Treatment of Adrenal Fatigue and Addison's Disease by Ron Kennedy, M.D., Santa Rosa, California Treatment of Addison's Disease In the case of true Addison's disease, the only proper solution is a prescription for one of the hormones made exclusively by the adrenal cortices: hydrocortisone (cortisol). President John F. Kennedy had Addison's Disease and was restored to full function when hydrocortisone became available in 1949.Except for hydrocortisone, he most certainly would not have had the energy required to run for political office leading to the presidency. Treatment of Adrenal Fatigue Addison's disease is the complete shutdown of the adrenal glands. Addison's disease is so rare, and adrenal fatigue so common, that I prefer to spend most of our space here on the latter. This syndrome is marked by loss of energy with the experience of fatigue and oversleeping. The use of adrenal glandular concentrates is easy, simple and economical and is the first thing I recommend. You can buy these at your health food or vitamin store without prescription. Another easy, simple, effective, economical treatment is freshly made licorice tea two to four times each day. Licorice tea contains glycyrrhiza, mentioned above. By itself, or together with adrenal glandular concentrate, the effect is potent. Glycyrrhiza works by blocking the breakdown of hydrocortisone in the liver. Therefore, the hydrocortisone level becomes higher, and this slows down the production of ACTH (adrenocorticotrophic hormone) from the pituitary gland, so the adrenals are given a much-needed rest.Thus, glycyrrhiza can be discontinued later when the adrenal gland function is restored. Glycyrrhiza also can be purchased in capsule form but it is probably more fun to drink the tea and, who knows, there may be something else in licorice tea which we don't know about that helps do the job. Nevertheless, if your condition is too progressed to respond to these measures, you may need to visit a doctor who practices nutritional medicine. To understand the treatment you may encounter there, we need to discuss a bit more about adrenal physiology. Adrenal activity is regulated by the pituitary gland. When the adrenals become fatigued, the pituitary senses this fatigue in the form of lowered levels of hydrocortisone and releases ACTH. ACTH commands the adrenals to perk up and produce more hormones. That works for a while, but the adrenals may become overworked and unable to respond — in which case, ACTH stimulation simply stresses them more and leads more quickly to fatigue. However, the pituitary is unmerciful and continues to pour forth ACTH like a man whipping a tired horse to do work it is incapable of doing. If the adrenal gland can get just a bit of rest from the ACTH whip, it is allowed to regenerate. To this end, your doctor may give you intramuscular or intravenous ACE (adrenal cortical extract). This makes the pituitary think the adrenals are back on line, and it shuts down ACTH production. During this respite, the adrenals can recover some lost function. Your ACE dose may be administered once, or daily for several days, or even several times in one day, depending on how fatigued your adrenals are. Of course, this should only be done in conjunction with adrenal glandular concentrate and glycyrrhiza by mouth. Usually, a course of adrenal glandular concentrate, glycyrrhiza, and ACE is enough to jump-start a tired adrenal gland. In case your adrenals are too far gone for this to be effective, you may need to take a low dose of hydrocortisone by mouth. Hydrocortisone has a checkered history in medicine. As mentioned earlier, when it became available in 1949 doctors had no idea what dose was "physiologic," i.e., natural. They guessed and, by and large, guessed wrong. While a physiologic dose is between twenty and forty mg. per day, divided into four doses, the usual dose given in the early days of adrenal steroid therapy was 100 to 200 mg. and in some cases much more. Anything, even a hormone natural to the body, is toxic in high doses. Even water, in excess, can kill you. Predictably (in retrospect), many side effects were noted, and the medical establishment became phobic of hydrocortisone. This trend was heartily supported by the pharmaceutical houses, which were busy developing synthetic, patentable substitutes for hydrocortisone, the most famous of which is prednisone. Since then, two generations of doctors have been trained to fear hydrocortisone while prescribing Prednisone and its cousins with their many harsh side effects. The truth is that physiologic doses of hydrocortisone, in distinction to "pharmacologic" (i.e., arbitrarily large) doses, are highly effective and extraordinarily safe for a variety of conditions. Because they are natural adrenal hormones they are without adverse side effects when given in physiologic doses. The same cannot be said of prednisone and its unnatural cousins. For disease states brought on by stress, adrenal support or supplementation is clearly the safest and most natural approach.