Adrenal fatigue: testing, symptoms and effect on Your thyroid explained.

Low energy and tiredness are among the most common causes patients ask help from a doctor.

Despite being so popular, it is frequently difficult to come up with a diagnosis as numerous medical problems can cause fatigue.

Doctors collect a medical history, do a physical examination and blood test. The results often produce no explanation for a patient's problem.

The thing is: conventional medicine tests only for conventional diseases. Adrenal fatigue is unfortunately not one of them.

That's why You probably won't hear from Your primary care physician or endocrinologist to check saliva or urine cortisol levels, because they simply don't believe that it can be linked to Your adrenal health.

Furthermore, it is often called "controversial theory", because of the few systematic reviews done on the 3000 articles.

But is it practical to treat patients just on the raw data taken from the articles? Well, as You can guess it's not.

What about literally thousands of patients who claim that they got much better after improving their adrenal glands health?

We can't simply deny thousands of patients' stories, who state that it worked for them.

We believe that if something helps the patients it's necessary to investigate it, before jumping into pharmacological treatment and not even considering adrenal glands health.

This is when conventional medicine meets alternative or functional medicine.

How do the functional doctors explain adrenal fatigue?

Continued stress can lead to changes in Your cortisol level, which then affects multiple organs of Your body like adrenal glands, thyroid and others.

Why is the cortisol important for the thyroid health?

Cortisol plays a crucial role for Your thyroid. When cortisol is low, TSH levels increase, which is a sign of a poorly working thyroid. 

Furthermore, low levels of cortisol also decrease T3 attachment to its receptors in the tissues where it is active. 

This is problematic for the patient as T3 is the active form of the hormone that is NEEDED for all of Your tissues to ensure proper metabolism.

Why is the cortisol important for Insulin response?

Under stressful conditions, cortisol provides the body with glucose by tapping into protein stores in the liver. 

However, elevated cortisol over the long term consistently produces glucose, leading to increased blood sugar levels. This can lead to insulin and leptin resistance and even Type 2 Diabetes

Insulin and leptin resistance contribute to the development and worsening of Your thyroid disorder.

As You can see both too low and too high cortisol can be problematic. Cortisol level has to be optimised for the thyroid health.

Is low or high cortisol more frequent in patients with thyroid disorder?

Cortisol increase is the first stage (resistance stage) of the progression that's usually followed by the low cortisol levels (adrenal fatigue-exhaustion stage).

So what are the symptoms of adrenal fatigue? (list by patients)

1. Continued Hypothyroid symptoms

2. High Heart rate

3. Flu like-symptoms

4. Weakness

5. Irritability

6. Shaky hands

7. Hypoglycemic episodes

8. Shaky Hands

9. Problem with focusing on a task

10. Diarrhea

11. Trouble getting to sleep and waking up

12. Waking up in the middle of the night for few hours

13. Difficulty falling asleep

14. Craving salt and sugar

15. Reliance on stimulants such as caffeine

16. Too sensitive skin

17. Dizziness

18. Light headedness

19. IBS symptoms

20. Dark circles under my eyes

21. Headache

22. Hypersensivity to noise

23. Sudden episodes of hunger

24. Muscle weakness

25. Frequent and worsening allergies

26. Elevated blood sugar

27. Belly fat gain

28. Poor recover from exercise

29. Low sex drive

30. Low blood pressure

31. Difficulty recovering from illness

So let's zoom on the Continued Hypothyroid symptoms.

First of all, what do we mean by it?

1. We mean having thyroid symptoms for several months or years before being diagnosed by Your doctor.

2. We also refer to patients who've tried thyroid medications below and it has still not helped them with their symptoms:

• T4 medications: Synthroid, Tirosent, Levothyroxine, Levoxyl, Euthyrox, Levothroid

• NDT medications (Armour Thyroid, Nature-Throid, NP Thyroid, WP Thyroid)

• T3 medications like Cytomel and Liothyronine

***If You fall into one of these 2 categories and experience symptoms listed above, You may want to examine Your adrenals.

So how can You test Your adrenal glands?

There are 4 available methods of testing Your cortisol level:

1. Saliva testing

2. Urine testing

3. Blood testing

4. ACTH Stimulation test (STIM)

Which of these methods is the best?

Well, it depends. All of them have advantages or disadvantages.

Blood testing is the cheapest method and is is usually covered by insurance. This is a big advantage. It's also available in most hospitals and laboratories.

The downside is that the blood test is measuring the cortisol level only at a specific time. It is problematic because the cortisol physiologically changes during our day.

Thus, even if the result on the test shows normal, it does not really inform us about the whole picture of what's happening with the adrenal glands, because at other time of the day cortisol can be too high or too low.

Another option is ACTH stimulation test (STIM). It measures how your adrenals can react to stress. The test measures the amount of cortisol that the adrenals produce after being stimulated by a synthetic form of ACTH.

The problem with this test is that most of the doctors are only looking for Addison’s disease. If the test does not show Addison’s disease, they conclude Your adrenal glands are fine. They don't look for the values in between.

So what's the solution to these problems and how can You check cortisol levels during 24h?

The solution to this is a 24-hour urine test or saliva testing. So which one is better? Both are very accurate.

The difference is that urinary cortisol output indicates an average of the time since the previous urine void (hours), while saliva gives an instantaneous evaluation at the time saliva was obtained (minutes).

That's why in general, patients find saliva test easier to use and interpret.

Now, Tell us Please:

• Do You experience any of the symptoms listed above?

• Do You still suffer from hypothyroid symptoms even on drug treatment? 

• Have you ever tested Your cortisol? 

• If yes, what tests did You do? What were Your results?