by Marcelle Pick, OB/GYN NP
Every day in my practice I talk with women about their health – so many different facets come up in conversation – the hot flashes associated with hormonal shifts, unwanted pounds, irregular periods, sleep disturbances, changes in libido, hair loss, fuzzy thinking, changes in energy – we talk about everything! Over the past few years I’ve noticed a trend – many, many more women are reporting fatigue, sometimes unrelenting fatigue, associated with sleep irregularities, changes in blood pressure, changes in thyroid, or even feeling ‘wired’ all the time…a feeling of not being able to slow down.
At Women to Women, we’ve long recognized these symptoms as potentially being associated with adrenal dysfunction. After testing to rule out other major medical concerns and testing adrenal function, we see an increasing trend with women – life is becoming increasingly stressful for women – the number of women who have total responsibility for a busy households is increasing, demands from family and children, financial demands, the constant flow of information with technological advances, the stressors from less than ideal nutrient intake along with environmental toxins which add to our body burden are taking their toll!
I’ve also noticed an increasing trend among endocrinologists – many are now starting to evaluate adrenal function. A recent New England Journal of Medicine article urged clinicians to become more aware of the predisposing factors which may lead to adrenal insufficiency. Most of these clinicians look at adrenal function as being compromised only when a patient is at either end of the spectrum – Cushing’s syndrome (also called hypercortisolism) is caused by long-term exposure to high amounts of the stress hormone cortisol, Addison’s disease (also called hypocortisolism) is a disorder where the adrenal glands don’t produce enough cortisol and other glucocorticoids. Patients with Cushing’s symptoms can feel irritable, anxious or depressed. They also may present some distinct features – a rounded mid-section, faces which are moon-like in shape and sometimes a fatty lump on the back of their necks.
Other symptoms of Cushing’s syndrome are: panic attacks, persistent anxiety, difficulty staying asleep, abdominal weight gain, feelings of inadequacy, difficulty winding down to get to sleep, feeling tired but unable to wind down, having a short temper and worsening PMS symptoms. With Addison’s disease patients may experience weak muscles, loss of appetite, cravings for salt, abdominal pain, nausea, vomiting or diarrhea, weight loss, feeling lightheaded especially when standing up quickly, worsening fatigue and patches of dark skin on skin folds, knuckles, elbows, knees or scars. Both of these extremes are very unusual and are seldom seen in clinical practice, but non the less they do exist. As you can see, Cushing’s syndrome and Addison’s disease seem to be at complete opposite ends of the spectrum. As a functional medicine practitioner, I’m always asking the questions like, “how did this patient get on this road?” and “how could this have been prevented?”.
What I’ve come to understand is that adrenal imbalance symptoms can be treated long before developing full blown disease. Many of my patients tell stories about seeing well-intentioned practitioners who aren’t able to help them because conventional practitioners are only trained to treat the disease state – not the pathway leading to it. It is important to point out that we’ve seen this trend before with gluten sensitivity – for many years this was overlooked by conventional medicine unless the patient presented with full-blown celiac disease. Today, however, we are seeing a different understanding about gluten sensitivity and, I suspect, we’ll see this about adrenal function in the future as well.
There’s good news to share – you can take control of your adrenal health! You can make great improvements in your adrenal health by lowering your stress and focusing on quality nutrition. Some women may also want to include a dietary supplement to help with adrenal support. One patient puts it this way “I made a practice of eating well and managing my stress and everything else just fell into place!”. I don’t want to make it seem like these changes will make a difference in your life over night. But after working with thousands of women, it takes time for the changes to be seen – but it is possible and almost always happens when the right support is given.
We know that cortisol is released in higher amounts when we are under stress or anxious. Our adrenals can’t differentiate between types of stress – trying to meet a deadline at work, coping with a sick family member, financial concerns, a car breaking down, getting married and dieting – yes even dieting (think about how many women you know who are constantly dieting!) places stress on the body. When blood sugar and insulin are continuously on a rollercoaster due to eating irregularly or an intake of highly refined carbohydrates and sugar, your adrenals will produce cortisol in an attempt to level things out. Constant cortisol production can lead to the adrenal exhausted state of low cortisol. I’ve seen thousands and thousands of women turn their lives around by healing their adrenals and restoring balance in their bodies and their lives! Some patience and awareness is needed – but the end result will be worth it!