Why Semantics Matter: The Adrenal Fatigue Debate Rages On

I found this article when researching about adrenal fatigue and found it very interesting. My chiropractor has told me on numerous occasions that I exhibit adrenal fatigue symptoms, so I thought I would look into it further. I also admit that chiropractic is an alternative therapy that many do or do not believe in, but for me it works a treat! Of course there is always a debate between the medical and alternative health community. My chiropractor has over 30 years experience and is very up to date in his methods, so I thought I would find out about ‘adrenal fatigue’ if in fact I show the signs. Anyway, what do you think? Here is the article…

Why Semantics Matter: The Adrenal Fatigue Debate Rages On

By Lena D Edwards

In August 2010, the Hormone Foundation and Endocrine Society published and distributed their “Myth vs. Fact” sheet about Adrenal Fatigue where they claim:

“Adrenal fatigue is not a real medical condition. There are no scientific facts to support the theory that long-term mental, emotional, or physical stress drains the adrenal glands and causes many common symptoms. There is no test that can detect adrenal fatigue. Supplements and vitamins made to “treat” adrenal fatigue may not be safe. Taking these supplements when you don’t need them can cause your adrenal glands to stop working and may put your life in danger.”

What exactly is ‘adrenal fatigue’? According to proponents, it is a maladaptive state in which adrenal hormone production is significantly decreased in response to repeated and chronic psychological stress; the resulting state of ‘hypoadrenia’ then renders the body incapable of perpetuating an adaptive chronic fight or flight response or mounting an appropriate stress response to acute stressors. As one major advocate of the term states, “The adrenals simply cannot keep up with demands placed upon them.” So, if adrenal fatigue is not accurate or useful, what do healthcare providers, whether conventional or alternative, have to gain from applying and promoting this diagnosis? The reasons vary and include everything from misunderstanding and misinformation to personal financial gain.

As a physician who has practiced both conventional and integrative medicine for over a decade, I can tell you that the description ascribed to adrenal fatigue does not adequately describe the complexity of our stress response systems. While the adrenal glands do play a definite role in how we feel day to day (whether that’s energetic or exhausted), as we’ve now established, the term “adrenal fatigue” is, at best, a misnomer. According to the Mayo Clinic (one of several medical establishments in disagreement with this concept), the term adrenal fatigue is used by some practitioners of alternative medicine who claim adrenal fatigue to be too mild to be picked up on standard blood tests. Mayo goes on to state that proponents of this “unproven term claim it to be a mild form of adrenal insufficiency rendering a patient incapable of producing enough stress hormones to produce an adequate fight or flight response.”

Consider other opinions on this topic by some other reputable medical establishments:

“Adrenal fatigue is a worthless diagnosis… claims of marked improvement following some intervention most likely fraudulent.”

Dr. Paul Rosch, President American Institute of Stress

“Is adrenal fatigue real? Yes and no… Like many things in this arena, it’s a grain of truth surrounded by a lot of hype and peddlers of quick fixes.”

Dr. Brent Bauer, Mayo Clinic Complementary and Integrative Medicine Program

“Adrenal fatigue” is not a real medical condition. There are no scientific facts to support the theory that long-term mental, emotional, or physical stress drains the adrenal glands and causes many common symptoms… Supplements and vitamins made to “treat” adrenal fatigue may not be safe. Taking these supplements when you don’t need them can cause your adrenal glands to stop working and may put your life in danger.”

The Endocrine Society

If we look to the roots from whence this mammoth tree emerges, we would find them grounded in the desperation of millions of chronically stressed, depressed, and fatigued people for whom conventional medicine has no answer. The level of frustration is at an all time high, and patients often leave the office of their healthcare provider in despair when they are told that all of their test results are ‘in the normal range’ and that an anti-depressant prescription is in order.

There is a gaping chasm between conventional and integrative medicine on the topic of stress and stress related disease. The ‘black and white’ mentality of my conventional training reinforced the ‘what’ behind disease but rarely provided ample insight into the ‘how’ and ‘why’. Symptom ‘A’ equals drug ‘B’ and disease is not present unless a patient’s test results fall outside of the statistically derived reference ranges. My integrative medicine training allowed me to embrace all the shades of gray that exist between black and white.

My many years of research on this topic have provided clearcut evidence that low cortisol states do exist and contribute to disease formation. In fact, up to 25% of all stress related bodily disorders (PTSD, chronic fatigue syndrome, fibromyalgia, irritable bowel syndrome, etc.) are associated with low cortisol states. However, the medical terminology used to describe low cortisol has everything to do with acceptance of, proper diagnosis of, and evidence based treatment for this condition. Patients shun from uttering the words ‘adrenal fatigue’ to their doctor for fear of being chastised and shunned, and I am speaking from direct personal experience. The medically appropriate term for low cortisol states is known as hypocortisolism, and it is true that conventional medical testing often misses the diagnosis. This is where the dichotomy between conventional ‘black and white’ and more integrative ‘shades of gray’ diverge.

Convergence of these diametrically opposed medical factions is evolving and ultimately inevitable. In the interim, the millions of people suffering from symptoms of hypocortisolism will remain undiagnosed at the hands of their conventional medical doctors and therefore self treat as they continue to seek medical advice and purchase the nutritional supplements from the internet based ‘adrenal fatigue’ gurus, many of whom lack MD degrees. Buyers beware!

By incorporating aspects of her conventional medical training with her integrative and functional medicine training, Dr. Lena Edwards offers her multidimensional insights into numerous aspects of medicine with an emphasis on stress and stress related bodily disorders and diseases.

Article Source: http://EzineArticles.com/?expert=Lena_D_Edwards

I would also like to hear your comments as it certainly feels like a real condition to me and I find that natural supplements and vitamins do give me more energy. That said, I also agree with Dr. Edwards in that there are many self professed gurus giving advice on the topic and they hold no qualifications. (You can read my disclaimer and disclosure. I do not hold any qualifications, but I am interested in my health!)

I have been reading many articles, all claiming that adrenal fatigue supplements work for them. So…who is right and who is wrong? Maybe it is only a placebo effect for those who have positive results, or maybe it is a debate that will continue for more years to come.