6, 50 to 100 mg
- Magnesium citrate, 400 mg (here I strongly disagree. Magnesium lotion is far better absorbed and tolerated)
- Calcium 750 to 1000 mg
- Trace minerals of manganese, selenium, molybdenum, chromium, copper, iodine and zinc
- Adequate fiber
- Ashwagandha—up to 2 grams daily
- Siberian Ginseng, up to 1 gram daily
- Ginger root, up to 1500 mg of capsules or as a tea of fresh root
- Ginkgo biloba, up to 1000 mg
- Adrenal cell extracts—essentially dried adrenal gland
- Natural progesterone—I prefer the cream
- Pregnenolone, 10 to 40 mg daily
Obviously stress reduction, adequate sleep and R & R are also essential. Overall this book is comprehensive and the best I know on the subject. What is missing, I think is a look at the whole hypothalamic-pituitary-adrenal axis, which must include the thyroid, which is more intimately tied to adrenal function than the gonads. Indeed, I believe that it is the General Adaptation to Stress, as outlined by Hans Selye, which must be looked at. I will address this in a future newsletter.
Norman Shealy, M.D., Ph.D. is the father of holistic medicine. He recommends autogenic focus (the basis of the Biogenics System) as part of your overall commitment to self-health. Register to download your FREE autogenic focus MP3 now.