Low Adrenal Function /
Adrenal Insufficiency

Low Adrenal Function / Adrenal Insufficiency: Overview

The adrenal glands, located above the kidney, often become 'exhausted' as a result of the constant demands placed upon them.  An individual with adrenal exhaustion will usually suffer from chronic fatigue, may complain of feeling stressed-out or anxious, and will typically have a reduced resistance to allergies and infection. The adrenal glands secrete several important hormones that help maintain the balance of many body functions.  Stress, fasting, temperature changes, infections, drugs, and exercise all stimulate the adrenals to release their hormones.  When the adrenals release too few or too many hormones, the body responds differently to the everyday stresses of life.

The adrenal cortex is involved in the production of glucocorticoids (such as cortisol i.e.  hydrocortisone), mineralocorticoids (aldosterone) and androgens such as androstenedione and DHEA.  A mild to moderate adrenocortical deficiency can substantially reduce your quality of life, yet this condition is not recognized by most doctors, who only think of the adrenal gland's condition as being at either extreme – normal or in overt failure (Addison's disease).

Adrenal Insufficiency (AI) is generally classified as primary (failure at the adrenal gland level), secondary (failure at the pituitary gland level), or tertiary (failure at the hypothalamus level).  Because it is difficult and rarely useful to differentiate secondary and tertiary AI, these are often grouped together as 'Central AI', or 'Secondary AI'.

Treatment and Prevention

For those concerned about taking a hormone (cortisol) – perhaps for life – a more natural approach to strengthening the adrenal gland can be tried.  This may include vitamin C, PABA, adrenal glandulars, ACE (Adreno-Cortico-Extracts) injections, licorice root, ginsengs, TMG (tri-methyl-glycine) and DHEA among other possibilities.

Adrenal Fatigue

Information On This Page

Signs, symptoms & indicators of Low Adrenal Function / Adrenal Insufficiency:

Lab Values - Common

Symptoms - Allergy

Symptoms - Environment

Symptoms - Female

Symptoms - Food - Beverages

Symptoms - Food - General

Counter-indicators:
Eating regularly throughout the day may contraindicate Low Adrenal Function / Adrenal InsufficiencyEating regularly throughout the day
Regular, healthy eating habits support adrenal function.

Symptoms - Food - Preferences

Symptoms - Gas-Int - General

Symptoms - General

Counter-indicators:

Symptoms - Hair

Symptoms - Head - Eyes/Ocular

Symptoms - Head - Nose

Symptoms - Immune System

Symptoms - Metabolic

Symptoms - Mind - Emotional

Symptoms - Muscular

Symptoms - Reproductive - Female Cycle

Hot flashes during period is often a sign or symptom of Low Adrenal Function / Adrenal InsufficiencyHot flashes during period
Adrenal estrogen seems to be necessary to avoid hot flashes during normal menses when the ovarian production of estrogen drops.  Hot flashes during menses may be a symptom of mild adrenal cortex deficiency.

Symptoms - Reproductive - General

Symptoms - Respiratory

Symptoms - Skin - Conditions

Symptoms - Skin - General

Symptoms - Sleep

Counter-indicators:
Being a deep sleeper may contraindicate Low Adrenal Function / Adrenal InsufficiencyBeing a deep sleeper
Regular good sleep habits (non-wakeful rest during the night, not snoring, waking refreshed) tend to contraindicate adrenal stress.

Conditions that suggest Low Adrenal Function / Adrenal Insufficiency:

Autoimmune

Lupus, SLE often suggests Low Adrenal Function / Adrenal InsufficiencyLupus, SLE (Systemic Lupus Erythromatosis)
Lupus is one of the auto-immune diseases, caused by a hyperactive ("hypervigilant") immune system that attacks a person's own protein as if it were foreign matter.  One reason for this is poor adrenal function.  Adrenal steroids modulate (slow down) the immune system: when there is not enough of these steroids the immune system goes berserk.
Counter-indicators:

Circulation

Counter-indicators:
Anemia often contraindicates Low Adrenal Function / Adrenal InsufficiencyAnemia
If anemia is identified as a problem then the likelihood of low adrenal function is reduced.  Therefore, it is wise to rule out anemia first, because both can contribute to similar symptomology.  Of course, it is not impossible for both to occur simultaneously, but this is less likely.

Hormones

Progesterone Low or Estrogen Dominance often suggests Low Adrenal Function / Adrenal InsufficiencyProgesterone Low or Estrogen Dominance
The inner most layer of an adrenal gland is the zona reticularis which produces small amounts of sex hormones.  Specifically, it produces androgen, estrogen and progesteroneAdrenal exhaustion can therefore cause hormone deficiencies.
Hypothyroidism often suggests Low Adrenal Function / Adrenal InsufficiencyHypothyroidism
A suggestive but unresolved issue is the connection between the thyroid and the adrenal glands.  An altered sensitivity of tissues to thyroid hormone may take place when there is a reduction in adrenal hormones.

Immunity

Weakened Immune System may suggest Low Adrenal Function / Adrenal InsufficiencyWeakened Immune System
Adrenal insufficiency can lead to a host of problems, including a weakened immune response, anxiety and panic attacks.

Infections

Inflammation

Chronic Inflammation often suggests Low Adrenal Function / Adrenal InsufficiencyChronic Inflammation
The adrenal glands produce hydrocortisol, the major natural anti-inflammatory steroid in the body.  Without enough circulating cortisol there may be a tendency to become easily inflamed.

Lab Values

Mental

Anxiety may suggest Low Adrenal Function / Adrenal InsufficiencyAnxiety
Adrenal insufficiency can lead to a host of problems, including a weakened immune response, anxiety and panic attacks.

Metabolic

Musculo-Skeletal

Nervous System

Organ Health

Reproductive

Fibrocystic Breast Disease often suggests Low Adrenal Function / Adrenal InsufficiencyFibrocystic Breast Disease
[The Safe Uses of Cortisol, William Mck.  Jefferies, MD 1996, p.156]
Painful Menstruation (Dysmenorrhea) may suggest Low Adrenal Function / Adrenal InsufficiencyPainful Menstruation (Dysmenorrhea)
Dysmenorrhea caused by ovarian dysfunction may disappear when low doses of cortisol are used to improve adrenal influence on ovarian function.  [The Safe Uses of Cortisol, William Mck.  Jefferies, MD 1996, p.157]

Respiratory

Skin-Hair-Nails

Risk factors for Low Adrenal Function / Adrenal Insufficiency:

Childhood

(Severe) sexual abuse during childhood often increases risk of Low Adrenal Function / Adrenal Insufficiency(Severe) sexual abuse during childhood
Females who have been abused are more sensitive to life's stresses many years after the original abuse event(s).  This elevated stress response can lead to adrenal exhaustion.

Diet

Counter-indicators:
Healthy Diet Choices often decreases risk of Low Adrenal Function / Adrenal InsufficiencyHealthy Diet Choices
Healthy and regular eating habits support adrenal function.

Habits

Counter-indicators:
A Good Aerobic Exercise Level often decreases risk of Low Adrenal Function / Adrenal InsufficiencyA Good Aerobic Exercise Level
Those regularly engaged in exercise and hobbies are less likely to suffer from adrenal problems.

Hormones

Immunity

HIV/AIDS often increases risk of Low Adrenal Function / Adrenal InsufficiencyHIV/AIDS
In general, diagnosis and treatment endocrine issues in HIV patients is no different from non-HIV patients.  However, HIV can cause reactive changes in pituitary and adrenal function, as can many HIV medications.

Nutrients

Counter-indicators:
A Good Supplementation Level may decrease risk of Low Adrenal Function / Adrenal InsufficiencyA Good Supplementation Level

Personal Background

Counter-indicators:
Being in a good relationship may decrease risk of Low Adrenal Function / Adrenal InsufficiencyBeing in a good relationship
Happy and fulfilling relationships tend to contraindicate adrenal compromise.

Supplements and Medications

Prednisone use may increase risk of Low Adrenal Function / Adrenal InsufficiencyPrednisone use
Long-term use of prednisone can lead to adrenal suppression, possibly resulting in depression, euphoria, hypertension, nausea, anorexia, high blood sugar levels, or increased susceptibility to infection.

Symptoms - Allergy

Symptoms - Food - Beverages

(High) coffee consumption may increase risk of Low Adrenal Function / Adrenal Insufficiency(High) coffee consumption
Caffeine raises adrenaline levels and heavy coffee consumption can lead to a state of adrenal gland exhaustion, where the adrenal glands are no longer able to adequately respond to stress by releasing enough adrenaline.

Symptoms - Glandular

History of hypothyroidism may increase risk of Low Adrenal Function / Adrenal InsufficiencyHistory of hypothyroidism
A suggestive but unresolved issue is the connection between the thyroid and the adrenal glands.  An altered sensitivity of tissues to thyroid hormone may take place when there is a reduction in adrenal hormones.

Symptoms - Head - Nose

Symptoms - Immune System

Symptoms - Mind - Emotional

Counter-indicators:
A low-stress lifestyle often decreases risk of Low Adrenal Function / Adrenal InsufficiencyA low-stress lifestyle
A slow-paced lifestyle would tend to contraindicate adrenal compromise.

Symptoms - Muscular

Symptoms - Respiratory

Symptoms - Skin - Conditions

Low Adrenal Function / Adrenal Insufficiency suggests the following may be present:

Hormones

Immunity

Low Adrenal Function / Adrenal Insufficiency may suggest HIV/AIDSHIV/AIDS
In general, diagnosis and treatment endocrine issues in HIV patients is no different from non-HIV patients.  However, HIV can cause reactive changes in pituitary and adrenal function, as can many HIV medications.

Low Adrenal Function / Adrenal Insufficiency can lead to:

Autoimmune

Low Adrenal Function / Adrenal Insufficiency sometimes leads to Lupus, SLELupus, SLE (Systemic Lupus Erythromatosis)
Lupus is one of the auto-immune diseases, caused by a hyperactive ("hypervigilant") immune system that attacks a person's own protein as if it were foreign matter.  One reason for this is poor adrenal function.  Adrenal steroids modulate (slow down) the immune system: when there is not enough of these steroids the immune system goes berserk.

Recommendations for Low Adrenal Function / Adrenal Insufficiency:

Botanical

Licorice Root is highly recommended for Low Adrenal Function / Adrenal InsufficiencyLicorice Root
Licorice root is a specific herb that has been used for centuries to support these glands.  If cortisol levels are low, one of the ways to sustain more normal levels is to slow or inhibit its breakdown.  This can be accomplished naturally.

The only known readily available inhibitors of the enzyme that deactivates cortisol (11 beta-HSD) are glycyrrhizic acid (found in licorice root extract), progesterone, and flavonoids (in grapefruit).  The concept of extending cortisol bioactivity via 11 beta-HSD inhibition is well established, but the manner in which progesterone alters 11 beta-HSD is not currently clear.  You could eat 10 to 15 grapefruits or take licorice root extract to sustain cortisol levels.  However, licorice root used regularly in large doses can produce high blood pressure, water retention, potassium wasting, and breast enlargement in men.  A Naturopathic Doctor should be able to guide you in using licorice root alone or in combination with other adrenal agents.
Korean Ginseng may help with Low Adrenal Function / Adrenal InsufficiencyKorean Ginseng
Both Chinese ginseng (Panax ginseng) and Siberian ginseng (Eleutherococcus senticosus) are known to exert beneficial effects on adrenal function and enhance resistance to stress.

Ginseng may prove especially effective for the restoration of normal adrenal function and prevention of adrenal atrophy associated with corticosteroid administration.  In rats, ginseng has been found to inhibit cortisone-induced adrenal and thymic atrophy.  Ginseng could be combined with other botanicals with adrenal enhancing activity in the treatment of adrenal atrophy.

Diet

Caffeine/Coffee Avoidance often helps with Low Adrenal Function / Adrenal InsufficiencyCaffeine/Coffee Avoidance
Caffeine raises adrenaline levels and heavy coffee consumption can lead to a state of adrenal gland exhaustion, where the adrenal glands are no longer able to adequately respond to stress by releasing enough adrenaline.

Hormone

Hydrocortisone is highly recommended for Low Adrenal Function / Adrenal InsufficiencyHydrocortisone
Physiologic replacement doses of oral cortisol can make a dramatic difference in cases of adrenal exhaustion.  Because of side-effects induced by larger doses, many doctors are reluctant to use it and many patients are thus deprived of a valuable and needed therapy.  Physiologic doses of cortisol (5-25mg per day) are safe.  Lab testing can confirm the diagnosis of mild adrenocortical deficiency.  A doctor experienced with cortisol use should be consulted; a typical prescription is 5mg four times per day, with an emphasis on early morning use if later doses keep you up at night, or if fewer doses are taken.
Not recommended:
Melatonin is sometimes not recommended for Low Adrenal Function / Adrenal InsufficiencyMelatonin
Since melatonin helps to control excess cortisol production, those with low adrenal function and low cortisol levels need to be careful about taking too much melatonin: it can make them even more tired.

Lab Tests/Rule-Outs

Test Adrenal Function is highly recommended for Low Adrenal Function / Adrenal InsufficiencyTest Adrenal Function
Adrenal function can be evaluated in several ways by blood, saliva, and/or urine testing.  Your doctor should know the best test to use depending on the suspected severity of the condition.

Mineral

Increased Salt Consumption often helps with Low Adrenal Function / Adrenal InsufficiencyIncreased Salt Consumption
Sea salt should be included in the diet, unless contraindicated for other reasons, as it benefits adrenal gland function.  When seasoning foods, use as much salt as tastes good to you.

Nutrient

TMG (Tri-methyl-glycine) may help with Low Adrenal Function / Adrenal InsufficiencyTMG (Tri-methyl-glycine)
The adrenal gland uses nutrients such as TMG (betaine), tyrosine, vitamins B5, B6 and C to maintain function and produce its hormones.

Vitamins

Vitamin B5 (Pantothenic Acid) often helps with Low Adrenal Function / Adrenal InsufficiencyVitamin B5 (Pantothenic Acid)
Key nutrients to aid adrenal function include vitamin C, B5 (pantothenic acid), vitamin B6, zinc, and magnesium.  These nutrients not only play a critical role in the health of the adrenal gland, but also in the manufacture of adrenal hormones.
Vitamin A may help with Low Adrenal Function / Adrenal InsufficiencyVitamin A
The adrenals need lots of vitamin A, C, and B-complex.
Vitamin C (Ascorbic Acid) may help with Low Adrenal Function / Adrenal InsufficiencyVitamin C (Ascorbic Acid)
Taking 1-3gm of mineral ascorbates up to 3 times daily is supportive of adrenal gland function.
Vitamin Paba may help with Low Adrenal Function / Adrenal InsufficiencyVitamin Paba
PABA potentiates the hormone cortisol.  When cortisol is being supplemented, the dosage of PABA may need to be reduced.

KEY

Weak or unproven link: may be a sign or symptom of; may suggest; may increase risk of; sometimes leads to
Weak or unproven link:
may be a sign or symptom of; may suggest; may increase risk of; sometimes leads to
Strong or generally accepted link: is often a sign or symptom of; often suggests; often increases risk of
Strong or generally accepted link:
is often a sign or symptom of; often suggests; often increases risk of
Definite or direct link: strongly suggests; increases risk of
Definite or direct link:
strongly suggests; increases risk of
Weakly counter-indicative: may contraindicate; may decrease risk of
Weakly counter-indicative:
may contraindicate; may decrease risk of
Strong counter-indication: often contraindicates; often decreases risk of
Strong counter-indication:
often contraindicates; often decreases risk of
May be useful: may help with
May be useful:
may help with
Moderately useful: often helps with
Moderately useful:
often helps with
Very useful: is highly recommended for
Very useful:
is highly recommended for
Caution: is sometimes not recommended for
Caution:
is sometimes not recommended for