One of the most commonly ignored aspects in the treatment of Fibromyalgia is the evaluation and treatment for a closely associated condition called adrenal fatigue. In fact, the two conditions are very much interrelated that it is a rare instance in which adrenal fatigue is not present with Fibromyalgia. If you are diagnosed with fibromyalgia, you may not be able to fully recover if this aspect of your care is not addressed.
What exactly is adrenal fatigue? It is continued stress on the adrenal glands which causes production of high levels of cortisol over weeks to months. In an acute injury or illness, the body has a built-in defense mechanism called the immune system that produces an acute inflammatory response to deal with the acute insult and help the body to recover. After the acute event has been dealt with, the inflammatory response “cools down.” Cortisol is primarily involved in the body’s “cooling off “of inflammation. A comparable example would be the antibodies that your body develops after an acute infection. After the acute infection has been dealt with, there is no further need for your immune system to be so “revved up.”
Chronic inflammation and continued stress, on the other hand, is harmful to the body over time, especially to the adrenal glands. This continued overwork of the adrenal glands due to both sustained psychological and physical stressors, can cause the adrenal glands to fatigue and become exhausted over time. This adrenal fatigue and exhaustion causes decreased production of many adrenal hormones, including cortisol, aldosterone, and the sex hormones. The consequences of adrenal fatigue on total body health and organ function can be devastating.
While Fibromyalgia is strongly associated with the development of adrenal fatigue; the opposite may also be true. Some research has demonstrated that abnormalities of the receptors in the adrenal glands themselves (ie, the glucocorticoid receptor) may be partially responsible for the development of fibromyalgia to occur in the first place.
With fibromyalgia, the adrenal glands’ response to inflammation may be blunted. Often, an inciting event, such as acute illness, infection, or trauma (psychological or physical), is the “stimulus” that can trigger the development of the fibromyalgia syndrome. If the adrenal gland receptors have decreased sensitivity, then there is a delay in “turning off” the inflammatory response. It is this continued inflammation in response to an inciting event (in the setting of a blunted adrenal gland) that may significantly contribute to the development of fibromyalgia. Following this line of thinking, adrenal fatigue may be present more often than we think in someone with fibromyalgia. This is why it is important to not only ask your healthcare practitioner about adrenal fatigue, but also to be aware of the potential signs and symptoms of it as well.
The symptoms of adrenal fatigue are many, and in many ways can overlap with the symptoms of fibromyalgia. Some symptoms that you should be on the lookout for can include:
- Feeling tired and drained all of the time
- Dizziness and lightheadedness, especially when you stand up
- Battling recurrent infections (signs of a very depressed immune system)
- Dealing with digestive problems
- Craving salt
The evaluation of adrenal fatigue is comprehensive and consists of blood, urinary, and salivary measurements of the hormone levels that the adrenal gland produces. These include not only hormones responsible for the maintenance of blood pressure such as cortisol, but also sex hormone levels, including DHEA, progesterone, and various forms of estrogen. Did you know that in situations of chronic stress that the adrenal glands actually can decrease production of these hormones in order to make more cortisol in an effort to deal with the sustained inflammatory response?
The treatment of adrenal fatigue is multidimensional, and includes improving nutrition, trying to get a good night’s sleep, vitamin and trace mineral substitution, the use of glandular extracts and/or bioidentical hormone replacement therapy if needed.
Some things you can do to help maintain and improve your adrenal health are:
- Eating a diet high in antioxidant value
- Get a good night’s sleep
- Take 1000mg of Vitamin C daily
- Take a B complex Vitamin daily
By Rich Snyder, DO
Rich has written several books, including What You Must Know About Kidney Disease, What You Must Know About Dialysis, as well as Adrenal Fatigue For Dummies.
- Geiss A, Rohleder N et al. “Evidence for an association between an enhanced reactivity of interleukin-6 levels and reduced glucocorticoid sensitivity in patients with fibromyalgia.” Psychoneuroendocrinology. 2012 May;37(5):671-84.
- Tanriverdi F, Karaca Z et al. “The hypothalamo-pituitary-adrenal axis in chronic fatigue syndrome and fibromyalgia syndrome.” Stress. 2007 Mar;10(1):13-25.
- Wingenfeld K, Heim V et al. “HPA axis reactivity and lymphocyte glucocorticoid sensitivity in fibromyalgia syndrome and chronic pelvic pain.” Psychosomatic Medicine. 2008 Jan;70(1):65-72.