NB! Jeg har oversatt teksten til norsk lenger ned i tråden.


3. BEHANDLING



Fra Mary Shomon:


- Treatments (s. 245-247)

If you are suffering from adrenal fatigue, what can you do? Here are a few tips that can help.

Physiologic Replacement Dose of Hydrocortisone - Some people with adrenal fatigue or unresponsive hypothyriodism have found that low-dose hydrocortisone at physiologic doses can help their immune system and resolve many symptoms of adrenal fatigue. According to Drs. Richard and Karilee Shames:
What we are talking about is the use of small amounts of natural adrenal hormone (hydrocortisone) to bring slightly low adrenal function up to its proper normal daily range. This is in stark contrast to the high doses of powerful synthetic adrenal hormones commonly used to treat severe health problems, or to assist in building muscles.
(Se under for mer fra boken deres.)
You will need a more open-minded, aware doctor to obtain this sort of treatment.

Adrenal Glandulars - Desiccated adrenal gland can be helpful to some people in supporting the gland, and in replacing some missing adrenal hormones. If your practitioner recommends this treatment, be sure to get at reputable brand from a reputable supplier, to ensure quality, potency, and safety.

Hormones - Pregnenolone and DHEA are hormones that can help resolve adrenal fatigue. Use of these hormones is recommended only under the guidance of your practitioner.

Dr. Kate Lemmerman uses DHEA with her patients whose test results show low levels:
I aim for supplementation to restore values in the mid-level of a healthy 30-year-old which is about 175-250 mg/dl in our lab. I usually start with 5-10 mg in the morning for women and 10-25 mg for men and recheck after 6-8 weeks along with recheck of the thyroid values. Once the DHEA-S levels become more ideal I have seen some patients need to decrease their thyroid supplementation. I DO NOT recommend that people just take DHEA without checking their levels, as excess DHEA can also be a problem with excess hair growth, acne and agitation. And because DHEA is not regulated by the FDA it is important to recheck levels because I have seen patients hardly raise their levels with certain brands, while overshooting their target level with other brands.
Natural Support - There are a variety of herbal treatments that can help support the adrenal system, including licorice and ginseng, among many.

Avoiding Stimulants - As much as you may want them, stimulants are the equivalent of giving a car too much gas and "flooding the engine". They put additional stress on the adrenals to work harder and produce more energy, and end up further depleting the adrenal glands. Things to avoid include caffeine, ephedra, guarana, kola nut, and prescription stimulants.

Balance Your Blood Sugar with Your Diet - To minimize stress on the adrenal system, and ensure maximum energy, you should consider a low-glycemic (low-sugar) diet, consisting of sufficient protein and fat; low-glycemic carbohydrates; eaten in smaller more frequent meals throughout the day. Sugar and simple carbohydrates put stress on the adrenal glands by rapidly shifting blood sugar levels. By switching to vegetables, fruits, proteins, and high-fiber carbohydrates, blood sugar remains more stable, providing less strain on the adrenal glands.


----------------------

Fra Shames' bok:

The Thyroid-Adrenal Connection

(...)

Correction of low adrenal is similar to correction of low thyroid. You merely take a pill that contains some of the hormone you are lacking. The purpose of this chapter is to assure that doing so, when appropriate, is not only safe and effective but can change your life for the better.

Cortisol is in the category of medicines called steroids, a class of body substances built upon the structure of the common cholestereol molecule. Both health practitioners and the lay public have great concern about the safety of taking oral steroids. We would like to address this issue directly by making a distinction between high-dose steroid therapy and low-dose adrenal supplementation.

What we are talking about in this book is the use of very small amounts of natural adrenal hormone (hydrocortisone) to bring slightly low adrenal function up to its proper normal daily range. This is in stark contrast to the high doses of powerful synthetic adrenal hormones commonly used to treat other health problems or to assist in building muscles.

The Best Treatment for Low Adrenal Function (s. 147-149)
Where does all this leave us? Fortunately, the news is good. Although adrenal testing is quite complex, adrenal treatment can be quite simple.

Imagine that you have an inordinate level of anger, fear, anxiety, and stress. Suppose that you have been able to get at doctor to test you properly, and you do have mild adrenal insufficiency. One good thing to do is identify the causes of your stress and see what can be done to eliminate and/or manage them. Another is to take a small daily amount of hydrocortisone (brand name Cortef). This comes in 5 milligram tablets, and many low thyroid sufferers will find their situation improved with the simple addition of one pill daily in the morning with breakfast.

Other people with a slightly worse adrenal condition might find better improvement with one pill at breakfast and one pill at lunch. Still other people might require slightly more hormone. For them, the best way to take this kind of adrenal hormone may be four times daily, one pill at breakfast, lunch, dinner, and one at bedtime with a small snack.

You need not increase to four times a day if a lower dose adequately improves your adrenal function. Improvement in your status can be confirmed by retesting, once you have been on medication for a month or two. You may need to taken an extra dose or two of adrenal hormone temporarily, for a few days, if sudden unusual stress causes you undue fatigue. You will need even more adrenal supplement if a respiratory infection severely diminishes your energy.

The addition of adrenal hormone to your regimen could easily result in your getting more mileage out of your thyroid hormone. In fact, many people are thereby able to reduce a high thyroid intake to a more appropriate dose.

As with thyroid hormone replacement, the literature on the subject has overemphasized the hazards of mild supplementation and minimized the enormous benefits. We want to make it clear that taking these very modest amounts of mild natural adrenal hormone, when needed, will not cause an excess of adrenal hormones in your body. Nor will you experience the side effects commonly attributed to steroids (puffy face, weakened bones and skin, high blood pressure, water retention). We're suggesting 5 milligrams of natural hydrocortisone (Cortef) one to four times per day, as opposed to 100-200 milligrams per day for treatment of severe disease. If you notice any intestinal side effects, simply stop this medicine and try something else.

Most people who are treated for inflammatory conditions of the skin, lungs, or joints are not given natural hormone. Instead, they are prescribed the much more potent, and side-effect-provoking, synthetic analogue of hydrocortisone, called prednisone. Under no circumstances are we recommending that any mildly low thyroid or low adrenal person take synthetic chemicals such as prednisone for the kind of hormone balancing we are discussing in this book.

There are also a number of nutritional products available over the counter that can be supportive or even curative of mild low adrenal function. A discussion of which natural products are most useful will be found in the next step, along with our best thoughts for other nutritional and alternative therapies to optimize your thyroid. For now, we wish you good luck for your adrenal balance.

(Det neste kapittelet i Shames-boken handler mest om alternativ behandling av stoffskifteproblemer, lite om binyrer. Anbefaler de som er interessert å kjøpe boken for å lese dette!) ;)


----------------------------

Dr. Durrant-Peatfields artikkel:


You will be given hydrocortisone 10mgm, which is the natural form, to take in a dose appropriate to your needs. Half a tablet three or four times a day is usual, later to be increased, if required. Hydrocortisone has the problem of very rapid uptake by the system, and it needs to be given every four hours, at least. This creates practical problems for many patients, and we use more often, Deltacortril, or Prednisolone. 2.5mgm is usually given to start with, increasing to 5mgm after a few days. Rarely, a total dose of 7.5mgm may be required.

Most patients feel benefit within a few days. You will be asked to ring the surgery if you are in the slightest doubt about how you feel, or how things are going. A report by phone after a week is pretty important, and then we see you in two or three further weeks to assess matters. You will probably have been asked to keep a diary of events. If you have a thyroid problem, the thyroid replacement will start after a week, at a very low dose, working slowly upwards.

It sometimes takes many weeks for all the benefits to come through, but some improvement is clear within a week or so. Adrenal insufficiency related to low thyroid function corrects itself, as the thyroid levels improve, and usually after, two, three or four months, have recovered sufficiently for the cortisone therapy to be stopped.

The question is often asked. Will the cortisone replacement suppress my adrenals? The answer is that in physiological dose it does not at all; and in any event, the adrenal activity is curtailed anyway, making the options quite clear. Suppression occurs in the super-pharmalogical doses, which do not concern us in this context. Even then, the adrenals are able to recover, if the primary illness is dealt with, and the dose reduced gradually.

Low adrenal reserve means that under a state of challenge, the problem is going to show. While on replacement treatment therefore, any further illness and stress is best dealt with be a temporary increase of dose. Influenza, heavy colds, dental extraction, injury and the like, require, for example, the 5mgm Deltacortril to be doubled, just for a few days. (I find that a 5mgm dose almost completely prevents jet lag; and influenza is over in one or two days.)

We have now a considerable fund of practical experience in the treatment of the adrenal deficiency syndrome, and are very much aware of its great benefit.

It should not be considered in isolation, however, any may well be part of the management of other deficiencies. The aging process is the result of deficiency in a number of different aspects of the system, so that full benefit may not be gained until both nutritional and hormonal imbalances are looked for and corrected.