Adrenal Insufficency

In medicine, adrenal insufficiency (or "hypocortisolism") is the inability of the adrenal gland to produce adequate amounts of cortisol in response to stress.

Causes can include:
Acute adrenal insufficiency
Addison's disease (autoimmune adrenalitis)
Septic shock
Waterhouse-Friderichsen syndrome
Addisonian crisis in case of:
Discontinuing corticosteroid therapy without tapering the dosage
Surgery, illness or any other form of stress in patients with long-term corticosteroid therapy
Chronic adrenal insufficiency
Addison's disease
Congenital Adrenal Hyperplasia
antiphospholipid syndrome
haemochromatosis

Hypoadrenia is a term for a hypothesised condition of the adrenal glands. The terms adrenal exhaustion or adrenal fatigue are often used (and connected to hypoadrenia) by complementary and alternative therapists, but are not formal medical terms.

The adrenal glands are part of the body's mechanism for short term stress response and management, they are involved in the production of the hormone adrenaline (also known as epinephrine), the famous fight or flight chemical released in stressful situations, which increases the body's metabolic rate and muscular contraction strength. Along with the thyroid gland they are also part of the body's metabolic energy regulation and control system, and thus control to an extent the energy available to body systems.

It has been theorized by alternative medical practitioners that under conditions of long term stress, the adrenal glands can become less responsive to circumstance, or maladapted, and cease to function optimally, leading to a wide (but slightly vague) range of fatigue and stress related conditions including a greater likelihood of psychological conditions such as depression and possibly certain other mood disorders. However, it is important to note that this theory has not yet gained acceptance within mainstream medicine.

Biological background
Main article: Stress: neurochemistry and physiology

Biologically, long term stress is a modern phenomenon in the human environment (in evolutionary terms through most of human and mammalian history, stress was a reaction to a point incident, rather than a continuing way of life). As a result, the human body and its internal regulatory mechanisms are poorly adapted to handling many aspects of the types of stress found in civilized cultures. They evolved, so to speak, to react to predator attacks, rather than (for example) constant belittlement, decades long abuse, high risk hobbies, pressure to succeed, or existential and religious inspired worries about ones life and future.

Organs such as the brain, the endocrine system-- including the sympathetic and parasympathetic systems, and the various glands contained therein, which were not evolved for, or designed to handle and respond optimally to, constant stimulation may therefore, under modern social conditions, become constantly or abnormally stimulated. Other organs which form part of the whole, such as the nervous and musculoskeletal system, are also made to work for decades under different (and comparatively abnormal) conditions than existed throughout the rest of human evolution.

It has been hypothesised by alternative medical practitioners, but not clinically proven, that under certain long term stress and physical conditions, that the body's stress management systems cease to regulate stress and stress related body systems and hormones appropriately, and instead become adapted to continual over stimulation in various inappropriate ways which can lead to the symptoms described. This is strictly hypothetical, and by no means universally accepted, particularly in mainstream medicine.

Symptoms
The theorized symptoms for adrenal exhaustion include a depletion of energy reserves and a loss of resilience. They range from fatigue, nervousness, anxiety, exacerbated PMS, depression, brain fog and carbohydrate cravings to allergies, muscular pain, tenderness, joint pain and irritable bowel syndrome.

Clinical views on hypoadrenia
"Adrenal exhaustion" and "adrenal fatigue" are common diagnoses in alternative medicine, but are not recognized in conventional medicine. The mainstream medical view of hypoadrenia is that its alleged symptoms are vague and non-specific, and that day-to-day emotional stress is highly unlikely to lead to an "exhaustion" or imbalance of the adrenal glands.

Psychological conditions and mood disorders referenced above may be linked to hypoadrenia. Symptoms of chronic fatigue and depression could result from diminished adrenal stores, caused by prolonged exposure to a particular stressor (i.e. poverty) or a series of stressful events occurring closely together (i.e. loss of job, divorce, and children ill). The adrenal gland, responsible among other functions for producing cortisol, when in constant use may produce cortisol over a long period of time, resulting in a high amount of cortisol in the bloodstream. Cortisol functions to return the body to a state of rest/repose after a stressor or fight/flight stimulus. An individual with low cortisol levels may demonstrate mood disorders as anxiety, depression or fatigue as a result of the increased cortisol present in the bloodstream. An indication that psychological conditions may be linked to the amount of cortisol is that the hypothalamus, or master gland, is shared by both the nervous system and the endocrine system; endocrine system containing the adrenal gland and hormone cortisol.

Adrenal Insufficency