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Treatment Options for Adrenal Fatigue
The approach that is probably the most common is to do nothing, which can occasionally result in problems during thyroid hormone replacement. However, very frequently when the correct thyroid hormones are provided at the right levels then the adrenals quickly recover.
Another approach used by some doctors prior to commencing thyroid hormone treatment, is to do laboratory tests for adrenal fatigue. If the test results indicate a sufficiently low cortisol level then some form of treatment might be administered, prior to prescribing thyroid hormone replacement. Typically, only physiological doses of adrenal hormones are used.
Physiological doses of any naturally occurring hormone are doses that are small and only raise the level of hormone in the body to the normal level and no higher.
An alternative approach is to commence thyroid hormone replacement therapy and watch carefully, to see if any of the tell tale signs of adrenal fatigue exist. If there is evidence of adrenal fatigue during thyroid hormone replacement, then laboratory tests for cortisol levels may be done at that time. The doctor can then assess if there is any need to use any form of treatment for adrenal fatigue.
If a doctor concludes that a patient may be suffering from adrenal fatigue that is severe enough to prevent the success of thyroid hormone replacement, then it is possible that the patient may be offered a trial of adrenal support.
Adrenal support may involve the use of very small, physiological doses of hydrocortisone, which are designed to only correct a patient's cortisol to normal levels and not above this. In this case, because of the short-lived nature of hydrocortisone in the body, several small doses may be given during the day.
Alternatively, a more natural form of adrenal support may be used, which is likely to contain some level of ground up adrenal glandular.
James L. Wilson in his excellent book 'Adrenal Fatigue The 21st Century Stress Syndrome' discusses various treatment options for adrenal fatigue. He clearly feels that natural adrenal hormones, as found in adrenal glandular products, are safer and generally effective for adrenal fatigue. His main concern stems from the worry over the potential suppression of the adrenal glands through the use of steroids like hydrocortisone, which can with continued use result in long-term loss of adrenal function.
There are plenty of information sources on the Internet that describe how patients have used adrenal support and there are patient based forums that provide helpful and friendly advice for anyone who suspects that adrenal fatigue is preventing them from getting well. I see no issue with anyone finding out as much as possible about topics like adrenal fatigue, as gaining as much information as possible about other peoples' experiences is usually quite valuable.
I recommend no particular website or source of information on the treatment of adrenal fatigue. Any patient should always be working in cooperation with their own doctor or endocrinologist on these types of issues. Adrenal hormones used incorrectly can cause serious issues and so a patient ought to be working with a suitably experienced and qualified medical doctor.
In the case where some form of adrenal support has been provided, once the correct dosage of thyroid hormone replacement has been established, then any form of adrenal support may usually be reduced gradually and then stopped.
It is also important to be aware that the form of thyroid hormone treatment may directly affect the performance of the adrenal glands.
In my own case, I had adrenal fatigue when on T4 replacement therapy but no adrenal fatigue when I was successfully using T3 replacement therapy. Just because adrenal fatigue is present it does not necessarily mean that it is the adrenal glands themselves that are the problem.
The 'Recovering with T3' book has further information on adrenal fatigue and how this might be handled during T3 replacement therapy.