Causes of Adrenal Insufficiency
by Michael B. Schachter, MD, FACAM
Stress and Adrenal Insufficiency
stress may contribute to the development of mild adrenal cortex insufficiency--a
deficiency of hydrocortisone. Stress may take many forms. For
example, stress can result from: (1) infections; (2) exposures to toxins; (3)
sleep deprivation; (4) nutritional deficiencies; (5) loss of love or emotional
support; and many others. All of these factors can adversely affect
may be either acute or chronic. The adrenal glands are involved with both
types. The adrenal glands are small structures located above each
kidney. The internal part is called the adrenal medulla. It secretes
adrenaline in response to acute stress and prepares the body for fight or
adrenal cortex, the outer part of the gland, secretes steroid hormones, such as
hydrocortisone, to help the body adapt to chronic stress. Experimental
animals, whose adrenal glands have been surgically removed, live normal life
spans as long as they are not stressed. However, if stress stimulation,
such as extreme temperatures, is introduced, they quickly die. From
experiments such as these, scientists have deduced that the adrenal glands are
necessary for stress management.
name of the disease characterized by the complete loss of adrenal cortex
function is Addison's Disease. Symptoms include severe fatigue, low blood
pressure, low blood sugar, dizziness, weakness, depression, anxiety, loss of
appetite, weight loss, and increased skin pigmentation. Our most famous
public figure to have this disease was President John F. Kennedy. Patients
with Addison's Disease can lead relatively normal lives by taking physiologic
replacement doses of natural hydrocortisone pills. Addison's Disease, or
complete adrenal cortex insufficiency, is described in every textbook of
medicine and endocrinology. What is not mentioned is the common condition
of mild adrenal insufficiency. This condition contributes to a wide range
of symptoms and diseases.
with mild adrenal insufficiency may suffer from the same symptoms as those with
Addison's Disease. Symptoms can include headaches, muscular aches and
pains, joint pains, confusion, impaired memory, low motivation, and many
others. Additionally, such people may suffer from an increased
susceptibility to all kinds of infections including those caused by bacteria,
viruses, parasites, yeast, and fungi.
such as rheumatoid arthritis, other autoimmune disorders, ulcerative colitis,
Crohn's Disease, hay fever, asthma and many others are made worse when mild
adrenal insufficiency is present and may be helped by correcting this
condition. Mild adrenal insufficiency is aggravated by, but also
contributes to, a person's abuse of substances, such as alcohol, tobacco,
caffeine, recreational drugs, sugar, and artificial sweeteners.
can mild adrenal insufficiency be diagnosed? One method is the ACTH
stimulation test. A fasting level of hydrocortisone is taken in the
morning. Then the patient is given an injection of a derivative of ACTH,
the pituitary hormone that stimulates the adrenal cortex. An hour later,
another blood sample is taken to check the level of hydrocortisone.
Normally, the hydrocortisone level should double. If it doesn't, this
would indicate relative adrenal insufficiency. However, sometimes patients
may benefit from treatment of this condition, even when the test is normal.
can relative adrenal cortical insufficiency be treated? First, whenever
possible, we correct underlying causes, such as infections, toxic exposures,
poor nutrition, and psychosocial stresses. Next, the adrenals should be
nourished. This can be done with nutritional support using specific
supplements. The most important supplements for adrenal support are:
vitamin C, pantothenic acid, vitamin B6, manganese, magnesium, and raw adrenal
New York physician, Dr. John Tintera introduced the concept of mild adrenal
cortical insufficiency in the 1940's and 50's. He used adrenal cortical
extract (ACE) injections to rest the adrenals and allow recovery. He
successfully treated functional hypoglycemia, alcoholism, allergies and many
other conditions with this treatment.
the 1950's and quite independently, Dr. William Mck. Jeffries has been
advocating the use of low, oral doses of hydrocortisone to treat mild adrenal
insufficiency and related conditions. In his book Safe Uses of Cortisone,
Jeffries recommends half the maintenance dose used for Addison's Disease, namely
5 mg four times a day. With increased stress or infection, the dosage is doubled
for a short time.
of the conditions helped by this therapy are: chronic fatigue, frequent
infections, asthma, allergies, rheumatoid arthritis, acne, excessive hair growth
in young women, infertility, thyroid problems, autoimmune disorders, functional
hypoglycemia, ulcerative colitis and many others. He points out that this
therapy, even when given for long periods of time, does not cause any of the
side effects and problems associated with the use of high doses or even low
doses of synthetic steroids, such as prednisone or decadron. Low dose
hydrocortisone also does not suppress normal adrenal function when used in this
way. This approach offers hope to many patients who have not been helped
by any other treatment method.
treat relative adrenal insufficiency using the nutritional approach and safe,
low doses of hydrocortisone. Both of these therapies have been almost
totally ignored by the medical profession.
William McK., Safe Uses of Cortisone (Springfield: CC Thomas, 1981)