Adrenal fatigue

Discussion in 'Fibromyalgia Main Forum' started by Smurfette17, Feb 19, 2009.

  1. Smurfette17

    Smurfette17 New Member

    My primary care doctor (family practice MD with an alternative bend) just emailed me with the results of my labs-- he said I have adrenal fatigue, common in CFS. Mainly, my DHEA-S is too low and my pregnenalone is also low. My cortisol is actually too high, and that can make people feel lousy when the hormones don't balance.

    I won't have my follow-up with him for another 3 weeks, but he suggested I read a book and hinted that most of my changes will be behavioral, maybe with some hormone supplements.
    He does know I see Dr. Lerner and take AVs.

    Can anyone relate to these results?

    Also, I hesitate to bring this up with Dr. Lerner next week because many physicians don't believe in adrenal fatigue (my husband said they never learned this in medical school- only Addison's). I don't know yet with my GP will suggest as a course of treatment, so I don't know what to tell Lerner. I know that giving steroids when treating bacterial infections are a no-no. Not sure about viral infections, since many people with mono are given a 3 day course of prednisone to unswell their throats.

    Has anyone taken something like hydrocortisone and AVs together?

    It's frustrating-- I'm in the middle of a Valcyte herx and now this!
  2. richvank

    richvank New Member

    Hi, smurfette.

    For what it's worth, I think you are in an early stage of adrenal fatigue. The cortisol level usually goes up initially, in response to a person's combined load of stressors (physical, chemical, biological, and psychological/emotional). If the stress situation can be corrected at this point, the cortisol level goes back down to normal. If not, this condition progresses to later stages, and eventually the cortisol level drops. People who have had CFS for an extended time usually have low cortisol levels. In my hypothesis for CFS, this results from a dysregulation and a lowering of the secretion of ACTH, which is secreted by the pituitary gland to control the output of cortisol and DHEA by the adrenal glands. These effects on ACTH result from glutathione depletion in the pituitary gland. Glutathione depletion and a partial methylation cycle block also cause dysfunction of the immune system, which is what I believe allows the reactivation of latent herpes-family viruses in CFS. So I believe that the viral infections and the adrenal fatigue result from the same basic biochemical causes, as do the other aspects of CFS. Incidentally, when Dr. Lerner read my paper about this at the IACFS conference two years ago, he told me that he thought it made sense.

    It sounds as though your doctor has a good understanding of this.

    Did he suggest the book by James Wilson, or the one by William Jeffries?

    Anything you can do to lower your stress load or to improve the ways you cope with stress would probably be helpful.

    Since I'm not a licensed physician, I can't advise you on hormone replacements.

    I wish you the best.

  3. smadavid

    smadavid New Member

    This sounds a lot like me... my cortisol is too low in the morning, and too high in the afternoon. And I have low pregnenalone. I'm on low-dose hormone supplementation, which does help somewhat, especially during the mornings.
  4. ladybugmandy

    ladybugmandy Member

    smurf....lerner won't give you adrenal supplements and i don't think he will give you steroids. i think he believes the adrenal problems are a result of long-term viral infections and will reverse once your infections are under control.

    when i mentioned to him that another doctor found adrenal problems, he sent me for an ACTH stimulation test (i think that's what it was) at beamont. the results showed that the adrenals are still OK but the problem is more of a signaliing issue (result of chronic viral infection).

    you may want to ask dr. lerner for a stimulation test.

  5. Smurfette17

    Smurfette17 New Member

    Thanks Kelly and everyone else.

    That information about Dr. Lerner helps a lot. Yes, I'm on Valcyte (I posted on another thread) and am having a miserable time with it.

    To clarify, my AM cortisol is 25.5, which is higher than the range-- too high. The PM cortisol is 4.6, which I think is normal for that time (not sure). It's the DHEAS and preg. that are low, so I doubt my doctor would give me hydrocortisone since the actual cortisol is too high. This was from a blood test, not a saliva test, btw.

    I haven't seen my doctor yet for us to discuss what to do, but since the appt with Lerner comes sooner, maybe I'll just show him the actual test results and see what he says.

    It's really tough when one has 3 doctors trying to manage one....

    Rich- the book he recommended was the one by James Wilson.
    [This Message was Edited on 02/20/2009]
    [This Message was Edited on 02/20/2009]
  6. Smurfette17

    Smurfette17 New Member

    I mentioned to Dr. Lerner last week that my primary care doctor had found some adrenal imbalances. I even showed him the test results. However, I think he misunderstood and, like most physicians, is thinking of adrenal insufficiency in the traditional sense (very, very low cortisol). He ordered a cort-stimulation test, which my other doctor said isn't really necessary since we know that I am actually over-producing cortisol. I knew that.

    I'll do the test, but get frustrated at having to go in for needless tests when my energy is already so low. It is also hard to have multiple doctors-- I'm going to try to see if they can communicate with each other more!
  7. Wolverine

    Wolverine Member

    Lol nofool. Interesting but very biast article there. ;) There is some truth to it in that I think more people use adrenal extracts and cortisone that need to.

    However, there certainly is a spectrum of adrenal insufficiency. People with high cortisol and fatigue often means the body is constantly overstressed from whatever condition the body is trying to deal with. Over time cortisol lowers of course. Adrenal fatigue i think is just the name for the stages between normal/healthy adrenal / HPA system, and full adrenal insufficiency. We don't have perfect adrenals one day then suddenly wake up the next with addisons disease. It's progressive, and common sense that there would be a period in between. I've had CFS/FM for 8 years before the HPA finally getting too bad. My morning cortisol was NORMAL and they didn't think I had an adrenal problem until i had the insulin tolerance test (similar but one step up from the ACTH stim test), and FAILED it. They were rather suprised. I was almost collapsing all over the place, which is the only reason i started HC. It was a last resort for me.

    James Wilson's book - 'Adrenal Fatigue' has helped many people who have only mild problems in rhis area too.

    Smurfette - If you are able to get about town, go to the shops etc without being on hydrocortisone, I would look for a natural way to try balance the adrenals. When are you having the cort stim test? I would not say that one is needless - it is very important in determining if you have proper adrenal insufficiency or not.

  8. JoFMS

    JoFMS New Member


    I was diagnosed with stage 5 adrenal fatigue last year by doing a 24hr saliva cortisol test. There is a lot of info on Dr Lam's site below:

    I am currently on 17.5mg cortisol per day along with a bunch of supplements:

    Pregnenolone 30mg twice day
    Vit B5 500mg twice day
    Vit C 3g per day
    Ashwaganda 2000mg per day
    B complex
    Biotin 2000mcg per day

    I also take many other supplements and oregano oil to combat yeast. Much of my problems are also due to mercury poisoning which can cause adrenal and thyroid probs. The low dose cortisol definitely helped me deal with stress much better and I'm much calmer now instead of feraking out at the slightest bit of stress which helps my muscles to relax also.

    I am using Dr Cutlers protocol for mercury chelation which is also helping me.

    My GP pretty much left things to me and I go to him if I need a prescription or tests as he says I seem to know what I'm doing. Read as much as you can about it and also about the supplements.

    Hope this helps.

  9. BeanyMalone

    BeanyMalone New Member

    I have been reading Dr. Joan Matthews Larsen lately. She does very cutting edge research on depression and alcoholism and a lot of things in between. If I remember right she is an advocate of high levels of vitamin C in the repair of the adrenals. A good book is "Depression Free Naturally."