by Marcelle Pick, OB/GYN NP
Over the years, we’ve talked with many women who know that something is just not right. They suffer from overwhelming fatigue, inability to cope with stress, sleep disturbances, lightheadedness, recurrent infections, fuzzy thinking, low libido, marked irritability, and many other symptoms.
These women have told us that even when their symptoms are so severe that their quality of life is significantly compromised, their health practitioners dismiss that “adrenal fatigue” exists — or more importantly, that there are options for them to feel better!
After years of helping thousands of women, we have found that some of the confusion and resistance surrounding adrenal imbalance comes from the term “adrenal fatigue,” as well as the traditional view of medical testing. We want to clear up the misunderstandings — and most importantly, let you know that there are ways to restore your adrenal health.
“Adrenal fatigue” or “adrenal imbalance”?
“Adrenal fatigue” is another name for subclinical adrenal dysfunction, also called adrenal imbalance. It was popularized by James Wilson, ND, DC, PhD, whose 2001 book Adrenal Fatigue: The 21st Century Stress Syndrome first highlighted this condition. We believe the term “adrenal imbalance” is a better way to describe what your body is going through. After all, we don’t describe your heart, lungs, or other organs as being “fatigued” when they are under strain and need support.
While adrenal fatigue is well recognized in other parts of the world, there has been some skepticism about it within conventional medical circles here in the US. Many physicians are quick to point to other health issues (depression, fibromyalgia, hypothyroidism) that cause similar symptoms. We’ve found, though, that many times these issues are related to an underlying adrenal problem, and that treating them on their own with medications generally doesn’t solve them — but supporting adrenal function often does wonders.
Conventional testing only looks at extremes
Unfortunately, current tests that doctors are likely to recommend will look only at the extremes of adrenal imbalance that require immediate medical intervention: Addison’s disease, which occurs when the body’s cortisol production is severely deficient, and Cushing’s syndrome, in which the body produces excessively high levels of cortisol.
Many medical tests draw a sharp, dividing line between “healthy” and “unhealthy” based on test result numbers, rather than how you are feeling. This is the case with adrenal testing: Because Cushing’s and Addison’s are defined by specific values in conventional blood tests, if you fall anywhere between the cutoff points on the test — even if you’re very close — it is likely that you’ll be told that your adrenal function is normal. Saliva tests for adrenal function tend to be more accurate, but many conventional practitioners are unaware of them or don’t trust them. And, of course, the best indicator of all is whether you feel physically unwell.
Adrenal imbalance is part of a continuum
The medical model we follow (Functional Medicine) acknowledges and understands that every disease has a past, present, and future. We know that adrenal health acts on continuum. Every woman who comes to our clinic with symptoms of adrenal imbalance undergoes a series of tests that evaluate markers of stress, including cortisol and DHEA levels as well as basic metabolic tests to make sure there are no other health concerns.
And the results — in over thousands of cases — are remarkably consistent: only 20–25% have cortisol levels consistent with healthy adrenal function, while 75–80% suffer impaired function, in various patterns ranging from mild to more serious. With careful examination, it is possible to discover where you are on the continuum before facing medical emergencies or chronic disease states. Our symptoms are providing us with the opportunity to heal.