Adrenal Fatigue part 5: Worse Than I Thought

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Edit: The results of this test are completely unreliable. For starters, the company was dishonest at the onset of the test. The test claims it analyzes the four saliva tubes throughout the day, but when it came to it, they only analyzed the morning test and threw the others out. Well, you can't very well have an accurate reading of hormone levels if they're not actually tested! I call false advertising and shenanigans on this company. Although I did still have all the symptoms of adrenal fatigue.
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The results came in...late stage adrenal fatigue. The state where, after years and years of compounded stress on a weak adrenal system, my adrenals are just giving up. My dhea levels were extremely low. My cortisol levels and sex hormones, while within normal range, were also very low. In the early stage of afs, the adrenals produce high amounts of cortisol. But eventually they just can't anymore.

The top line is where I should be. The bottom line is where I am. Many people have a reverse graph, where they start really low and then get higher throughout the day. At least mine is going the right direction?

On the upside, it seems like a confirmation that this was the cause of my HG. It's also disappointing because it's worse than I thought. This will be harder and longer to recover from. Every corner I've turned just to find a big, fat sign blaring WAIT! Seems to be a theme. But I don't want to wait! I want to be better now! I want to be healed now! I want to be pregnant now! (Ha. How reflective of our culture, no?) 

I'm taking an adrenal support right now. Not really sure what I do from here. I'm awaiting the micronutrient panel as well. Also not sure how to combine those results with these results. I'm just feeling a whole lot of unknown right now. Everything I've read says "lifestyle changes" and "dietary changes" - and I'm thinking What more could I possibly do?! It's not as though I can just stop mothering.

I'm nervous thinking about delving into healing those area because I know there will be a bazillion opinions out there ranging from insensitive to seemingly impossible. BUT I need to safeguard myself against self pity and helplessness, because that. won't. help. 

In sticking with the theme of this blog, I did find one suggestion about finding ways to increase JOY everyday. That increasing joy naturaly raises dhea levels anyway. So let's bring on some joy in morning!!! (Which is one of the toughest times of day for me, oh man.)

Adrenal Fatigue part 4

The previous post on mitochondrial dysfunction ended with with the question "what about the adrenals?" She mentions liver function over and over, but the adrenals aren't mentioned once! This post will explore if there is a relationship between adrenal fatigue and mitochondrial dysfunction.

First off, let's just talk about the adrenals. The adrenal glands sit atop the kidneys and aren't actually one organ. They are two organs sandwiched together - the adrenal medulla (non-essential for life) and the adrenal cortex (essential for life).  Most of my research has focused on the adrenal cortex. The cortex is in charge of cortisol which assists the body in metabolism (among other essential functions, but the metabolizing of fats, carbs, and proteins is more vital to our purpose, especially as it relates to mitochondria). 

This article discusses adrenal fatigue and its symptoms (note: I've had many of these symptoms for years). It mentions adrenal cortex injections being beneficial, which is what Dr. Kemp gave his HG mamas as a sublingual serum with 100% recovery success. 

I found this very interesting article that discusses the adrenals' role in liver and gallbladder function. In it I learned that high cortisol levels can cause non-alcoholic fatty liver. Also, the body recycles 95% of bile acids from the bowels, and it is cortisol that controls this function. If coritsol levels aren't at their optimum, however, that negatively impacts the gallbladder - one symptom of which is fatigue. So...what came first? I've explored all of these things already in regards to HG. Did HG cause a liver or gallbladder problem? Or was Adrenal Fatigue the underlying condition that caused HG in the first place and, after prolonged insufficiency due to the demands of pregnancy, resulted in gallbladder damage and non-alcoholic fatty liver? These questions are posed, of course, in relation to HG. Clearly liver, adrenal, and gallbladder issues occur independent of pregnancy. 

Of course I haven't even looked at adrenal fatigue AND mitochondria yet...so let's do that now. In short, mitochondrial dysfunction is really, really difficult to determine. It also shares many characteristic symptoms with adrenal fatigue (among other diseases). One good marker is - wait for it! - low glutathione levels. Which is interesting, since glutathione aids in the oxidation stage of the methylation process. (So what role does mitochondria play in methylation?) Many of the nutrients needed in particular for mitochondrial function are: coQ10, carnitine, vit c, glutathione, b complex, trace minerals, marine phytoplanktons (sea food?), vitamin D, magnesium...most of those sound familiar? ALL THE OVERLAP! This article discusses how to treat mitochondrial dysfunction AND adrenal fatigue, if you happen to have them concurrently. It's tricky because treating one could exacerbate the other. Personally, I do not think mitochondrial dysfunction is my problem (mostly because the symptoms do not resonate with me - such as muscle weakness and exhaustion during exercise), but I have also noticed that I do not react well to B vitamins, even in their activated forms and I'm more tired than I've ever been in my life. Which does make me wonder, have I made something worse by trying to target something else? All of this stuff is so off the beaten track (and not even in the "quack" sense), it's frustrating. This article is extremely interesting, though, so please do give it a read. In the end, it seems there is some connection between adrenal fatigue and mitochondrial dysfunction, but it doesn't seem entirely clear what. My own theory, as I understand things so far (someone please inform my ignorance!), is that if the adrenals are in charge of metabolizing fats, proteins, carbs, and nutrients for the entire body and the mitochondria are in charge of breaking down nutrients, glucose, and fatty acids at the cellular level, then the impaired adrenal function comes first. Although, I just wrote that out and two "buts" popped into my head. So. In MY case, I think adrenal function comes first. 

Through reading various articles, I've noticed a strong overlap between adrenal fatigue, mitochondrial dysfunction, and methylation and the nutrients required to support the functions of all of them.  I suppose, realistically, they are all tied together in one way or another as well as being essential for...well...life.

Currently I am awaiting the results of an adrenal test. It was a saliva test that will measure cortisol, dhea, estradiol, testosterone, and progesterone levels over the course of the day. Interesting fact is that I had to take it on the 21st day of my cycle. I love how specific that is. The test is the Endocrine Essential 1, item number 7070. It's also only $99 out of pocket, which is a very good price. 

Additionally, I will be having an intracellular micronutrient panel done. I'm completely geeking out about this one. It will measure everything I've already been researching, which will give me an exact knowledge of what micronutrients my body is lacking: copper, zinc, magnesium, vitamin Bs, glutathione, carnitine, among many other vitamins, nutrients, acids, metabolites, and antioxidants. And if you've been reading this much, you will understand the significance of those specific nutrients listed and are geeking out with me.

I am anxious to get the results back from these tests. I should know about the adrenals by the end of the week. The micronutrient panel won't be for another 5 weeks (2 weeks until my appt, 3 weeks for the results)! I am having some good lessons in patience. Which is good. It's not my strongest area. 

**Unrelated, but I feel a need to mention it. Mitochondrial disease can be inherited. A few years ago the first ever court-awarded vaccine-autism case happened. It was found that the child, Hannah Poling, had an undiagnosed mitochondrial disease that, exacerbated by the vaccinations, resulted in her autism. When I think about my mother and her many physical problems, my own health issues, and some of the frustrations I've had with my daughter, I find myself frequently wondering if she's been spared a starker future because we chose a different vaccine path for her. Genetic predisposition is real. Which is not at all meant to incite a vaccine debate, it's just to say there are deeper problems some of us carry, things they don't test for in those newborn exams. Medicine isn't one-size fits all. And I bring this up because it was the first time I ever heard about mitochondrial disease before starting this HG research.

Ferritin

It was recently suggested to get my ferritin levels to 70, so naturally I had to explore this. Ferritin is the body's store of iron, which is different from hemoglobin. In short, one can be iron-deficient (lacking iron stores, ferritin) but not be anemic (lacking hemoglobin). I was diagnosed as anemic in college and then again during my first pregnancy. In fact, I nearly risked-out of my first Homebirth because my iron levels were too low (I'll have to look up specific numbers and if it looked at ferritin too). Thankfully, with Floradix and an iron-folate-A supplement, the iron levels were increased and my child still had perfect iron levels after 15 months of exclusive breastfeeding (she didn't give a crap about food - it was for the birds).

This article on iron deficiency anemia was interesting to me because many of the symptoms coincide with adrenal fatigue, as do a number of the supplements (ex: b12). Symptoms of fatigue, depression, dizziness. When I was diagnosed with adrenal fatigue, I was also simultaneously diagnosed with anemia. The two are definitely connected, but it's unclear to me which comes first, if there is, indeed, one which does come first. Perhaps it varies. 

The best sources of iron are meat and shellfish, and some foods that inhibit iron absorption are diary, coffee, tea, and chocolate. This is interesting, personally, because I have very few cravings when pregnant, but one has consistently been seafood. My second pregnancy specifically had me craving crab. I have also learned that my body type needs red meat. I can feel the low iron when I don't consistently eat red meat (but I do have aversions to meat when pregnant...go figure). I've also decided to consciously increase my seafood intake to 2-3 times a week, if/when possible.

In my first post on adrenal fatigue there was an article that discussed having functional adrenal levels that, when taxed by pregnancy, resulted in low adrenal function. It seems to be a similar situation with the ferritin. Perhaps one has functional Ferritin levels, but, with the increased demand caused by pregnancy, the levels become low and readily depleted. 

So next up is an iron test specifically to measure my ferritin levels. 

Mitochondrial Dysfunction and HG (or Adrenal Fatigue part 3)

Mitochondria...the word conjures up an image of a picture I had to draw of a magnified mitochondria. It was either middle school or high school. I recall being very proud of the finished product...I wonder if it's stashed away anywhere...hmmm...

Google def: 

1. an organelle found in large numbers in most cells, in which the biochemical processes of respiration and energy production occur. It has a double membrane, the inner layer being folded inward to form layers (cristae).

Rachel over at HyperG Pregnancy sent me a link about mitochondrial dysfunction and HG. Fascinating, complex stuff. Dr. Chandler, the author of the article, began comparing HG to other diseases caused by mitochondrial dysfunctions that involved vomiting. She found that in the other "disease processes...severe, ‘unexplained’ nausea and vomiting are present and, more importantly, share mitochondrial components in the form of deficient fatty acid oxidation." She goes on to say that "a critical component of mitochondrial energy production is impaired within the liver (and likely elsewhere) that hinders the liver’s capacity to metabolize fatty acids and detoxify metabolic waste products effectively." So, basically fatty acids can't get processed and the body needs to eliminate them - ergo, vomit. That's her theory anyway.

It seems like there is a lot of minute overlaps in the article and what I've already researched, which I'll note below:

- Mitochondria are responsible for breaking down nutrients and giving energy to cells. One of the key roles they have is breaking down fatty acids. Carnitine - an amino acid micronutrient - is necessary for metabolizing fatty acids (as well as glucose). Carnitine is derived through diet (meat - particularly beef, dairy...), but a leaky gut or poor bacterial balance can prevent proper absorption of this essential nutrient. I found that last part to be particularly interesting, considering the previous post on gut health and HG. (Perhaps unrelated, but I'm also convinced, more than ever, that a vegetarian lifestyle is not a pro-fertility lifestyle.)
- The article mentions "that supplementation with L-carnitine also appears to offset liver damage and improve liver function " in an animal-study (specific to acetominophen damage to the liver). Which, I found interesting because that's what Milk Thistle does, too; it helps the liver repair itself. 

- In the HyperG podcast on methylation, genetics, and HG, Dr. Tim specifically mentions that the heart and the liver are particularly mitochondrially dense. Now I want to re listen to that podcast! I think he also mentioned something about carnitine supporting the oxidation stage of the methylation process. But don't quote me on that yet. 

While reading through the article, though, I couldn't help but think "what about the adrenals?" She mentions liver function over and over, but the adrenals - secretions of which are necessary for full liver function - aren't mentioned once! So, of course, adrenal fatigue and mitochondria need to looked up. I will address that topic in another post. 

Adrenal Fatigue part 2

I have been thinking back on first being diagnosed with adrenal fatigue. I'm seeing some overlap from then and now. I remember having to take a magnesium supplement and a (horrible tasting!) B complex. The Dr. told me that the body needs magnesium to stay asleep, and if I'm not getting enough magnesium, then my body will just wake up when it runs out. Seeing the overlap? Magnesium....B vitamins....

What's the next step? is what I keep thinking. I did the at-home adrenal test of my eye contraction/dilation. I did this in college too. Instead of remaining contracted for 1-2 minutes, my eyes would dilate again after barely 5 seconds. no bueno. I now understand why my eyes hurt so much when driving at night....oh, and also anytime outside.

So I think the next step is a saliva test that measures my cortisol levels over the course of a day. I've already got an appointment scheduled with my dr...but i have to wait and that's stressful! I also have an appt with my dentist tomorrow for help with my chronic clenching due to alignment issues.

And I'll be honest....I'm exhausted. Maybe it's the heat or the blogging or the researching or just the reality of life and mothering etc...I am dead tired every afternoon. I'm getting more sleep than I have in a really, really long time (thanks magnesium and B vitamins!), yet wake up exhausted still. Why do I STILL have this problem so many years out? Even with a much better diet? It answers so many other issues I've dealt with - especially the myriad after my 2nd birth (inability to heal from a mild tear, low testosterone, PPD for 2 years, falling asleep while driving and eventually totaling our car - and God had so much mercy on me because I was milliseconds away from a head-on with a pick-up, funky milk supply - not low, but off....among other things). I don't know why, but I didn't want to believe I had something. I still don't want to have something. But it's also something that's fixable. Which is silly to try and fight against. Especially if it's my answer.

Copper and Zinc

There seems to be a strong connection with copper/zinc imbalances, low zinc, and low magnesium and HG. You can read about it here, here, and here (the latter has a commenter testimony about copper deficiency causing her HG). HyperGPregnancy suggests having an RBC Magnesium draw done which tests all three levels. I don't know about you...but I have copper pipes. There's not much more to add to this, other than it's another possible factor for some women with HG. Of which, I am more certain than ever, that there is not just one cause, but many possible causes.

Adrenal Fatigue and HG

I'm not sure why, but adrenals have been on my mind. Maybe it's because I tried the very low carb diet and was exhausted beyond anything I've ever experienced, only to learn that the vlc is not good for those with adrenal fatigue. I've always questioned my being diagnosed with adrenal fatigue back in college, but maybe it was accurate. I was under chronic stress, to the point where I became anemic and would black out for a second upon standing up. I had to go to bed at 9 pm in order to function. I would cry at the drop of a hat. I was depressed. Among other things. The more extreme symptoms were gone before my first pregnancy, but lately I've been wondering if maybe there are some lingering adrenal problems. In fact, while en route to an herbal class recently I was taking a mental note to research the relationship between adrenal fatigue and HG, and what herb did we then learn about? Borage - one that calms the endocrine system. It was Providence!

I'm pretty floored at what I'm reading right now in the Journal of Orthomolecular Medicine.  In 1933 a Dr. Kemp argued that HG is a result of subclinical, temporary adrenal cortex insufficiency. He reasoned that:

"Prior to pregnancy some women have suffcient adrenocortical function just able to meet their physiological demands. However, when these same women become pregnant they experience a temporary adrenocortical insuffciency until their adrenal cortex hypertrophies suffciently (usually at the end of the third month) to produce adequate amounts of hormone to meet the demands of their remaining pregnancies. " (pg. 70)

Dr. Kemp successfully treated cases of HG with a physiological (as opposed to pharmacological) dose of adrenal coritcol extract (bovine sourced) taken subcutaneously.  There have been modern studies based off of Kemp's theories that were less successful (Dr. Kemp's clients made an immediate and complete recovery from HG). However,

 "None of these modern reports used physiological doses of cortisol as a treatment approach. Kemp’s work showed that physiological doses of adrenal cortical extract possess therapeutic value in keeping NVP (nausea and vomiting in pregnancy) from progressing to HG. For patients that progress to HG, highdose steroid therapy appears to be indicated based on the best and most current available evidence. It appears more likely that physiological doses of cortisol when given during the first trimester of pregnancy might serve to prevent the onset of HG, and thus eliminate the need to resort to hospital admission and high-dose steroid therapy. Given the possibility that early pregnancy does represent a state of “relative adrenal insuffciency,” the use of physiological doses of cortisol to prevent HG should be more formally studied. " (pg. 72)

Dr. Kemp's original study is here. Bless his soul - he argues for his sick mamas, during a time when HG women were told it was purely psychological. He notes in his research that because of the lack of adequate adrenal function, "the liver bears the brunt of the pathological changes from this grave disturbance in body chemistry while degenerative changes also take place in the kidneys." I have read that liver and kidney diseases can result from HG. He goes on to postulate that "the liver only exercises its manifold and excessive functions in the presence of an adequate supply of a catalyst or autocoid (possibly several) which is a secretion of the adrenal cortex." - HOLY LIVER!!!! So, I could do everything to help my liver, but if my adrenals aren't functioning fully, neither will my liver. This is sobering.

There have been multiple instances where I've been encouraged to take a cortisol test. Maybe I ought to, finally, look into this.

I'm having a moment right now. A "THIS IS IT" moment. I truly, truly think this is the root of my problem. I am part of the 1% of women that suffer from HG. I am further part of the 10% of that 1% that suffer for the entire pregnancy. I'm not saying this is the "across the board" root for all HG mamas, because I think there are many underlying causes, but for me....my intuition is screaming and crying within me... this is it!