[00:00:20] I'm Dr. Ritamarie Loscalzo and I passionately believe that all disease can be prevented or reversed. If you work with people who are exhausted, overwhelmed, and brain fogged, this episode is for you. We're answering some of the most common questions I get regarding adrenals and HPA Axis dysfunction.

[00:00:51] So let's get started. One of the questions that I get a lot is, how can I differentiate between adrenal and thyroid symptoms? After all, people are going to be tired either way, and the difference that I see a lot is that with adrenal dysfunction, there's often a tired and wired presentation.

[00:02:05] The other thing that differentiates the two, are tests. With thyroid, you can run a blood test and see if there's some things out of balance. But as we learned in some of our thyroid episodes, you can't always trust the blood test. And with the adrenals, the blood test really generally doesn't give us much information because a fasting first morning cortisol isn't going to tell us the state of our HPA Axis. I would say they're really good, we have, in our nutritional endocrinology practitioner program, we have a chart where we compare thyroid and adrenals, and I would highly recommend that you check that out.

[00:03:05] We need to be looking at a complete health history. We need to be looking at all the symptoms. We need to be looking at the origin and when this started, we need to be looking at their lifestyle factors. We need to look at how they sleep, how do they manage their blood sugar? So we need to do a really, really thorough test.

[00:04:07] How do I know what tests to run is something people ask me all the time because we have saliva tests, we have blood tests, we have urine tests, we have dry urine tests, we have 24 hour urine tests.

[00:04:55] I like that test. Saliva tests can work really well to give you an overall view. Blood tests, unless you're doing them at several times throughout the day. Often it's just such a snapshot looking through a binocular or a monocular, you're not really looking at the big picture. So I don't really like blood tests, but if we find that their cortisol in the blood is really already super, super low, then that just does give us a sign that there's some adrenal involvement.

[00:05:48] So when they have to take all their urine for 24 hours and carry around a big jug with them even to work in the supermarket and wherever they go, they oftentimes can't do it. And we have false starts and have to start again. The best test is going to be the one that they'll do, the one that they'll complete, and also the one that their budget is going to be able to manage. So sometimes people will only do the blood because that's what their insurance will pay for. I always encourage them to at least get a salivary panel, which is at a lower cost than a Dutch panel.

[00:06:50] So here's how you know, you invite them to do some kind of small exercise. So if they go out and they walk around the block and they do fine, the next day they want to do it again, just tell them to go a little bit more that day and a little bit more. And if they can get up to, you know, walking for a mile or two or three, great.

[00:07:48] So this is a good question that I get a lot. How do I know if this is something I can help them manage? Or if they need to be referred to a specialist, like an endocrinologist or even a psychologist to rule out other pathologies or symptoms or syndromes. It's a really good question. Very excessive adrenals can indicate a tumor somewhere can indicate a tumor in the pituitary that is pressing on and stimulating more ACTH and is causing the adrenals to produce too much cortisol.

[00:08:51] Basic lifestyle principles. Maybe throw in some adaptogenic herbs, some vitamin C, some B 5, some of the things we talked about in other episodes, and then see how they do. But if the symptoms are extreme, and when you do the testing, you're seeing extremes of low or high cortisol, it may be time to refer them out.

[00:09:35] So usually when I do testing, I like to redo it three to four months, depending on what I'm seeing. Also, how are they feeling? How's their mood, how's their energy level? And I have them at the beginning of our plan together. Just give me a number, like on a scale of 1 to 10. How exhausted are you? How much energy do you have, and where is it changing? And then you ask them again later on.

[00:10:19] And when we have an out of balanced gut microbiome, it can often lead to cortisol gettingcortisol, getting out of balance, cortisol being asked to do its job over and over again to address it. So I'm a big fan of doing some work with the microbiome, even if they don't have symptoms of gut dysbiosis, even if they don't, because it can manifest in other parts of the body and fatigue is one of them. Looking at addressing, making sure that they're not eating a lot of sugar that's feeding organisms we don't want. Making sure they're eating a lot of colorful vegetables to feed the bacteria that then create the short chain fatty acids that supply the intestinal lining with its. It's good stuff. Really important to be looking at this.

[00:11:23] So there's a lot of controversy. We've discussed this in other episodes, that doctors will say, well, The adrenals are functioning just fine. Unless the person has Addison's or Cushings or some sort of pituitary tumor that's producing too much ACTH, the adrenals are going to be fine. This is just a bunch of hooey and we know from testing, from doing Dutch tests and from doing saliva tests and from correcting things that we find out of balance, that it's not a lot of hooey and that we live in a stressful environment.

[00:12:46] And this last question that I want to throw out is a questionis question I get a lot, and I think it's a really important one for you guys to address. Whenever you're working with somebody with adrenal dysfunction, with these symptoms, these low energy and the tired and wired and the things that are happening that are causing them to crash, basically is how can the individual support system and the social environment be contributing to this problem and how can it be optimized to aid in the management of the HPA Axis dysfunction? That's a loaded question. A lot of times the stressors that are hurting people that are causing them to be in this dysfunction come from their social environment, come from peer pressure, come from family stressors, whether it's a kid or a young adult who's being pressured by the family to perform, whether it's parents of young babies that are not sleeping and they're getting stressed out, whether it's people that have aging parents that they're stressed about, that they're trying to take care of, that they're debating between putting them in a nursing home or keeping them at home. They're finding that they're stressed because they don't feel like they can take care of it, or whether it's physical.

[00:14:18] If they have good support, if they have a parent or a partner that they live with. That is supportive, that's going to help them with, okay, you're eating this kind of food. How can I support you? What do I need to do to help? If they have a social structure where they really talk to their friends or they find new friends, right?

[00:14:55] I would love you to support me.” And it's asking and teaching them how to ask for support because most people don't know how to ask for help. Teaching them how to create this social and home environment that's supportive of their new habits. Of their new attitudes. If they live in a home where everybody's nNegative Nelly all the time, where they're watching the news all the time, it's asking, “Hey, when you're listening to the news, can you put on headsets?”

[00:15:35] We're at the end of this episode on the most commonly asked questions I get about adrenal problems and HPA Axis problems. And we're at the end of our adrenal topic in this. So if you haven't watched all the rest of the adrenal episodes on this podcast, then just go to reinventhealthcare.com/adrenal and that will bring all those up on the page. You can also go there and find this beautiful document that I created for you with lots of resources to help you in your quest, to empower others to take charge of their health and to get their adrenals under control.

[00:17:01] So until next time, shine on.