COLUMNIST NUTRABITES Adrenal fatigue A Easy and practical in-office assessment by victoria coleMan Some of the symptoms associated with low output include: fatigue not relieved by a few good night’s sleep; poor circulation; low blood sugar level (hypoglycemia); low blood pressure; aller-gies; apathy or depression; joint aches and pains, specifically in the lower back and knee; low gastric hydrochloric acid produc-tion; constipation; muscle weakness; need for excessive amounts of sleep; lowered resistance to infection; subnormal body tem-perature; sugar and salt cravings; dependency on caffeine or other stimulants to get through the day. The symptoms may seem vague and somewhat common to many conditions, and this is where some simple in-office tests may prove helpful in assessing if the adrenals maybe involved. drenal fatigue, adrenal burnout, hypoadrenia, adrenal exhaustion, adrenal insufficiency – whatever you want to call it – refers to lowered adrenal function or output. However, it is prudent to address the terminology correctly when referring or discussing cases with other allied care professionals. Adrenal insufficiency, the term used by the allopathic com-munity, indicates a dysfunction of the adrenal glands most commonly referred to as Addison’s disease. It would be wise to reserve the use of this terminology for that clear diagnosis when discussing with the medical community, who, at this point, has not yet embraced the idea of adrenal fatigue as even existing. This will likely change with time – no different than restless leg syndrome or fibromyalgia that were once consid-ered nonexistent conditions until the drug companies created pharmaceutical treatments for them. Adrenal glands produce key hormones that prepare our body for stress. They are innervated by the sympathetic branch of the autonomic nervous system. Epinephrine, noep-inephrine, cortisol, cortisone, aldosterone, DHEA and other sex hormones including estrogen, progesterone, testosterone and pregnenalone are all secreted by the adrenal glands. When the body senses a threat and moves into a flight or fight response, both adrenalin and cortisol will elevate blood pressure and increase the release of glucose in the blood, preparing the body for survival. Blood pressure test (Ragland Test) Prolonged stress This is a situation that we are all aware of, or, at least, should be, considering that it affects the majority of the population. Just look at the increase in work hours, pills for insomnia, coffee shops on every corner serving extra large cups of coffee, and technology keeping us dialled in 24/7. Prolonged stress is now the norm versus the exception. In the early phases, the body responds appropriately with elevated stress hormones. High cortisol output affects blood vessel constriction, elevates heart rate, increases blood sugar, raises blood pressure, reduces gastric motility and digestive juice production, and creates a natural high, the opposite of depression. After a prolonged period of time the adrenals cannot keep up and low cortisol and glucocorticoid output is the result. dr. viCToriA CoLemAn is a 1994 graduate of CMCC and has a BSc in Kinesiology specializing in fitness assessment and exercise counselling. She is also the president of Douglas Laboratories/Pure Encapsulations Canada. You can contact her at [email protected]. 32 Canadian Chiropractor September 2013 Be sure the patient is well hydrated. Take BP while patient is lying down; ensure they have been at rest in supine posi-tion for 10 minutes. Have patient stand and take their blood pressure. A normal response will see a rise in BP of 10-20 mm Hg in both systolic and diastolic BP. If the BP drops, it could indicate adrenal fatigue; the amount of drop may represent the severity of fatigue. The simple act of standing up is a physical stressor to our body as we must ensure oxygen delivery to the brain. This stimulates the hypothalamic-pituitary-adrenal axis to respond, and all the glucocorticoids should be released. Epinephrine and norepinephrine vasoconstrict and cortisol vasodilates, two out of three win and the vessels constrict to ensure the push of blood to the brain so one does not pass out. With adrenal fatigue, the release of epineprhine and norepinephrine is too low and vasoconstriction does not predominate. Pupillary constriction test Have patient in a dark room and shine a pen light into the eye. Watch for expected normal pupillary constriction that is maintained. In adrenal fatigue, the pupil will constrict but then cannot maintain the constriction, and the pupil will dilate within two minutes and maintain that for 30 seconds before constricting again. Timing the length of the dilation should be noted and this test can be used to test recovery. Sergent’s White Line This may be present in only 40 per cent of those with adrenal fatigue, but is almost always indicative of adrenal fatigue when present. Run a pen cap or tines of a fork along the belly or forearm. This should result in a red mark within 10 seconds. An abnormal reaction occurs when the marks remain white for up to two minutes and may widen. These tests are rudimentary and serve to be easy, in-office www.canadianchiropractor.ca
Chiropractic + Naturopathic Doctor September 2013: Page 32
