Adrenal Fatigue

Is there a link between sleep apnea and adrenal fatigue? I was just researching hypochlorhydria (which I think is the real cause of my GERD) and I came upon adrenal fatigue. The symptoms match pretty well, especially the part about feeling better after 6pm.

Can sleep apnea itself bring about adrenal fatigue? I've also been taking a corticosteroid for my sinusitis which can also cause adrenal fatigue.

The adrenal glands produce the body's natural supply of steroids. Normal adrenal glands will increase or decrease production to maintain a healthy circulating steroid level.

Exogenous steroid medication (ie prednisone) increases the body's level of circulating steroids. This high level activates a feedback system to slow or stop adrenal gland steroid production. (Basically the body is telling itself there's too much steroid in circulation and it needs to make less)

If the adrenal glands slow or stop production, they atrophy and lose their ability to produce steroid. This becomes a problem if the exogenous steroid medication is suddenly stopped. Failure to taper down exogenous steroids creates a sudden increase in demand for adrenal-produced steroid. The adrenal glands CANNOT suddenly start up production. This leads to falling circulating steroid levels which can become a medical emergency.

Steroid medication MUST be weaned slowly to allow the adrenal glands to build up production on their own.

Suneilp asks...Is there a link between sleep apnea and adrenal fatigue?

And it makes sense that there would be, but a hasty search turned up little. (In fact, if you google the question, you get this thread.)

I suspect that the nightly battering of the adrenals with continuous fight or flight arousals would take it's toll. (This might provide an explanation of some of the gale-force nightmares we experienced pre diagnosis, as well.)

Poster Schnertling offers some excellent advice re steroid med considerations btw.

.

suneilp wrote:Can sleep apnea itself bring about adrenal fatigue?

Both Captain Midnight and Schnertling offer good answers. I'll try another one.

First question is whether or not adrenal fatigue is a real condition or is just being used to sell books and supplements: http://www.mayoclinic.com/health/adrena ... ue/AN01583

Having gone through many years of alternative medicine before finding what appears to be the underlying cause of UARS and OSA, I think it has a place as an adjunct for some things...but grand unified theories like this tend to be another story.

That said, one of the things that has really disappointed me is how relatively little work there's been done on sleep disorders and hormones, since there's a ton of evidence that it can plays utter havoc with them. Legitimate, peer reviewed studies in reputable journals show some great correlations between OSA and large increases in cortisol, leptin levels and resistance and fat distribution, show how progesterone/estrogen do have a preventive effect in women, that release of growth hormone is directly related to deep sleep (which is why all the steroidal baseball players took GHB, much safer and less detectable then injecting yourself), that endogenous testosterone levels go way down with OSA, that administration of exogenous testosterone can massively exacerbate your AHI (probably because you screw up hormonal production and balance even further), and that there's chronic inflammation in a variety of ways when your brain and body are forced to do battle each night. All those can be aided significantly by dealing with the underlying sleep disorder.

But considering the size of the problem, there's very little research being done. Worse yet, almost nobody specializes in it; I'm still trying to find an endocrinologist who even knows about sleep medicine, let alone passing their sleep boards. That's almost frightening, considering how often testosterone replacement therapy is now prescribed without checking for an underlying sleep condition. You'll feel great...on your way to an early death.

So to answer your question in another way, yes, you could have "adrenal fatigue." But it's better to put it this way - you probably have a bunch of stuff going on with hormones thanks to your SBD. Get that under control first, and then 6 months seems to be the time frame in which the studies show there can be a range of improvements.

By the way, if you've not read Dr. Park's book, Sleep Interrupted, it's worth it for your question on GERD. He answers it in a way that is beyond my ability.

I'm resurrecting this thread because I've been on bipap for 2.5 years and a
only getting worse and worse. I have been diagnosed by an alternative m.d. with adrenal fatigue, but my research shows I actually have symptoms of Addisons including high white count and hyper pigmentation in my armpits and knees. I called my regular internist to have testing done. The vitamins and herbs the alt doc recommended have actually helped some, but I am still fairly sick most of the time. Anyone have any thoughts on this?

Yes - if you even think you have Addison's, please don't mess around here and there with alternative meds, see an endocrinologist asap so you don't end up with damage (or further damage) to your body. You need to be properly tested and diagnosed, then evaluated for what treatment would be best in your case. You're cheating yourself of good health by what it sounds like you're doing now and Addison's is not something to fool around with.

Hi Socknitster. Good to hear from you, but just not under these circumstances. I'll be watching this thread because it is of interest to me. When I was 48 some tests showed my adrenal function to be at the expected level of a 52 year old. I shudder to think of what it might be now. I have been considering seeing an endocrinologist to see if there's more going on with me (not just adrenal) that keeps me feeling so bad. Let us know what your tests reveal. Just from past interactions, it seems once you are onto something you become informed and proactive, so I'm guessing you are pushing for definitive answers without delay. Keep us informed.
Kathy

Well, you know, I have been proactive from the beginning. I keep pushing and pushing my regular doc to figure out what the hell is wrong with me and he can't seem to find anything. I saw an endocrinologist last April and she couldn't find anything. My list of symptoms is long, vague and sometimes bordering on bizarre. I am beginning to feel like my doc might think I am a hypochondriac, though I KNOW I am not. There is something wrong with me. I'm sure of it.

But no one seems to find anything until this new alternative medicine doc who IS a medical doctor who practices alt med to compliment traditional meds. When he said adrenal fatigue, I started researching it, and realized that I have every symptom of this fringe diagnosis and my symptoms go even further, to some of the symptoms of Addisons. As soon as I realized this, I called my internist and made an appt. I go for a metabolic panel and salivary cortisol tomorrow morning. And I guess I'll make another appointment with a diff endocrinologist (there are only two in town, hope this one is better.)

I've been sick for a several years. I had some releif when I started cpap in June 2007, but then I got pregnant that fall. Since the baby's birth I have been progressively getting sicker and sicker and he is 19 months old now. It really got bad after I got the flu in October of last year. I have been severely debilitated since then.

Here is my list of symptoms. Maybe someone will be able to tell me what the hell is wrong with me.

(I'm 37 years old, female)
OSA
Waking up is extremely difficult--feel drugged or drunk with sleep in the am. Takes a half hour to become alert
Multiple food allergies since 1998
Depression/Low Energy/Lethargy/Fatigue
Muscle Weakness
Joint Pain/Muscle Stiffness after rest
Extreme Irritibility--not unlike 24/7 PMS
Menstrual Irregularity/Fertility Problems/multiple miscarriages
acid reflux
slow gradual weight gain
hirsutism
acne
sweating with the slightest activity, rarely cold, always warmer than everyone else
dizziness if standing too fast or take stairs too fast
increased white cell count (leukemia has been eliminated)
purple pigment comes and goes on knees and armpits
I sometimes look like I have a tan, even though I don't tan
salt cravings
sugar cravings
excessive thirst
hair is coarse and extremely dry
eczema and seborrheic dermatitis are flaring up/dry skin in general
zero sex drive
swollen tongue
night sweats
April blood tests showed my SHBG is low as is my testosterone
cholesterol is high: 192 (LDL=140, HDL=40, triglycerides=62)
insulin was 8.4 which is borderline high
all other blood results (many, many tests) were in normal range at that time

edited to add: (I feel the worste between 3 and 5 pm and feel better after 6 pm, have difficulty winding down and mentally resist going to bed every night.
exaggerated startle reflex
when I go too long between meals I feel like I could kill someone if I don't get somethign to eat
sudden rage or angry outbursts are sadly a daily event for me (and if you know me, you know that is NOT my regular MO)
foggy thinking/mentally sluggish
emotionally oversensitive--I feel slighted all the time)


My thyroid has been tested about 4 times in the last 6 months, including for Hashimotos and always comes back normal

I think I have PCOS and either adrenal fatigue or Addison's. It makes sense that the adrenals would be tired, considering my history of severe osa--being hypoxic all night every night up until June 2007 can't have been good for me. Pregnancy followed by nursing and then the flu may have been too much for me in my weakened state. I don't regret having the child--he is the joy of my life along with my older son. But now, I just want to get better so I can enjoy being a mom and not feel like I'm dragging myself through every single day.

I know adrenal fatigue is a fringe diagnosis. But it wasn't that long ago that PCOS was too, as well as Guillone-Barre, Chronic Fatigue, even Fibromyalgia. I predict, from what I have read, that adrenal fatigue will mainstream in the next 10 to 15 years. I just don't want to suffer until then. I would never consider suicide as an option, but I do UNDERSTAND people who do. I feel that bad. I desperately want to get better. I am marshalling all my energy that I can spare into figuring this out.

Adreanal fatige is a mild form of adreanal insufficientcy so the only link i see is that since apnea lowers O2 sat the immune system can do some crazy stuff so adreanal insuficentcy could be some how linked

Good for you! It would sound ghoulish to say I can't wait to hear the answer, but I do hope you'll let us in on it when you get it, if only because it's such a puzzle, but of course because it would be great if you could feel better soon! I am a bit curious as to who told you Guillain-Barre was 'fringe' though. It's not as if doctors could very well ignore it when people specifically develop paralysis (from the bottom up) throughout their bodies following infection.

As you said...you had your thyroid tested 4 times. I had most of your symptoms and spent 2 years being tested with no answers. First problem, obviously since I'm on this forum, is OSA. That seems to be responsible for most issues. Second problem (likely seperate?) was thyroid cancer. All thyroid tests come back normal until a nodule was large enough to be felt. Have your endo check this out fully.

Julie wrote:Good for you! It would sound ghoulish to say I can't wait to hear the answer, but I do hope you'll let us in on it when you get it, if only because it's such a puzzle, but of course because it would be great if you could feel better soon! I am a bit curious as to who told you Guillain-Barre was 'fringe' though. It's not as if doctors could very well ignore it when people specifically develop paralysis (from the bottom up) throughout their bodies following infection.

Julie,

I only referred to this because when my Grandfather developed this in the early 80's no one knew what was wrong with him and he was told it was because he had polio as a child. It wasn't until much later that we realized what it had been. It was a scary time in his life (and for all of us who loved him!)

I understand and don't think its ghoulish. I can't wait to hear the answer, but am getting discouraged that I will find one and that takes a lot since I'm an eternal optimist! Short of being handed a death sentence, I would be glad to get a diagnosis, because then I can get on with it and get better!

Hattrick,

Excellent point. No one has so much as layed a hand on me or my throat. Everyone wants to take my blood but no one wants to do any scans or even touch me. Really, I don't have cooties!

I suspect some of it has to do with me being a nursing mother up until about a month ago when I finally told my son I had to cut him off because I just couldn't do it anymore (had I been in good health I would have nursed him as long as he wanted, but it was adding to the depletion I felt and I finally had to let myself come first for a change.) I've had doctors tell me that they couldn't do this or that test because I was nursing and that it would somehow skew the results. I don't know. It just seems like people are afraid of lactation and I always had to be up front about it in case they wanted to prescribe anything. I said all along that I would wean him if I needed some kind of hard core treatment.

I already had a follow up appt with my internist on Friday related to my antidepressant and have a sitter lined up so I can really focus. I'm going to demand a full exam, maybe some kind of scan of my throat and abdomen (adrenals are above the kidneys) and there will be the blood tests tomorrow morning. What kind of scan should I ask for Hattrick? Ultrasound, MRI? I'll go do some googling and see what I find.

My heart goes out to you, socknitster. I hope you and your doctors discover what's wrong and you're feeling better very soon.

~ DreamOn

socknitster wrote:...OSA
Waking up is extremely difficult--feel drugged or drunk with sleep in the am. Takes a half hour to become alert
Multiple food allergies since 1998
Depression/Low Energy/Lethargy/Fatigue
Muscle Weakness
Joint Pain/Muscle Stiffness after rest
Extreme Irritibility--not unlike 24/7 PMS
Menstrual Irregularity/Fertility Problems/multiple miscarriages
acid reflux
slow gradual weight gain
hirsutism
acne
sweating with the slightest activity, rarely cold, always warmer than everyone else
dizziness if standing too fast or take stairs too fast
increased white cell count (leukemia has been eliminated)
purple pigment comes and goes on knees and armpits
I sometimes look like I have a tan, even though I don't tan
salt cravings
sugar cravings
excessive thirst
hair is coarse and extremely dry
eczema and seborrheic dermatitis are flaring up/dry skin in general
zero sex drive
swollen tongue
night sweats
April blood tests showed my SHBG is low as is my testosterone
cholesterol is high: 192 (LDL=140, HDL=40, triglycerides=62)
insulin was 8.4 which is borderline high

OK, here's my 2 cents for what that's worth in today's economy . Low progesterone + high estrogens. Get salivary cortisol checked 4 intervals not just AM & midnight & might consider the 24 hr urine catch for same, very low omega 3s compared to omega 6s, sounds like thryoid system is not working right I'd check for reverse T3 to verify not excessively high...it's a biological blank & if it gets to thyroid receptors before the real thing then you have no working thyroid regardless of your circulating thyroid levels & increasing T3 (Cytomel) helps with this situation as does drastically reducing stress as high cortisol increases reverse T3 and oh coconut oil helps conversion of T4 (storage form) to T3 (active form); as TSH rises so does LDL (LDL might rise on a low carb diet but it's because the particle size has become very large & fluffy, the safe form...a VAT Cholesterol Profile will give a detailed pic of your cholsterol patterns; the old (pre blood tests for low thyroid used muscle response times, seems to be very effective today if you can find a doc trained in those methods. My tongue is smaller since I started CPAP in '07...could your CPAP therarpy need adjustment? CHECK VITAMIN D LEVELS -- thuis neurohormone is intimately involved with the immune system and it sounds like your hormones are out of alignment; increasing D helps raise HDL. Might be useless info you've already knocked off the list; if not, things to consider. GOOD LUCK!

.