In the fourth installment of “Everything you need to know about Adrenal Fatigue“, I am going to what discuss the topic of how adrenal stress affects other systems of the body.

In our last edition of my adrenal fatigue series, we focused on the roll that cortisol plays with blood sugar regulation. In case you missed it here is the link.

Adrenal Fatigue: Part 3

Before I talk about the impact of adrenal fatigue on the other systems, let’s recap some of the symptoms of adrenal stress and adrenal fatigue:

• Difficulty falling asleep
• Difficulty staying asleep
• Lethargic/difficulty getting going in the morning
• Tired/fatigue/no energy
• Headaches with the onset of mental or emotional stress
• Getting sick more often/weak immune system
• Afternoon headaches
• Poor appetite
• Irritability before meals
• If meals are delayed or missed, lightheadedness or becoming shaky develops
• Craving for caffeine, cigarettes or sweats
• Eating to relieve fatigue
• Low blood pressure
• Dizziness when moving from sitting or lying to standing
• Transient spells of dizziness
• Unstable behavior
• Reduced libido
• memory/cognition/mental fogginess
• Abdominal pain
• Gastric Ulcers
• feeling full and bloated

The symptoms of adrenal fatigue extend across a wide spectrum.

That’s because the adrenals function very much like the battery of your car.

Like the purpose of any battery, your car’s battery function is to store power to be used for later. The car battery’s biggest purpose is to have enough energy to start the car. With newer cars, the battery runs the computers which are responsible for co-ordinating  all the components of the car.

The adrenals function very similarly. Getting started, having energy to go down the “road of life” and co-ordinating energy/power demands for now or later use, is the function of the adrenal glands.

As mentioned previously, the body’s internal time clock (circadian rhythm) is co-ordinated with cortisol and the adrenal glands. So if this battery/energy source is devoid of “juice”, the clock will start to run slow.

Adrenal Imbalances Which Lead to Adrenal Fatigue:

According to Dr. Sears, the “Standard American Diet” or the “SAD”  diet is as follows:

• High in animal fats
• High in unhealthy fats: saturated, hydrogenated
• Low in fiber
• High in processed foods
• Low in complex carbohydrates
• Low in plant-based foods

Add to that list:

• synthetic sweeteners (the next time I go into a starbucks and I hear someone order a triple-venti-non-fat-4 splenda-carmel-macchiato I’m going to scream),
• artificial flavors
• synthetic additives
• Caffeine
• Alcohol
• and all the B.S so called “energy potions”

The Result? Tremendous stress on the body.

As you know by now, couple 60-80 work weeks, deadlines, multi-tasking, and not enough hours in the day to accomplish all your tasks, and it sets the body up for adrenal fatigue.

Hence, adrenal imbalances are estimated to affect 27 Million people.1

Adrenal Fatigue Affects Other Systems of the Body

Adrenals and Blood Sugars:

As talked about earlier, adrenals help regulate blood sugar, so if the blood sugars are not regulated properly, adrenal fatigue is the ultimate destination.

Adrenal Fatigue and Food Intolerances:

By now you’ve seen the vast array of “Gluten-Free” products. I used to think that the “gluten free” movement was a load of crap (excuse the pun).

However, that is not the case. Continual dietary intake of gluten containing foods (wheat, rye, oats, spelt, barley) challenges the immune system.

That means that a person with a sensitivity to gluten (and diary, such as “lactose intolerance”) can eat those food daily without an immediate “allergic” reaction.

However, the immune system is being “fired up” with each exposure to these foods. The firing up entails your white blood sells to attack any foreign invader (in this case, the gluten peptide that passes into the blood stream without properly being broken down, causes the body to create antibodies, that begin to attack our own tissues).

That is yet another “chronic stressor” which in turn, signals the hypothalamus, which signals the pituitary, which then signals the adrenal glands to release cortisol to properly handle the stressor.

Adrenal fatigue and Gastro-Intestinal Inflammation:

The GI system is under constant daily stress from:

• bacteria infection,
• viral infections
• anti-biotic use
• NSAID use
• over-the-counter use
• prescription med use
• fungal infection
• yeast overgrowth
• parasite infections
• food intolerance
• etc

These stressors collectively signal an alarm to the HPA axis, which in turn cause cortisol to be released. Once again, continued, chronic stress leads to adrenal fatigue.

Adrenal Fatigue and Environment Toxins:

Environmental toxins are around daily. From heavy metal toxicity, such as the amalgam that is used to fill dental cavities. Mold exposure from water damage in a house. Synthetic chemicals be an environmental toxins.

All create a stressor to the body, that will cause a release of cortisol from the adrenal glands.

Adrenal Fatigue and Sex Hormone Production:

Cholesterol (whether you knew it or not) is vital for our body to produce our sex hormones (progesterone, estrogen, dhea, testosterone).

When cortisol demand is high, cholesterol is used to produce cortisol, at the expense of the previously mentioned sex hormones.

As a result, catabolism, breaking down muscle tissue, low sex drive, fatigue, lethargy, and many of the aforementioned symptoms of adrenal fatigue result.

Adrenal Fatigue and Thyroid Function:

We talked about at length the hypothalamus-pituitary-adrenal axis. Well the hypothalamus and pituitary also keeps track of the thyroid function.

When the hypothalamus and pituitary weaken because of chronic adrenal stress, they are not able to communicate with the thyroid gland as well. Because the thyroid gland functions as the bodies “spark plugs”, energy production, fatigue, heat and temperature regulation, and metabolism is affected in turn.

So as you can see, the adrenal glands are essential for a wide variety of bodily functions.

When we are under constant daily stressors, the adrenal glands can no longer keep up with the supply.

In our last part of “Everything you need to know about adrenal fatigue”, I will breakdown the tests that are used to determine adrenal fatigue.

Once I do this, I will start a new series entitled “Adrenal burnout recovery”.

1. Facts About Thryroid Disease, 2005. America Academy of Clinical Endocrinologists

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In our third installment of “Everything you need to know about adrenal fatigue” we begin to “breakdown” the relationship of cortisol and blood sugars.

Blood Sugars, Cortisol, and Adrenal Fatigue:

When we talk about blood sugars, the typical hormone people think of is insulin. Hopefully by now, most people in North America have an idea of the epidemic diabetes has here.

However, for some reason cortisol is the red-headed step child.

That’s because, it’s BOTH cortisol and insulin that work together to help control and regulate blood sugar levels, not just insulin.

If insulin is to diabetes as cortisol is to adrenal fatigue,  then adrenal fatigue is the next catastrophic health condition that many people need education about.

For diabetes, the rates here in America are an absolute travesty.

Conducted by American Diabetic Association, from the 2011 national diabetes fact sheet, and released Jan. 26, 2011, the following is the total prevalence of diabetes here in America:

25.8 million children and adults in the United States (8.3% of the population have diabetes).

Diagnosed: 18.8 million people

Undiagnosed: 7.0 million people

_____________________________

Equaling a whopping 25.5 million people.

If you add unto that, another 79 million people that are considered “pre-diabtetic. The final figure you get is a staggering:

104.5 million people that are pre-diabetic or diabetic!

Totaling about 33.6% of the American population.

One in three!!!

Meaning one in three have a problem here in the United States, with too much sugar in the blood stream.

Causing a whole source of physiological problems, all of which affect your health detrimentally, plummeting the quality of life, and absolutely decreasing the QUANTITY of your life.

Which actually makes me irate.

Irate because we have every pharmaceutical under the sun, yet, we CANNOT get our life together, make sensible, long-term, healthy life style changes.

But I digress.

So, as I mentioned earlier, blood sugar regulation is controlled BOTH by insulin and cortisol.

If I one in three have a problem with elevated blood sugars wrecking havoc in the body, then how many people do you think suffer from an adrenal fatigue problem?

The answer: A LOT.

But there’s hope.

Hope, because you are reading this. Hope because you’re a health conscious individual who wants to increase the quality and quantity of your own life.

So back to 1 in 3 people having “pre-diabetes or diabetes”.

The Relationship of Diabetes to Adrenal Fatigue:

Diabetes is classified into two types: 1) insulin dependent diabetes, and 2) non-insulin dependent diabetes. Type 1 and type 2 respectively.

Insulin dependent diabetes is when the individual has an auto-immune condition that results in the destruction of the insulin-producing beta cells of the pancreas. These people can’t produce any or enough insulin.

In the case of type 2 diabetes, it is closely associated with obesity. With this type, it has traditional been known as “adult onset” because it takes time to develop.

On a side note, adolescence are now developing this type of disease due to improper blood sugar regulations.

With time, the cells become  ”insulin resistant” because circulating blood sugars are always high.

Chronically high blood sugar levels result in chronically high insulin production. The pancreas produces even greater levels of insulin to try and get sugar into the cells and out of the bloodstream.

That’s like screaming louder at a hearing impaired person.

(Hypoglycemia may also result in insulin resistance but more on that in another post)

With Insulin resistance the cells no longer “listen” to the messages signaled by insulin to take sugars out of the blood stream. Hence, they become “resistant” to insulin.

When sugar is not getting into our cells, energy production is null and void.

Caput.

Eventually, the pancreas fails to keep up with the body’s need for insulin, causing excess glucose build up in the blood stream, and setting the state for diabetes.

So what do you think happens to all that circulating sugar?

Lipogenesis that’s what.

Lipogenesis is the act of converting those circulating blood sugars into triglycerides and its components.

WARNING: if you’re one of those that hit the wall or crash hard after a meal, then you most likely have high circulating blood sugars as well and this process is going on in your body too.

That’s because this process of converting blood sugars to triglycerides, itself requires energy, and a lot of it. That’s why you crash (and burn) soon after a meal.

Cortisol has a very similar story when chronically being stimulated.

Only this time, chronically high levels of cortisol is due to chronic stress.  Over time, the HPA axis begins to dysfunction, and when cortisol supply cannot keep up to demand, adrenal fatigue develops.

In case you missed my post on the the HPA axis, here it is

Cortisol’s best known effect is the ability to stimulate gluconeogenesis by the liver.

That is, whereas insulin’s job is to help empty the blood stream of sugars, cortisol is responsible for getting glucose into the blood stream.

The adrenal glands and cortisol work alongside the pancreas, insulin, and the liver to help maintain blood sugars.

I found a great picture from http://www.myhousecallmd.com/archives/tag/blood-sugar that illustrates really well, the physiology of blood sugars.

If you look on the left side of this diagram, inside the liver, circulating blood sugars (glucose) can convert to stored sugars (glycogen), and vice versa.

In stressful times, cortisol is released, glycogen is converted to glucose and emptied into the blood stream. This is illustrated where the blue arrow points to “raises blood sugars”. This process is  called “gluconeogenesis”.

In fact, cortisol can increase the rate of glucose production by as much as 6 to 10 times.  This well also cause the liver to store more glycogen providing necessary glucose in times of need (between meals and during sleep).

If you follow the yellow arrow at the top, high blood sugars causes the release of insulin from the pancreas, in order to a) lower blood sugars, and b) help the tissues in the body to uptake sugars (kinda the same thing).

Thus both insulin and cortisol help keep blood glucose steady.

In optimal health, this process “should” run smoothly, and be a self regulating process.

However, with one in three having abnormally high sugar levels, the process of blood sugar regulation is not always smooth sailings.

When Cortisol Demand Exceeds Cortisol Supply= Adrenal Fatigue!

So, how does insulin resistance affect cortisol production and adrenal fatigue?

Well, when a stressful event occurs, as I mentioned previously, the hypothalamus tells the pituitary, which tells the adrenal glands to release cortisol.

Cortisol stimulates an increase in gluconeogenesis. If you combine this with a subsequent decrease in glucose utilization by the cells (insulin resistance), both cause blood glucose to rise.

Next, a vicious cycle is formed because the mere stress of not being able to get glucose into the bodies tissue for energy, causes another signal from the hypothalamus to the pituitary to the adrenals, to release additional cortisol.

That’s because the cells of the body are not getting the fuel it needs to function.

As this scenario continues, insulin production and cortisol production are no longer able to keep up with the demand for each.

In my next installment of everything you need to know about adrenal fatigue, I will discuss the hormone testing that can measure both cortisol levels,  as well as insulin testing.

I will also discuss the relationship of those hormone to the steroid hormone pathway. That is, when cortisol production is in overdrive, how that affect the sex hormone, and what effect that has on overall health and wellness.

You will some become an expert of adrenal fatigue.

More importantly, I will teach you what you can do to combat adrenal fatigue, and replenish your supply…Naturally.

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In part one of “Everything you need to know about Adrenal Fatigue“, I tried to explain what exactly is adrenal fatigue, how adrenal fatigue occurs, and how stress effects the adrenal glands.

In case you missed that post, here it is again:

Everything you need to know about adrenal fatigue

I also talked a bit about the hypothalamus-pituitary-axis (HPA), and how when this axis is working properly, we are able to deal with stress appropriately.

Conversely, when this axis is not working properly, adrenal fatigue will ensue.

So the question becomes: What happens to cause the HPA axis to not work properly?

Elevated Cortisol Levels and Adrenal Fatigue:

When I hear the term adrenal fatigue, I think about terms like “tired”, “energy-drained,” burned-out”, or “exhausted”.

With terms like this, how is it possible that cortisol (the stress coping hormone, released by the adrenal glands) can be elevated, and not reduced? Isn’t it supposed to be “fatigued”?

Great questions, let me explain.

The hormone cortisol, secreted by the adrenal cortex, is released when the hypothalamus signals the pituitary gland, which then signals the adrenal cortex to secret cortisol. That in effect is the HPA axis at work.

Increased stress = Increased Cortisol (to a point).

That is, the more stress we undergo, the more the brain is called on to deal with the short and long term requirements of stress.

• Emotions: Anger, worry, fear, depression, guilt
• Too much exercise (with not ample recovery time)
• sleep deprivation
• poor digestion
• use of corticosteriods (ie. NSAIDS)
• surgery/trauma
• chronic illness
• death of a friend or family member
• divorce/marital woes/dysfunctional relationships
• inflammation
• infection/injury
• chronic pain
• hypoglycemia
• food sensitivities
• nutritional deficiencies
• insufficient sleep
• malabsorption
• temperature extremes
• toxic work environment
• financial woes
• and the list goes on and on

All are examples of stressors that lead to stimulation of the HPA, and cortisol being released.

But, when that happens repeatedly, cortisol levels will always be somewhat elevated, so long as the adrenal glands can continue producing the hormone, and keep up with the daily demands of stress, that is.

However, they can’t keep up forever (as I will explain later).

Not only that, even when cortisol can still keep up with production demands, the signaling of the HPA axis become faulty. That’s because the HPA axis becomes confused as it receives mixed messages.

On the one hand, the HPA axis is stimulated to cause cortisol release by yet another stressor, and on the other hand, because “baseline” cortisol levels are elevated, the feedback loop begins to  fail.

What’s the HPA axis to do?

Signs that you may be experiencing adrenal fatigue:

• weakness
• headaches
• sweet/salt cravings
• insomnia
• unexplained hair loss
• low blood pressure
• nervousness/anxiety/depression/irritability
• lowered resistance to infection, always seem to be sick
• difficulty gaining weight
• dizziness upon standing
• weak muscle tone
• heart palpitations
• hypoglycemia
• overall feeling of ill-health
• inability to concentrate
• osteoporosis
• excessive hunger
• tendency towards inflammation
• digestive dysfunction
• poor memory/brain fog, confusion/walk into a room and forget what you doing?
• feelings of frustrations
• lowered body temperature, or the sensation of always being cold
• complete loss of energy, get up and go, pep in your step

All are not diagnostic for adrenal fatigue, but rather, are consequences of feeling  ”stressed out”.

If you so happen to have any one (or more of the above), and have been experiencing the stressors for any length of time, chances are you are moving into an adrenal fatigue status.

Cortisol’s Role in Adrenal Fatigue:

What is the story with cortisol?

How does it help the body stabilize itself?

For one, its levels follows a normal circadian rhythm.

Have you ever heard the term “circadian rhythm”?

Defined: Circadian rhythm

“A daily cycle of biological activity based on a 24-hour period and influenced by regular variations in the environment, such as the alternation of night and day”.

Think of the circadian rhythm as your own internal biological clock that is synchronized to light-dark and other cues in the environment.

This internal clock accounts for waking up at the same time every day without the need for an alarm clock. Our internal clock also tells us to be tired at the end of the day when it is dark.

But guess what?

When cortisol levels are off (whether too high or too low), they begin to mess up our circadian rhythm (and vice versa).

With optimal cortisol functioning, levels begin to elevate are 3am-4am, peaks between 6-11 am, tapers off all day, till midnight, and repeats the same pattern 3-4am the next morning.

In this scenario, if everything is working properly, a person should wake up with an abundance of energy, ready to take on the world, have energy sustained throughout the day, and by evening time, when you hit the pillow, an easy, restful, deep, and comfortable sleep is experienced.

Sound familiar?

Probably not.

Most likely,  let’s just say your  ”some-what lacking” an ample amount of energy, and may be a “tad” short of a pep in your step.

What’s more, energy is probably sporadic throughout the day, varying from  no energy whatsoever, to “yo-yo” like up and down, to never quite being up, to having low energy through-out day, to not being able to get and stay asleep at night.

So that’s the story with cortisol and the circadian rhythm.

We’ve already talked about high a baseline of elevated cortisol levels, due to repeated daily stressors, and how these elevated levels of cortisol start messing up the HPA axis.

But oddly enough, we haven’t talked about the main function of cortisol so far.

That is: what biological function does the release of cortisol largely control.

Blood Sugars, Cortisol, and Adrenal Fatigue:

By far, the most famous role that cortisol is most famous for is the ability to stimulate gluconeogenesis by the liver.

Notice a couple of paragraphs back when I mentioned that when cortisol levels start to deviate from the normal patter,  they tend to “yo-yo” up and down, are chronically elevated, or start to become low, stay low, or never quite manage to get high?

Sounds a lot like energy level. More specifically, these fluctuations describe the erratic blood sugar values that plague the typical population of North America.

That’s because cortisol tightly regulates the demand for energy by our cells in stressful time.

When and only when cortisol production is no longer able to keep up with the energy demands of the body, we begin to CRASH AND BURN.

In “Everything you need to know about adrenal fatigue: Part 3″ I will explain the next step to adrenal fatigue and burnout: cortisol relationship to blood sugars.

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If you happen to be searching on the internet for the term Adrenal Fatigue, then you in the very least, have heard the words before.

Hopefully however, you may have already made the connection with adrenal fatigue

That is, the connection between:

• all the stress you’re under on a daily basis both physically (like the job you do  day in day out) AND emotionally, (such as financial matters and/or family “issues”)

Combine that with:

•  the stimulants you unknowingly or knowingly  ingest each day like excessive caffeine, sugar or other energy “mixes”, or the
•  harmful food additives or chemical, a good example of this are the processed unnatural foods, fast foods

Enter Adrenal Fatigue.

How our body processes all the stressors that affect or body on daily basis, moment to moment. From the initial reactionary feeling of energy and adrenaline, to the longer term stressor that breakdown and build up or bodies, eventually ovewhelming our body, and creating adrenal fatigue.

The Adrenal Glands are responsible for how our body fights stress.

Chances are, you have one or two stressors that are in your life, that affect you on a day to day basis, over and over, that takes its toll on you, too? (I know I do)

So the question becomes: How do I know if I have adrenal fatigue?

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Ever hear the words “Adrenal Fatigue“?

Have an idea what it is, but not exactly sure?

Let’s talk about adrenal fatigue, and its ravaging effects on the body. (Because “ravaging” is exactly what adrenal fatigue does to the body)

WHAT IS ADRENAL FATIGUE EXACTLY:

In order to understand adrenal fatigue, let’s first look at the anatomy.

The adrenals glands are a pair of pea-sized organs that can be found on top of each kidney.

Understanding exactly how the adrenals work requires  breaking the  adrenals into 2 components.

The adrenal gland’s inner portion  is called the “medulla” for middle,  and the outer portion called the “cortex”.

More on both later.

Like ALL  glands in our body, their main purpose in life is to produce and release hormones that are necessary for basic bodily functions.

Immune function, regulating blood sugar for energy demands, stabilizing body temperature, making sure blood pressure is optimal, even the production of our sex hormones.

All examples of bodily functions that are regulated by proper hormone functioning.

When it comes to the “adrenals”, I believe a lot of people have heard the words adrenal fatigue before. I just don’t think people understand what is actually happening with adrenal fatigue.

The good news is, when you do understand what is happening, you can make some effective, easy to implement lifestyle changes that can really help replenish your adrenal hormone production.

Thereby eliminating adrenal fatigue.

So let’s begin.

The adrenal glands are most famous for its ability to help you deal with “stress” on a day to day basis.

Although stress is a very general term, an infinite number of “stressors” exist.  As well, a vast number of theories exist about stress, it’s effect on the human body.

External stressors.

Emotional stressors.

Difficult relationships.

Financial stressors.

Work related stressors.

The list is endless.

Stressors can be physical stressors, like repeated texting, using an ipad, or sitting in front of a computer hour after hour. More intense physical stressors exist, like having a motor vehicle accident, or any  other type of injury.

Stressors can be  internal stressors. An example being too low or high blood sugar values. Other internal stressors could be an  unhealthy gastro-intenstinal system (GI),  a poorly functioning detoxification system, or even a tumor growth in the body.

Even perceived stressors, stressors that aren’t real,  fears, worry, and anxiety, are just as taxing to our body as all other stressors.

So the adrenal’s job is to release hormones that help our body deal with these day to day stressors.

Just exactly what hormones are released, and what they actually do to “deal” with these daily stressors are about to be explained.

But when these day to day stressors become week to week, month to month, and then year to year, what do you think happens?

Adrenal Fatigue, that’s what.

How Does Adrenal Fatigue Occur?

When we encounter a very stressful event, a number of interesting things occur inside your body, of course, inside the adrenal gland.

Let’s paint you a vivid picture.

Take for an example walking into a gas station right in the middle of a robbery.

May you and your loved ones never be held up at gun point. But I needed to paint you an image that you could probably imagine just how stressful that would be.

Imagine the immediate surge of adrenaline you would experience.

If you’re not exactly sure what that is, imagine:

• your heart rate pounding so fast and hard, you think it’s going to explode.
• Blood pressure would be pounding.
• You’d probably be breathing so hard, almost to the point of hyperventilation.
• Your muscles would be engaged, contracted, and ready to handle whatever in needs to do.

These basic bodily reactions, considered your “sympathetics” or part of the “sympathetic nervous system”, occur right from the moment that situation begins.

This is sometime known as the “fight or flight response”

From a physiological stand-point, the center portion of the adrenal gland (the medulla) receives nerve impulses that were initiated from the hypothalamus (a segment in the brain  that controls body temperature, hunger, thirst, fatigue, sleep, and circadian cycles, amongst other necessary bodily functions).

From there, information is sent down the spinal cord, and conveyed through nerve signals that go directly to the adrenal medulla.

When this happens, the adrenal medulla releases epinephrine/norepinephrine.

Aka Adrenaline.

That’s the acute, short-termed, immediate response to stress.

No adrenal fatigue yet.

As the robbery continues, a longer term stress response occurs.

Once the adrenaline hormone is released, and is at its peak,  the hypothalamus in the brain, sends signals to the pituitary gland (also located in the brain).

It does this because the hypothalamus is aware of the initial fight or flight response that resulted in adrenaline release, and now senses the need to help the body return to its normal physiological functioning.

The pituitary gland in turn releases ACTH, which stands for “Adrenocorticotropic hormone”.

The ACTH is released in the blood stream, that will ultimately get circulated to the adrenal glands.

Once the adrenal glands outer lining (the cortex) receives blood with ACTH in it, cortisol when then be released.

Thus, a loop between the hypothalamus, the pituitary, and the adrenals has been established to deal with stress.

This loop is called the HPA axis.

Both short term stressors and long term stressors are normal.

That is, our body, our HPA axis, is set up to enable the body to deal with stressful situations.

However, I believe in our modern society, with the advent of technology, the economic demands to survive (especially during recessionary times),  increased processed/sugary foods, fast-foods, and our love affair with caffeine and alcohol, not to mention “energy boosters/supplements, our body has to process stress like never before.

Adrenal Fatigue: Consequences of Repeated Stressors

As written earlier, the body has an immediate stress response that involves the release of adrenaline, and a long term stress response that involves the release of cortisol.

Cortisol is signaled by the hypothalamus, which signals the pituitary, which then tells the adrenal cortex to secret Cortisol.

Done over and over, and over and over again because of our stressful society, dysfunction of the HPA axis develops.

Depending on what stage of adrenal fatigue someone is in, will depend on how much dysfunction the HPA axis is in (more on this in part 2 of Everything You Need To Know About Adrenal Fatigue).

So the important take away from all of the above is the fact that “stress” is all around, day to day, month to month and year to year.

When this happens, adrenal fatigue will develop.

So much more to the story exists, such as;

In the next part of “Everything you need to know about adrenal fatigue“,  you learn:

• the action of cortisol
• the normal circadian pattern and cortisol
• low cortisol levels
• elevated cortisol levels
• Cortisol/DHEA relationship
• Cortisol and Insulin
• Adrenal Testing
• Adrenal Fatigue and Immune function

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