Adrenals 101--allergy, fatigue.

FATIGUE LIKE YOU HAVEN'T KNOWN BEFORE

I'll never forget the time I went to the emergency room with hives
from head to toe. The emergency room doctor gave me prednisone, the
steroidal anti-inflammatory drug widely known to cause an array of
uncomfortable and potentially dangerous side effects. My internist

thought the hives might be related to stress -- so he gave me
alprazolam (Xanax) to calm me down.

Needless to say I was not happy with either of those "treatments." I
finally went to a naturopath, who diagnosed me with adrenal fatigue
(also known as "burnt out adrenals") and helped me rebuild my adrenal
system, which apparently had been run down by too many years of
burning my candle at both ends.

The thing about adrenal fatigue, however, is that it masquerades as
many other ailments, it is difficult to diagnose, slow to treat and,
more importantly, most mainstream doctors poo-poo the concept. Seven

years later, I am hive free and Xanax/Prednisone free. But how many
people are riding a never-ending cycle of symptom-suppressing drugs
as their doctors treat one symptom after another but never identify
the real problem?

WHAT IS ADRENAL FATIGUE?

"Allergy symptoms are pretty classic for adrenal exhaustion," says
Howard Leibowitz, MD, medical director of the Hall Center in Santa
Monica and a specialist in adrenal health. "One of the main hormones
the adrenal glands put out is a steroid hormone called cortisol." Dr.
Leibowitz explained that the medications cortisone and prednisone are
both steroids, which is why they are such a common treatment for

allergies. "With normally functioning adrenals, you make enough of
your own cortisol to respond to an allergen," he told me. "When
people come to the clinic complaining of fatigue, or when they have
allergy symptoms, I immediately consider adrenal insufficiency."

Here's how it works: The adrenals are two small glands approximately
the size of walnuts that sit on top of the kidneys. "The adrenals
make about 50 different hormones," Dr. Leibowitz told me. "The ones
we know about are metabolic drivers for the body. Among them are the
stress hormones -- cortisol and adrenaline." Cortisol and adrenaline
are the body's "fight or flight" hormones. They act as turbo chargers
in our system, sending our bodies into overdrive. They are what
allowed our ancestors to pick up a stick and fight off a woolly
mammoth (fight) or shimmy up a tree to get away from it (flight). But
the common stresses of modern life keeps them permanently in the "on"
position, playing havoc with the delicate hormonal balance intended
by nature. The result is a condition known as "adrenal fatigue."

"Look at the way we were designed," Dr. Leibowitz said. "Paleolithic
man would wake up with the sun and return to the cave and go to sleep
when the sun went down. That's exactly the way the normal cortisol
curve behaves -- it's highest around 8 am, rises in a circadian
pattern to wake us up and over the course of the day until we go to
sleep, it falls." But since the invention of electricity, our lives
no longer follow that natural trajectory. "We don't practice what I
call sleep hygiene," Dr. Leibowitz said. "We come home from work and
we want to do a ton of stuff. We go exercise -- or we have coffee
late in the afternoon, or alcohol to relax. We run to the computer to
catch up on work. All these things stimulate cortisol. So do the
everyday stresses of traffic, arguments, deadlines and not sleeping
enough. Initially all these stimulatory things cause us to produce a
lot of cortisol, but eventually your adrenal glands exhaust
themselves from the constant demand."

HOW DO YOU KNOW IF YOU HAVE ADRENAL FATIGUE?

Adrenal fatigue masks itself in a number of ways. It can display as
assorted allergic reactions, as well as show itself in the form of
weight gain, fatigue, lowered resting body temperature, and
lightheadedness in arising quickly, to name just a few.

Since it can masquerade as a number of different ailments, Dr.
Leibowitz favors salivary testing to determine if you are suffering
from adrenal fatigue. "There are blood tests for cortisol, but they
only show one point in time," said Dr. Leibowitz. "Urine tests are
also an option, but the salivary tests are inexpensive and a very
good guide. We take four samples over the course of 24 hours to
really understand what the cortisol is doing." Should the salivary
test point to a problem, more extensive testing may be required to
get an in-depth view of broader hormone levels.

THE MISSING MAINSTREAMERS

So why don't conventional doctors examine this phenomenon more? "Most
conventional medical doctors don't know much about the nature of the
adrenals and what they do," Dr. Leibowitz told me. "A naturopathic
physician may pick it up because they are well-trained in this area.
But the conventional doc will do a test and say 'adrenals look fine'
because they're only looking for specific diseases. Their tendency is
to make a diagnosis and then treat the diagnosis. Adrenal health
requires a more holistic approach that considers the interaction of
lifestyle, nutrition and other glands in the body -- in other words,
the whole system."