And then there was adrenal fatigue

I guess this could be considered part two of what I needed to get caught up on writing about health-wise here. (Part one would be about the laryngeal granuloma.)

Adrenal fatigue

Have you heard of "adrenal fatigue"? There's been a lot of talk about it more recently in alternative health circles, but it's not just one of these flaky reasons to do more yoga and eat some kale. It's a real medical condition. 

Mainstream medicine has long only recognized the most extreme forms of adrenal disfunction: Addison's disease, where the body doesn't make enough cortisol, and Cushing's syndrome, where it makes too much. In the mainstream paradigm, you are not "sick" until you have one of these diseases. In other words, you may be sick, but until you're extremely sick, they won't treat you. Luckily alternative health practitioners, as well as more progressive "mainstream" doctor's (when I say "doctor" for the purposes of this post, I mean someone with an MD), are coming to recognize and treat adrenal fatigue or "hypoadrenia" and it's very real symptoms.

People with adrenal fatigue typically don't produce sufficient cortisol, like with Addison's disease, but less severe. It's not just an "oh, you're tired?" kind of diagnosis either. Abnormal adrenal function shows up in blood tests (and saliva tests) for cortisol and DHEA, and can cause a ton of other symptoms because of how intertwined the various components of the Hypothalamus-Pituitary-Adrenal Axis (HPA Axis) are. This article does a great job covering all the basics if you want to know more. 

Here's a quick and dirty explanation of what the adrenal glands do:

This explains a lot

I know, you were probably thinking that the whole laryngeal granuloma thing was pretty heavy, on top of my usual issues. Well, as Robyn would say, "I diversified my disease portfolio" once again. But this was one of those diagnoses that's a huge relief. After years of being told there was nothing "real" causing my fatigue, and nothing to be done about it, I found out that is completely untrue.

Thanks to the miracle of integrative and functional medicine, and the awesome care I've been receiving with my new doctor, so many things are starting to make sense.

A few months ago I went through a ton of blood tests and stool tests - this is nothing new to me. But I was surprised to see I was being tested for many things that I hadn't been tested for before. Heavy metals. Vitamin levels. And hormones. Most things were actually normal (which is typical for my blood tests), which is great - it means despite feeling like crap all the time, my organs are functioning fairly normally and managing to compensate for everything that's going on. To me, this also means that I do still have the potential to be healthier than I am.

The tests that did come back far out of range, however, were hormonal tests. I knew from some test in the summer (with a practitioner I didn't end up having a good vibe with) that my cortisol levels in the morning were low, explaining why I always feel so tired and horrid for the first chunk of the day. But getting these tests redone within the mainstream system in Canada showed just how out of whack things truly are in my body.

The adrenal glands in a healthy person produce DHEA, which is a main precursor to cortisol and the sex hormones. My body produces levels of DHEA (and testosterone for that matter) that are untraceable by blood labs. This explains a lot about why I'm so brutally exhausted a lot of the time, and a lot of other symptoms I have related to the sex hormone imbalances. My adrenals do still produce low levels of cortisol, and when I'm stressed, too much adrenaline, leaving me with a "wired" then later hungover feeling. Too low of overall cortisol also contributes to too much inflammation in the body.

The kicker is that in going through my old health records with my new doctor, it turns out that my DHEA has been untraceable for at least five years. I was convinced years ago that some of my IBS symptoms were being affected by hormones, so went to a women's clinic and had them tested. My levels were way off, but apparently the doctor didn't see fit to flag that or do anything about it (and I didn't know a thing about any of this back then), and told me there was nothing wrong. Yet another piece of my medical history where a medical practitioner's (innocent) ignorance or (less innocent) lack of desire to really help me has set me back years health-wise.

I'm not just tired all the time, my body is basically running on fumes, and has been for a looooong time.

Now what?

Well, knowing what's wrong after years is a huge step, but it's also only the beginning.

The main cause of adrenal fatigue is prolonged chronic stress. (Yes, I am a classic case of not only the symptoms, but the causes.) I've been dealing with anxiety disorder, probably since I was a teenager in hindsight, though I only found out in university there was name for what was going on.

Even as a child, I believe I was often stressed or in "fight or flight" mode, due to... let's say "family issues". Whether the chicken or the egg, developing IBS at a young age certainly didn't help the anxiety, nor did the anxiety help my digestive system (chronic systemic or digestive infections of things like candida or bacteria can also severely tax the adrenal system).

Add on pushing myself through 8 years of university, while in less than stellar health, feeling misunderstood and abandoned by many of the people closest to me, suppressing my deep desire to pursue creative work, many years of 'high stress' treadmill-style work, and you've got a recipe for disaster. I am, of course, responsible for all the choices I made during those years, but until recently I can admit that I truly didn't have the wherewithal to gain some real self-awareness about my situation, and make some changes.

Though I've been on my "sabbatical" turned health pilgrimage for about 8 months now, it took me until a couple months ago to really fully acknowledge what was going on. Something in me snapped, and since then, all the pieces have been coming together... everything starting to make a lot more sense... and me starting to take charge of my well-being in a very real way.

Working with my doctor, for the first time maybe in my entire life, I've got a plan. It's complicated, and I know there will be setbacks, but I've got a plan of lifestyle changes, stress management, pharmaceutical drugs, and more "natural" supplements that given time should help bring me back into a better place.

I'm trying not to get my hopes up too much, but I have to say it's the first time I've really felt any well-founded hope that I may be able to get better and recover from this. Even small improvements will be huge victories to me, and will help me regain some of the parts of my life that I've had to put on the back-burner.

Please learn from my mistakes

For years I've had this nagging feeling that "this just can't be normal". Feeling stressed, exhausted, and overwhelmed all the time is not normal. If you are feeling burnt out, exhausted, and like you don'd know how you get through each day, don't let it go on for years like I did. The further depleted you get, the harder it becomes to get back to "normal" again. Listen to your body. Slow down. Find someone who can really help you. Your health is important enough to make it your number one priority, without it everything else starts to fade away.

Comments

I am so glad you're taking the time to figure this out, and it's inspiring to everyone, whether dealing with a chronic condition or not, to take time and take care of themselves, and to advocate for better answers from the medical establishment.

Thanks. :) Trust me I resisted it for a looooong time, even for a good while after I started taking my break. It sucks that it can take something like this to realize how truly important it is. Better late than never, as they say.

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