Adrenals
The Truth About Adrenal Fatigue.
Adrenal Function
The adrenal glands are 2 of the most powerful glands in the body. The adrenals produce a variety of hormones such as cortisol, DHEA and adrenaline. The adrenals modulate the body’s stress response, and are involved in numerous other biological functions including: digestive functions, inflammatory and anti-inflammatory responses, and the adrenal hormones interact with a simplex of other hormones.
The most accurate way to assess adrenal function is through a saliva cortisol and DHEA biopsy. There are other ways however to assess adrenal function, including through blood tests and through Hair Tissue Mineral Analysis. These methods won’t give you exact cortisol and DHEA values (blood tests can measure the adrenal hormones but saliva hormones are considered far greater due to the fact that saliva hormones are ‘free-fractioned’) but nonetheless they can give you insight into the 2 basic phases of adrenal imbalance: adrenal hyperfunction and adrenal hypofunction.
Adrenal Hyperfunction
Adrenal hyperfunction indicates an excess of cortisol and adrenal activity. Adrenal hyperfunction is indicative of a loss of certain mineralcorticoid hormones, and consequently a loss in potassium through the urine. Adrenal hyperfunction can be a primary cause of hypertension (which quite often involves a loss of potassium and an increase in sodium in the blood and cells) as well as anxiety, irritability and headaches.
On a blood test, when potassium levels are decreased (about 4.0 or lower) and sodium is increased (greater than 4.2) and chloride levels are higher than 105, it is a sign of adrenal hyperfunction.
Because there is a loss of potassium from inside the cell, in the blood and in the urine, there is the tendency for metabolic acidosis. Hypertension, metabolic acidosis, adrenal hyperfunction and anxiety are very often seen together because of the chronic loss/deficiency of potassium intracellularly.
Adrenal Hypofunction 
Adrenal hypofunction indicates an insufficient amount of cortisol and adrenal activity, exactly the opposite of adrenal hyperfunction. in adrenal hypofunction there is an excess in the amount of mineralcorticoids in the blood. This causes an increase in the amount of potassium in the cells and blood, and a decrease in the amount of sodium in the blood. Adrenal hypofunction, sometimes referred to as adrenal burnout, can result in chronic fatigue, exhaustion after exercise, abnormal fluid dynamics, low blood pressure and hypothyroid function.
On a blood test, adrenal hypofunction is indicated by the following: potassium levels greater than 4.5, sodium less than 136 and chloride values 101 or less.
Because there is excess potassium and decreased sodium, this is a major marker for metabolic alkalosis. It is wrong to assume that only acidosis is pathological. Alkalosis is just as common as acidosis, if not more so.
Low blood pressure, low blood volume, metabolic alkalosis, hypothyroid function and adrenal hypofunction are very commonly seen in the same clinical picture.
What Can Go Wrong
High cortisol can be a real problem, especially with regard to getting results in the gym. A summary of the negative impacts of elevated cortisol includes:
1. Suppression of TSH, decreased conversion of T4 to T3, increased production reverse T3 (rT3) and decreased cellular thyroid receptor binding. (In other words, you get fat, among other things.)
2. Increased blood glucose levels.
3. Suppressed pituitary function, leading to low luteinizing hormone and low Testosterone.
4. Decreased liver detoxification.
5. Suppressed secratory IgA, increasing potential of gut inflammation, infection and permeability.
6. Decreased immune system function, leading to increased risk of infection.
7. Insomnia.
8. Neurodegenerative disorders, including degradation of the blood-brain barrier and destruction of the hippocampus.
Low cortisol also has negative health impacts including:
1. Suppression of the immune system.
2. Hypoglycemic tendencies, leading to increase in catecholamine release, fluctuations in blood sugar and insulin spikes.
3. Increased inflammation.
Something not often talked about with cortisol is an abnormal circadian rhythm. This often indicates a hippocampus issue due to its regulation of the circadian rhythm. Cortisol should be highest in the morning and lowest at night. However, an inverted rhythm can result in:
1. Learning and memory issues. (Neuroendocrinologists are using cortisol circadian rhythm as an early biomarker for Alzheimer's.)
2. Insomnia and sleep difficulties.