Stages of Adrenal Fatigue

Adrenal fatigue isn’t well understood by the public or the medical establishment. That’s why you might not recognize the stages of adrenal fatigue even when you’re in the middle of them. Here are the symptoms and problems associated with each stage and what to do about them.

1:30 - Stage 1 "Alarm Reaction"
4:50 - Circuit Dysfunction Example
6:40 - What happens when you see your Doctor for Adrenal Fatigue
9:25 - Stage 2 "Resistance Response"
11:00 - Stage 3 "Adrenal Exhaustion"
13:20 - Abnormal Diagnostics
16:20 - Stage 4 "Adrenal Failure"

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Transcript

Dr. Jeremy Lam, MD: 0:06

Adrenal fatigue can look very different in different people. In some people, it might appear quite mild and have a specific set of symptoms, and in others the symptoms may be different and quite severe. This is partly due to individual differences, but also because there are different stages of adrenal fatigue. Welcome to the Dr. Lam show, where we educate about integrative medicine. I'm Dr. Jeremy Lam, and I focus on chronic disease prevention, as well as preventative medicine.

Dr. Carrie Lam, MD: 0:40

I'm Dr. Carrie Lam. I practice family medicine, and also really into holistic solutions that will work in tandem with conventional medical approaches. We are both well versed in adrenal fatigue as our father, Dr. Michael Lam is an expert in this field, author of textbook on Adrenal Fatigue. He has himself suffered from adrenal fatigue. Together as a team, we help many people to recover from it. Today, we're going to talk about the stages of adrenal fatigue. If you find this information useful or want to know more about adrenal fatigue, please share this show with your friends and family and hit the button to give us a five star review. So Dr. Jeremy tell us about the first stage of adrenal fatigue,

Dr. Jeremy Lam, MD: 1:31

The first stage is, the fight or flight response. Most people go into this stage almost every day due to regular stress. The stress releases cortisol, with little amounts of epinephrine and norepinephrine. And so stage one is called the alarm reaction, where our body receives stress signals from our eyes, ears, nose, when we hear loud voices, we see violence, we smell problems, these signals reach the brain and gets converted into a chemical signal. These signals cause the release of neurotransmitters and hormones, like norepinephrine and epinephrine that cause physiological changes. So in the first stage, norepinephrine and epinephrine is activated and therefore called the alarm reaction. The body's response to stress is by releasing these hormones and neurotransmitters that can fight off stress. So Dr. Carrie, what does norepinephrine do?

Dr. Carrie Lam, MD: 2:51

Norepinephrine is released in the brain and cause alertness. The epinephrine makes us alert when the enemy approaches or there is a test next day, the heart may start pounding faster. So you might have a faster heart rate, and makes you more in tuned to your environment. And cave. There. It's very similar to even what street drugs like amphetamines, as they mimic these neurotransmitters and alarm reaction. And, and most people do go through the dis alarm reaction without having any problems, the first stage of adrenal fatigue, they might feel a little tired in the morning, they need a cup of coffee. And so they, they drink the coffee and then go throughout their day, and there's no problems, right? The adrenals, then, with the norepinephrine, try to balance it out by putting out more cortisol to suppress it as a cushioning mechanism. It's like a car starting to go on overdrive, then the body puts on this braking mechanism to soften in the landing. And so these are the alarm reactions that you can happen when you get yelled at by your boss or you work overtime or you're studying overnighters and then your body just gets really tired. So then you eat a doughnut or like I said, you you drink that coffee or you take a nap for a pick me up. So that's how you can go from stage one onwards, it day in and day out, you start having chronic stress. And biochemically, we look at the stress response as neuro endo metabolic stress response which consists of six circuits and 12 organ systems in your body where they all work together biochemically to put output out fires that are happening in your body as you don't know which one is going to come out but it could be this organic beat this organ. And so, just one at a time you It happens and then you put it up. Okay, so Dr. Jeremy give us an example of one of the circuits that can go off

Dr. Jeremy Lam, MD: 4:58

right so if your bioenergetics are is already off, you know, your pancreas may be trying to secrete more insulin, your cortisol but is starting to rise and that you know system. Sometimes the ovarian system may also start to put out more estrogen if you're having more PMS symptoms. And so you know, the important thing to understand is that stage one, the body is like a rubber bat as being stretched. And because it's pretty strong, it has the ability to rebound. So, you know, you often say, Oh, I'm just a little off today, let me rest for a couple hours, let me just take a nap, and your body's able to bounce back. And so that's the alarm reaction and the fight or flight response in stage one. So now let's take a look at stage two. And stage two is when your body hits some resistance, and when the body rings, the alarm bell. And so this is often really shelved by some physiologic symptoms that the body's whispering for you to take action. And this is what is defined in this stage, now the symptoms start to come up, and they kind of become more prevalent, and they won't go away, such as in stage one. And so some people feel more tired, especially towards the end of the day, they go through their workday, their whole day, and then they just crash. And then they might start to feel a little more hungry more than normal. And their hormonal symptoms are popping up left and right, not only during their periods, but throughout the month. And so you know, Dr. Carrie, what happens when they go see the doctor with all the symptoms,

Dr. Carrie Lam, MD: 6:45

right? They go see their doctor for the first time, maybe because they feel a little more often normal, they need to drink more coffee, and the coffee stops working, they start building tolerance, the doctor can order a bunch of tests to work them up, you know, make sure Hey, what is going on? Is it a sleep problem is a depression is it fatigue, you know, they order lab tests, but normally really comes back normal, okay, within the normal range and just tell them go home stress a little less sleep a little better. And but what people find is, then their sleep actually gets a little more affected and they have a harder time falling asleep, they could start waking up in the middle of the night, and their exercise capacity becomes a little reduced. So this is the resistance that your body is starting to put up. Okay. And stage two can go on for years and or it could be even very acutely, some people just have it after a surgery or let's see an accident, a car accident and your body gets so worked up that he goes into stage two. And that kind of differentiates because your body is still able to be functional, most people are still able to work and push through, as they just kind of ignore their symptoms, okay, because they feel like it actually there's nothing wrong with me, even though they do feel these symptoms. And so make sure if you're having any of these symptoms to take a step back and don't just push through your body is telling you these symptoms for a reason. As you go through the stages, you'll see what Adrenal Fatigue is and how your body's warning signs and whispers are getting stronger and stronger. And if you keep pushing through it, you can get punished down the line. Okay. So if you have questions about it, and you're going through these stages, just know that you're not alone, there's lots of people that are just like you that have gone through the same thing. And we've helped many of them. So if you have any questions at all, you can call our office at 714-709-8000, her free phone call and we can actually help you figure out what is the underlying problem, fix what you don't know, help you listen to those symptoms that keep popping up. Okay. So, Dr. Jeremy, can you tell us what are some common mistakes that people make in stage two as they go into stage three?

Dr. Jeremy Lam, MD: 9:16

Well, in stage two, again, you know, your body is whispering those symptoms out to you. But oftentimes, we mask those symptoms with drinking more coffee. You know, if we do work out, it becomes more straining and you start to have some slumps for a few hours after exercise. And so, in stage two, it can take years to really go on before you proceed to stage three. And stage two again, is your body still able to get up you're able to work you're able to be functional, and that differentiates from stage three people where their adrenals are more exhausted and When they are more exhausted, really, you know, you feel like your body is punishing you and you don't have an answer for what is going on. And so that's the key for stage three.

Dr. Carrie Lam, MD: 10:14

At this point, some people might also start looking for supplements. And sometimes that's a very common mistake, just like you're trying to get a quick fix with a caffeine, you might be taking hormones, or glandulars, or herbs that kind of stimulate you. And you might feel good for a short amount of time. But over time, as you continue to use these artificial glandulars are herbs, or adaptogens, try to stimulate your adrenals for more energy. It's like whipping a horse that it's tired or ready, instead of nurturing the horse back to health, you are actually making it worse, you're making your adrenals work harder. And so after a few months of energy being improved, your gradually deteriorate and you get into stage three. So, Dr. Jeremy, let's talk about stage three.

Dr. Jeremy Lam, MD: 11:03

So stage three is Adrenal Exhaustion. And what are you going to feel here? Well, a lot of people feel chronic fatigue. But this is also when the body starts to break down its muscles. So some people actually go into catabolic states where they feel weak, their muscles get weak. In addition to all of that their bioenergetic symptoms also come up where they find that they eat every two to three hours because they feel that their blood sugar's are low, their hormones are also off and that's when the fatigue starts to set in. The neuro FX circuit also goes haywire with mood instability, irritability, depression, and anxiousness. In addition, their detox circuit pathways are all so congested so that you're going to feel build up of metabolites and toxins and potentially feeling brain fog.

Dr. Carrie Lam, MD: 11:59

So it seems like everything just is going haywire, and the whole neuro endo metabolic stress response, right, the six circuits to 12 systems, every circuit is being affected in different people, and maybe not all at once.

Dr. Jeremy Lam, MD: 12:16

That's right. And those symptoms can also move from mild to moderate to severe. And when it's severe, it becomes a medical problem. When it's mild, right, you can still overcome it. So you have to be very careful to be able to understand the symptoms to be able to put the picture together, just like you know, sleeplessness in stage one and two, and the early part of stage three, it can just be occasional, where you have problems sleeping. But when insomnia becomes chronic, such as in the later phases of stage three, then you get these very classical symptoms with that are telling your body and screaming out giving us these warning signs. But it's quite unfortunate because you know, these we go to, to these doctors, you tell doctors and your lab tests come back normal, your diagnostic tests come back normal, and that's when you become even more frustrated.

Dr. Carrie Lam, MD: 13:15

So like diagnostics that can come back abnormal, sometimes is the thyroid tests, where your thyroid starts to slow down a little because just overall as your body's stress, it's gonna tell your body, hey, I need to conserve my own energy, and therefore it slows down some of your thyroid numbers may come come out a little, a little abnormal, okay? But is that really truly an underlying thyroid problem, and your doctor puts you on thyroid, you might feel better for a few months, and then somehow, you feel like your symptoms all come back again, fatigue, hair loss, weight gain, and it's not getting better despite increasing and increasing your thyroid medication. And so that's very classic. Or sometimes your hormones are a little off people, doctors might put you on more hormone replacement therapy. But these are all trying to stimulate your adrenal to put out more cortisol to deal with the stress to deal with the thyroid. And instead of making it better, it actually makes the exhaustion worse over time. So do you know exhaustion is your body's loud and clear voice for you to take action, and you should not go and self navigate? If you've been doing so already, make sure you seek professional help. Because if you don't know how to listen to your body's whispers and you don't know how to deal with it, you don't know what dose what delivery what, how much to exercise, how much you want to eat. You can actually overstimulate your adrenals and you can make it worse. And so it is always very important to find someone who knows what they're doing, especially if you're already in Adrenal Exhaustion, which is stage three. Okay. Dr. Jeremy tell us if your body do you think the body has a chance of healing by the time it gets to stage three?

Dr. Jeremy Lam, MD: 15:11

Oh boy, your body definitely has its way of healing your body has many different mechanisms. And you just have to have the proper nutrition and lifestyle ba to be able to help the body recover. The body has its built in mechanisms to be able to heal itself, you just have to give it a chance. And if you don't give it a chance, or you don't know what you're doing, then you can actually make things worse. So you know, it's very important, again, to be able to listen to what your body's telling you and use the built in mechanisms to help your body recover. Now all all, everything that we've described in Adrenal Exhaustion is fairly serious. And those symptoms start to feel pretty serious if you're in stage three, or approaching it. So adrenal fatigue, recovery can be very difficult or complicated, particularly if you can't find a doctor who understands it, and knows what is going on in your body. So if you're in the stage, give us a call and talk to our team at 714-709-8000. And now we're up to stage four of adrenal fatigue. And that's where things get serious and sometimes even life threatening. We've dealt with a lot of people in stage four, and we're able to get them out of that. But you know, what is stage for that to carry?

Dr. Carrie Lam, MD: 16:38

I stage four is adrenal failure, okay? Imagine your body's like a rubber band, okay, at stage one is able to stretch and it bounces back at stage two, it stretches and bounces a little less. And then stretch three, you're really stretching it, okay, you're really stretching it, and it's a little more intense. And with time, hopefully it would be able to come back, but sometimes it doesn't, if you stretch it even more, you can break it, right and that's where stage four comes in, where your your adrenals really they just fail, okay? You are unable to produce the hormones that you need to. And it's very, very severe. For example, you can go into a catabolic state, where you continue to lose your muscle mass, electrolytes become imbalanced your blood pressure is low than high tonight than low, you know, very volatile, your sugars become very poorly, imbalance having to eat every two hours in order to keep your muscle mass sleep is so severely disrupted that you cannot get good rest. Some also have postural symptoms where your heart rate can just get triggered by any little thing. Going fast and pounding or arrhythmias or things like that. Clinically, this could look like some form of an addisonian crisis Addison's disease where your body really starts to get to the point where it's crying out for help, it doesn't know what to do, it's in its last drive. And your neural endo metabolic stress response is super dysregulated in all its systems. And so this is definitely a medical situation where you have to go see your doctor and do anything that they can do, whether it's balancing your, you know, electrolytes, making sure that you have a reset, making sure your blood pressure is good some, some also will find themselves in the hospital needing IVs needing hormones meeting steroids. And the endocrinologist puts them on steroids to try to stabilize the body as this has become so severe. Okay. Good news is that this happens to very few people. So Dr. Jeremy, tell us what happens when also when people start to go see a doctor for help or they end up in the hospital.

Dr. Jeremy Lam, MD: 18:55

Well, this is where people are kind of caught in the no man's land, right? Despite extensive workup, heroic measures, things don't necessarily work well. And they become very depressed and very and lose hope because you know, from a medical standpoint, nothing can be done. And so by this point, most people are homebound or couchbound. Sometimes they need ambulatory help, and sometimes, again, do intensive outpatient or hospital therapies. And this is the stage for adrenal fatigue, which is adrenal failure. So if you think you are in the stage, you have to make sure that you get medical help right away, to really stabilize your body and hopefully get your body back into at least stage three where things can be handled at a proper pace. And so that's all we have for today on the stages of adrenal fatigue. We've hope that you found this information you For and it helps you understand your body and what's happening to it. Knowledge is often so powerful. And with this knowledge, we hope that you can turn your fear into empowerment and start taking control of your condition. Thanks for listening. And if you found this show helpful, please like the show and subscribe to our channel so we can keep sharing content with you. See you next time and remember that we're always here to empower you to take control of your health.

Unknown: 20:36

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