Where do you start when patients come into the office with symptoms of abnormal cortisol release patterns? At the Equip seminar in April, Dr. Lena Edwards was asked to describe the testing she does to help her patients. Time did not permit her to cover testing protocols, so we asked her to address the question for our members here on ARKProgram.com.
The following question was posed by an attendee of our ARK webinar entitled, “Challenging Patients & Adrenal Assessment.” Our guest speaker for the webinar, Lena Edwards, MD, FAARM, has provided an answer, and we’d like to encourage you to share your experiences by commenting below.
If you haven’t viewed the webinar, you can link to it by clicking here.
There are innumerable stressors in life but most concerning are those stimuli that have a measurable impact on the HPA axis and the production of ACTH and thus a cortisol response. An excellent list of chronic stressors is listed on page 6 of the ARK Physician Road Map, 2nd Edition.
In order for practitioners to be excellent at diagnosing and treating stress related disorders it is imperative that we become experts at understanding stress and not merely nod agreement that stress causes disease.
Doctor, I started the adrenal supplements 10 days ago and for the last two days my heart is racing, I can't sleep and I'm getting "hot flashes"....what is going on?
Has this happened in your office yet? If not, it probably will if you are treating any patients taking thyroid medication. The very first patient I ever ran a salivary adrenal test on and subsequently put on the support protocol for adrenal function came back to me with this very scenario. That's when I learned the strong connection between adrenal function and thyroid function. (
See HPA HPT Connections blog 11/25/09).
When interpreting salivary Cortisol and DHEA panels it can be helpful to look at Cortisol to DHEA ratios. Most often they are elevated and can provide evidence of significant metabolic dysfunction in a patient much like a sailor looking at an iceberg in the distance. What he sees is a clue of bigger problems lurking below the surface.
Practitioners looking for physiologic markers to explain symptoms associated with FMS using conventional testing will grow frustrated and perhaps even discount the existence of such a diagnosis. But it is my personal opinion that FMS is an adrenal problem based on nearly a decade of clinical practice and roughly 200 patients diagnosed with FMS.
Though you may have seen and heard much about sleep on this website perhaps you are not clear on its important role in restoration of adrenal function and overall health. So allow me to make it clear at the risk of making it seem simpler than it really is.