|Hormonal Imbalance/Adrenal Dysfunction|
There are several stages of adrenal dysfunction. The most common cause of adrenal dysfunction is caused by stress. The body deals with stress through the hormonal responses of the adrenal glands. When under periods of prolonged stress, the adrenal glands can start to decrease their release of hormones. A decrease in adrenal hormones results in several issues including fatigue, blood pressure regulation problems, abdominal weight gain, and muscle wasting.
The effects of stress on the body are wide spread and can be partially explained by the effect that stress has on adrenal hormone production. Through supporting the adrenal function it is possible to return the adrenals to normal function and reverse any issues that might have occurred as a result of stress.
These adrenal hormones have a circadian rhythm that is regulated by hormones from the pituitary gland in the brain. Normally a surge of glucocorticoids occurs about 6-8 hours of sleep waking the brain up. There are several smaller peaks of glucocorticoids throughout the day to maintain energy levels. Stress (psychological and physical), exercise, and hypoglycemia can all stimulate glucocorticoid secretion in a good or bad way.
Mineralocorticoids like Aldosterone, help to promote the renal retention of sodium and the renal excretion of potassium to maintain a normal plasma sodium/potassium ratio. Maintaining this sodium/potassium ratio regulates the circulating blood volume and thus helps to maintain blood pressure.
Adrenal androgens include testosterone, dihydrotestosterone (DHT), androstenedione, and dehydroepiandrosterone (DHEA). The biochemical pathways involved in the synthesis of androgens are common to both the adrenal cortex and gonads (ovaries and testes). Most of the DHEA that enters the circulation is normally derived from the adrenal cortex, particularly in women. The sulfated form of DHEA (DHEA-S) is also one of the best indicators to measure adrenal function. Most androgens are transported by sex hormone-binding globulin (SHBG).
DHEA is a hormone that is still being studied to determine its effects. It appears to have effects on metabolism, moods, heart function, skin tone, muscle function, and regulation of the other androgens. Testosterone helps to maintain muscle bulk and tone throughout the body.
Adrenal medullary hormones are the catecholamines – epinephrine (adrenaline) and norepinephrine. Both of these hormones are neurotransmitters in the sympathetic nervous system. The adrenal medulla is a highly specialized part of the sympathetic nervous system and responds to stress by releasing epinephrine. If epinephrine is released in significant amounts, it can initiate the "fight or flight" response, an adaptive response to perceived danger.
Epinephrine is produced in the adrenal medulla from norepinephrine by the enzyme phenylethanolamine-N-methyltransferase (PNMT). The synthesis of PNMT in the adrenal medulla is induced by Cortisol. Increased Cortisol and epinephrine levels are associated with hypertension, atherosclerosis, insulin resistance, and various other chronic disorders.
Hans Selye, past director of Experimental Medicine and Surgery at the University of Montreal, performed several studies to explain the effects of stress on adrenal function. He developed a general theory to explain the typical response to stress and the adaptive mechanisms associated with the typical stress response. Hans Selye called the physiological adaptive mechanism the "General Adaptation Syndrome" (GAS).
Hans Selye presented the GAS as a model of stress adaptation that has provided insight into the pathogenesis of common stress-induced disorders. It also has clinical utility in promoting the understanding of how to better manage stress-induced disorders.
Hans Selye observed that: "The physician, in dealing with GAS may be faced with a patient with no clear-cut diagnostic pattern, but just vague feelings of ill health." He stated that the "GAS provides a means to:
The Maladaptive Stress Syndrome (MSS)
Hans Selye provided the basic framework that has contributed to the evolving understanding of the responses the body has to nonspecific stress. As more research has been done, a more comprehensive clinical model of the adaptive and maladaptive patterns of responses to stress has become known as the “Maladaptive Stress Syndrome” (MSS).
The Maladaptive Stress Syndrome is staged in four stages ranging from 0 to 3. Stage 0 of the Maladaptive Stress Syndrome (MSS-0) is a normal response to stress and describes a healthy, well-adapted range of attention from hypovigilance to hypervigilance. The level of vigilance is mediated by the autonomic nervous system, and the adrenal hormones – particularly by catecholamines.
General Treatment Measures – Stress Reduction is KEY
Higher Level intervention – DHEA Therapy and herbal support
Prior to complete exhaustion of the adrenals, which is essentially Addison’s disease, DHEA therapy can be used to support and turn the adrenal function around. Optimal ranges vary based on age and sex. Lab ranges reflect normal population values and rarely give ranges for age and sex.
DHEA does have a dependency factor over long periods of use. It is generally not recommended to use for long periods of time. DHEA is only meant to be a supportive therapy and the goal is to eventually come off of it. For this reason DHEA should only be taken with a doctor’s supervision. Most of the over-the-counter supplements do not contain much DHEA only derivatives that have little to no affect on the body. Only pharmaceutical grade DHEA is effective.
There are side effects that can occur with DHEA therapy, which include acne and aberrant hair growth, which can be decreased with a drop in the dose.
To complement DHEA therapy the use of several herbs can be used to enhance the effectiveness of the treatment. These herbs should be used under medical supervision due to side effects and interactions that can occur. The safest to use include licorice extract and ginseng.
The content and materials provided in this web site are for informational and educational purposes only and are not intended to supplement or comprise a medical diagnosis or other professional opinion, or to be used in lieu of a consultation with a physician or competent licensed health care professional for medical diagnosis and/or treatment. All content and materials including essays, research papers, case studies and testimonials summarizing patients' responses to care are intended for educational purposes only and do not imply a guarantee of benefit. Individual results may vary, depending upon several factors including age of the patient, severity of the condition, severity of the disease progression, and duration of time the condition has been present.