Chronic fatigue and deterioration of adrenal function can be suspectedㅣDr. Esther Lyuh

Chronic fatigue and deterioration of adrenal function can be suspectedㅣDr. Esther Lyuh

Esther's essay
What is about the cause of chronic fatigue that seems like death?

Treatment is possible if the exact cause is known. However, there is chronic fatigue for which the cause is unknown. Even if you do a comprehensive checkup from head to toe, the cause cannot be found. It's hard to get up in the morning and I don't have the strength to lift a finger. Some say that their socks hurt and they are so tired that breathing is difficult. Even if you go to the hospital, there is nothing wrong, they tell you to eat well, exercise hard, and sleep well. But I can't eat properly because I have no appetite, and I can't even exercise because I have no energy. I cannot sleep deeply at night.

After experiencing these symptoms for several months, most doctors recommend that they see a psychiatrist. When you go to a psychiatrist, you usually receive diagnoses such as depression, anxiety, and "Hwa-byung". And the medications follow. However, they stop taking the drug within a week or two of starting it. This is because it is difficult for people who have suffered from chronic fatigue for a long time and have lost their physical strength to tolerate even the mild initial side effects of antidepressants, such as nausea and a feeling of sinking. In this case, a decrease in adrenal function is a major cause of fatigue. 


What is the Adrenal Gland?

Many people know

Many people know about the stomach, liver, large intestine, and small intestine but do not know about the adrenal glands. The adrenal glands are attached like caps over both kidneys. The adrenal glands are very small organs, weighing only about 5 grams each, but the jobs they secrete are very diverse and important. The adrenal glands are involved in maintaining blood sugar and blood pressure, generating energy, and performing various tasks such as anti-inflammatory action, maintenance of immune function, and regulation of sex hormone secretion. In addition, the adrenal gland acts as an automatic regulator that keeps the body's autonomic nervous system well in the face of numerous stresses and external stimuli. The autonomic nervous system includes the sympathetic nervous system and the parasympathetic nervous system. When the sympathetic nervous system develops, the adrenal gland secretes a hormone called cortisol. Cortisol changes the body's condition so that when the body is in danger, it can get out of the dangerous situation. It raises your blood pressure, blood sugar, and pulse rate so you can run well, your pupils dilate so you can see your surroundings better, and you get a good grip on your weapon while youhand'sds sweat. It also keeps you focused when you need to work hard. Cortisol comes out in sufficient quantities when needed, and when you are resting, secretion should stop like turning off a faucet. However, if you look at a person suffering from chronic stress, cortisol does not come out well when it is needed, but on the contrary, cortisol is released when it is necessary to rest. When this happens, the immune system decreases, es and the inflammatory response of the whole body increases, resulting in digestive disorders such as gastritis or gastric ulcer.

How to overcome adrenal fatigue

Adrenal fatigue is a little different from normal fatigue recovery. People with impaired adrenal function should treat their bodies with care as if they were handling a glass. It is important to take nutritional supplements for adrenal fatigue, but proper exercise, proper eating, ng, and sleeping habits must be accompanied.

First, you must exercise. 

Many people get angry when I tell them to exercise when they are so tired that they cannot even lift a finger. But if you stop exercising because it's hard, you'll get more tired. What matters is how. Don't overdo it, and increase it little by little. If you exercised for 15 minutes yesterday and feel more tired today, try reducing your exercise time to 10 minutes today. If you exercised for 10 minutes today and feel good the next day, keep it as it is, then gradually increase your exercise time to 15 minutes the next week and 20 minutes the next week, looking at your physical condition. This is because regular exercise has the effect of training the adrenal glands. My primary goal is to walk for 30 minutes. If you do aerobic exercise such as walking for more than 30 minutes, you can expect not only fatigue improvement but also the effect of clearing blood vessels.

Second, you must eat well. 

However, there are a few things that people with adrenal fatigue should be aware of. It is better not to eat a lot of food at once, but to eat small amounts often over 5 to 6 times. When you eat food, you expected the effect of increasing the secretion of cortisol by stimulating the adrenal glands in blood sugar.


Especially breakfast is a must. This is because cortisol secretion is at its lowest during the day just before waking up. You should have some form of breakfast within an hour or two of getting out of bed, especially before 10 am. A simple whole-grain cereal and a glass of low-fat milk are fine. 4 p.m. is also important. This is because cortisol secretion drops to its lowest concentration during the day around this time. Snacks are good at this time. Nuts or low-fat yogurt are recommended over refined carbohydrates such as bread and snacks. Refined carbs temporarily raise blood sugar to get rid of fatigue, but after an hour or two, hypoglycemia causes dizziness and worsens fatigue symptoms. A small, unsweetened snack can help you overcome afternoon fatigue. It's also a good way to eat a little salty. In general, eating salty food is bad for health, but salt is helpful for people with severe adrenal fatigue. This is because sodium temporarily helps the adrenal glands secrete cortisol. It means that it is good to eat a little salty, not too bland for breakfast. 


Conversely, in the case of orange juice and vegetable juice with a lot of potassium, it is recommended to avoid it in the morning as it can temporarily worsen fatigue symptoms while excreting sodium out of the body. As for fruits, bananas and melons are high in potassium. Eating these fruits in the morning can flush out sodium and make you fere drowsy. This is, of course, true for those with adrenal fatigue. If you don't have adrenal fatigue, there's no reason to eat salty, and there's no reason to avoid oranges or bananas for breakfast.

Third, you must go to bed at a certain time. 

For people with adrenal fatigue, even a difference of just 1 to 2 hours in sleep time immediately worsens their physical condition. If possible, it is recommended to go to bed and wake up at a regular time to maintain a regular body rhythm. You should reduce overseas travel across continents and avoid meeting people who cause stress if possible.

Nutrients to help with adrenafatigues

As with general fatigue, a multivitamin containing the B vitamins is recommended first. This is because many ingredients such as vitamin B, beta-carotene, vitamin E, selenium, and magnesium help inefficient energy production and adrenal hormone synthesis.


In particular, a formulation that contains enough vitamin B1, not the recommended amount, around 100 mg is recommended. If the amount of vitamin B1 in a multivitamin is low, you can take additional B vitamins separately. It's also important to choose a multivitamin that contains at least 100 mg of vitamin B5. Vitamin B5 is essential for maintaining adrenal function. Vitamin C is also helpful. However, unlike general fatigue, the dose must be increased in case of adrenal fatigue. It is recommended to take 4,000 to 10,000 mg per day in divided doses.


Another important nutrient that can help with adrenal fatigue is protein supplements. It is commercially available in powder form. When you lose muscle mass, which is important for energy production, you feel more tired. Protein is the most important nutrient for building and maintaining muscle. In the case of patients with chronic fatigue syndrome, there are many reports that there is a problem with the intake ratio of amino acids, a component of protein. In particular, it is easy to be deficient in the essential amino acids phenylalanine and tryptophan, two amino acids involved in sleep function, response to stress, and synthesis of important neurotransmitters such as serotonin. In addition, it is good to supplement amino acids such as tyrosine little by little. This is because tyrosine is a source of adrenal hormones and helps regulate stress and mood. 


In the case of protein preparations, it is recommended to avoid taking a high dose of one amino acid component and choose a powder that contains various amino acids evenly.

Esther Lyuh, Doctor of Preventive Medicine, Seoul National University
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