Re: and yet another. Sorry for the length but a lot of great info.

One history, exam, and sometimes with positive lab results, they turn out to have pathogenic bacteria or yeast infecting the intestines. This causes the immune system to go into an inflammatory state as it fights the infection. The increase inflammatory cytokine signals are sensed by the nervous system, which then activates the sympathetic nervous system. The gut infection may interfere with nutrition. The patient may prefer to avoid certain foods which may further promote the immune system's inflammatory response. Often the brain interprets the immune response as nausea or GI upset. The innate immune system response can further cause diarrhea. The avoidance of certain foods can lead to nutritional deficiencies. The inflamed gut may have difficulty absorbing certain nutrients, further exacerbating nutritional deficiencies that then can impair metabolism. The activated sympathetic nervous system can cause the kidneys to lose certain nutrients such as zinc. This can then can se neurotransmitter and hormone signaling changes. The sum of the structural change (infection), signaling changes (e.g. inflammatory signaling, sympathetic nervous system signaling and the downstream signaling changes that occur), and the nutrient deficiencies which impairs metabolism and intercellular signaling is a dysregulation of the adrenal glands and suppression of adrenal function in response to stress. Preexisting problems such as hypothyroidism can exacerbate the ongoing processes.

Supporting adrenal function (e.g. using hydrocortisone, etc.) in such a person never addresses the primary problem - a gut infection which triggered a cascade of behavioral changes, nervous system, endocrine system, immune system, metabolic and nutritional changes that lead to their illness, of which adrenal dysregulation is one outcome. The patient becomes forever ill, perhaps somewhat better but never well because the treatment does not address the pathophysiology of the illness - the root cause(s). Treating the Depression and anxiety with psychiatric medications may help partially - as they usually do. But it is not a complete solution. Again, the psychiatric medications do not address the most important cause of the patient's illness.

For gut infections from pathogenic bacteria or yeast, as a pathophysiology of their illness, I had to develop a protocol to remove the infection, restore the good bacteria and yeast population, and heal the gut. It is a complicated protocol with multiple components. It doesn't always work given some pathogens are highly resistant where the best that can be achieved in research studies is a 95% kill rate. Nonetheless, when successful it rapidly helps a lot patients toward health, restoration of adrenal function, without having to use hydrocortisone, often within 2-4 weeks despite years of illness. Addressing the actual cause of the adrenal dysregulation works better. I've been very pleased with the outcomes.
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Romeo B. Mariano, MD, physician, psychiatrist
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