Adrenal Function

The adrenal glands, of which there are two, are small pyramidal-shaped structures which sit on top of the kidneys. These small glands make at least 8 hormones, including the cholesterol-derived steroid hormones progesterone, pregnenolone, estrone, testosterone, DHEA, DHEA-S, and aldosterone, as well as the catecholamine hormones epinephrine (AKA Adrenaline) and norepinephrine (AKA noradrenaline).

These small glands are involved in the regulation of blood pressure, fluid volume, reproductive hormones, hormonal control of blood sugar (the glucocorticoid known as cortisol), sleep, and basically involved in all biochemical reactions of the human body.  Thus we cannot address adrenal function alone.  Rather, we must evaluate what is commonly called the HPA axis.

The HPA axis stands for hypothalamus-pituitary-adrenal axis, but is more correctly called the hypothalamic-pituitary-thyroid-adrenal-gonadal-gut axis.  Yes, you read correctly: the gut is involved in the regulation of the entire body.

We now know that up to 70% of the immune system is present in the gut, which contains beneficial probiotic bacteriae which synthesize natural antibiotics and regulate hormonal reactions in the body, among many other things.

Adrenal gland function is found to be low in the majority of folks we see.  Low adrenal function can cause a myriad of symptoms, such as fatigue, pain, inflammation, sugar craving, low blood glucose, sleep disturbance, weight changes, allergies and chemical sensitivities, hair loss, and much more.

We start your evaluation utilizing the blood testing the levels of cortisol at 8 a.m. or 4 p.m.,  DHEA-S, sensitive estradiol, estrone, free progesterone, free testosterone, and the pituitary levels of ACTH, TSH, FSH, and LH.  If we don’t uncover the detailed information that we need in order to solve the problem, we will then proceed to salivary testing.  If adrenal function is exceptionally low, we perform the ACTH Stimulation Test to rule out Addison’s Disease.

Saliva is a traditional method used to evaluate the adrenal and gonadal axis.  Even Medicare covers salivary testing, so we can say that if Medicare covers it, it has to be considered mainstream traditional. 

Saliva contains levels of hormones which are not bound to the proteins present in blood.  Therefore, we can get accurate levels of “free” hormones in saliva, including estrone, estriol, estradiol, progesterone, testosterone, cortisols, DHEA, and DHEA-S.

Saliva testing is especially valuable in evaluating adrenal function, because the stress of the needle stick is avoided.  Cortisol levels rise in response to painful or stressful stimuli, and many times the serum (blood) levels are elevated due to the stress of venipuncture.  Saliva testing of the type we utilize costs $50.00 per item tested.

Another valuable test to investigate adrenal function is to analyze a specific portion of a person’s hair. Many physicians believe that hair testing is not accurate.  However, hair testing is utilized to screen people for drug-use, and is used extensively in Forensic Medicine.  Therefore we find it to be quite useful in many situations.  Insurances will not pay for hair testing, and it costs about $150.00.

 We know that the adrenal glands function by utilizing the heavy metal minerals sodium, potassium, calcium, magnesium, and others.  Indeed, in medical school we are taught that adrenal failure, known as Addison’s Disease, can be detected many times in bloodwork which will show low sodium (hyponatremia) and high potassium (hyperkalemia).  We rarely see adrenal failure. However, we frequently see adrenal dysfunction, and since hair contains most minerals in the body, hair analysis can be quite helpful to create a more scientific approach to nutritional therapies.

 Many times, correcting mineral imbalances such as lead/mercury/copper/arsenic/etc. toxicities, while replacing the deficient minerals, will activate the adrenal glands.  We accomplish this activation of the adrenals by utilizing nutritional supplements, diet, exercise, and sleep.

 Many people are low in the essential heavy metals known as minerals due to poor food quality (fields which are exhausted may not contain minerals which can be absorbed by the plants grown in those fields), malabsorption due to deficient stomach acid (can be caused by chronic use of antacids, H-2 blockers, proton pump inhibitors), or presence of toxic metals such as aluminum, mercury, cadmium, copper, arsenic, lead, and others.

As you can see, when we discuss the adrenal glands we have to address the hypothalamic-pituitary-thyroid-adrenal-gonadal, and gut axises.  This type of complicated analysis is just the sort of challenge that a competent Internist (Internal Medicine Specialist) enjoys.

Correcting complicated imbalances in the human body does take time.  For many folks, relief of symptoms will occur in the first 3 months, however, in many instances it may take a year or more to correct the problem.

We are up for the challenge.  Are you?