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[Hurdity]

Goodness Brightlight You certainly seem to be doing some reading! Great to try to understand what's going on in your body and sounds like you would benefit from studying human biology!

As you've found out our endocrine system functions less well as we age - as with many of our bodily functions. here is an summary of hormonal changes with ageing:
http://www.nlm.nih.gov/medlineplus/ency/article/004000.htm

And of course there is the wonderful interaction and influence of mind with body and body with mind so that - in terms of chicken and egg - it is both. Our mood is most definitely influenced by our hormones and oestrogen levels have a profound and direct effect here (and I think testosterone too?). This is what fluctuates and then decreases so dramatically at menopauses and gives rise to the bewildering myriad of symptoms that women experience.

The other way round also has a profound effect as you mention Brightlight - ie the negative effect of stress - through external factors - on our physiology and some hormones, and eventually our general health.

For those who don't have the time to grasp how all this works, and the complex mechanisms - then this is the time of life to try to reduce all the current stresses in your life, concentrate on general health and well-being - through diet, exercise, and control of weight, alcohol and smoking, to look for non-chemical ways to cope with hormonally induced anxiety - the best way to improve adrenal function -  and to look at replacing the hormones which become deficient, if you are medically able to do so - ie oestrogen.

Regarding the adrenal glands - the concept of adrenal fatigue is not a recognised condition - and I think originates in US where they have a different health-care system and may well be linked to a product you can buy that claims to cure adrenal fatigue?! There is a rare disorder of the adrenal glands called Addison's disease - but it is unlikley that any of us suffer from this - as far as  I understand adrenal function is not one of the standard tests on NHS except for individuals that could be suspected of this?

In terms of progesterone and the adrenal glands, from what I understand all the steroid hormones that are produced by the adrenal glands orginate from cholesterol and the production will balance itself through homeostatic mechanisms. Not sure where the idea of depleting progesterone comes from in this context but it is important to distinguish between the hormones produced by the adrenal glands and those from the gonads ( sex organs). Men and women produce progesterone - I think in the adrenal glands - in small amounts throughout our life including post-menopausally, which is responsible for a number of functions - I don't know all of this and not sure if it is yet completely understood?

The progesterone that we mostly refer to in our menopausal discussions is produced during the menstrual cycle (before fertilisation) by the corpus luteum ie the empty egg follicle after ovulation. The amounts are huge compared to the amount produced by the adrenal glands. It is this that decreases at menopause - because it is no longer needed for pregnancy, and depletion of this is not related to cortisol or the adrenal glands but the menstrual cycle and ovulation.

I realise the whole subject is extremely complex and there are different physiological processes going on but just wanted to highlight these points!

I don't know why thyroid function in particular seems to be affected in many women as we reach this age. This isn't explained in the link I gave - and haven't yet looked around for a biological explanation from reputable scientific/medical site!

Hope this ramble (really me thinking aloud) is of some interest to someone!! 

Hurdity x

[CLKD]

Dogs suffer from Addison's disease too …...

[BrightLight]

Hi Hurdity - I find it all really interesting

I have been aware of all these things for many years but only just getting a grip on how the stress response might have impacted my own fertility.  In a nutshell what you say about this time of life being an opportunity to look at all areas of lifestlye is the nugget I think is really important. 

My holistic thinking isn't so much about natural products, it's more about recognising that balance is all the body needs and wants to do and that times like menopause or other key changes in physiology or life events challenge that balance.  Although in the US they are indeed 'selling' on the back of theories, I generally agree with the understanding that there are precursors to all eventual imbalances (illness) and by trying to understand our own particular needs we can take care of our health.

The endocrine/hormonal system is vastly under cared for in my opinion, but it's not easy to pinpoint where things go wrong, but generally I do agree with the notion of adrenal fatigue/stress - call it what you will and yes Addisons disease is something different BUT I think that wellbeing and lifestyle factors could be integrated into mainstream healthcare a little more than they are   Doctors could promote the real benefits of relaxation and diet instead of an almost derogatory comment of 'it's just stress'. They could explain the very real impact.

Emotional wellbeing is my particular interest and not so much the biology/science, which I only investigated deeply when after having first hand experience of the body/mind causing problems for me. Coupled with my search for support outside the mainstream from practitioners that explained it to me - practitioners that were working in the mainstream but expanded there training to encompass wellbeing way before an 'illness' took hold.

I have a great diagram which I can't attach here called the "cortisol steal" and it shows clearly that when cortisol is needed any progesterone in the body will be taken - so I thought it did get taken from ovarian sources. (?)  Once stress has intercepted the natural mechanism the source of the problem lies with the adrenals.

The take home message from me, is that nevermind the science, I really think our emotional wellbeing is important for health.

[Rowan]

BrighLight I found this site interesting, I subscribe to his newsletter and always find them thought provoking and certainly don't think to dismiss

them because he is from the US.


http://www.drlam.com/articles/adrenal_fatigue.asp


Another interesting discussion 

http://www.patient.co.uk/forums/discuss/adrenal-fatigue--259115

The best thing for adrenal health is Vitamin C especially if you are stressed.

"Vitamin C is critical for adrenal function. Your body's highest levels of vitamin C are found in the adrenal glands and brain tissues, and the urinary excretion of Vitamin C is increased during stress"

[Hurdity]

Absolutely silverlady - noone should dismiss something just because from the US! I was just pointing out that a lot of these ideas come from the US because of their different health-care system and because people pay for their healthcare which they don't in UK, in the same way!

Here is an appraisal of adrenal fatigue from another US site -  science-based medicine:
http://www.sciencebasedmedicine.org/fatigued-by-a-fake-disease/ Here is the conclusion but the whole article is worth reading:

While adrenal fatigue may not exist, this doesn't mean the symptoms people experience aren't real. These same symptoms could be caused by true medical conditions such as sleep apnea, adrenal insufficiency, or depression. Accepting a fake disease diagnosis from an unqualified practitioner is arguably worse. Patients don't receive a science-based evaluation of their symptoms, and they may be sold unnecessary treatments that are probably ineffective and potentially harmful. There's no question that it would be frustrating to be experiencing fatigue symptoms and then to be told by a health professional that there is nothing medically wrong. But that is arguably better than the distraction of treating a fictitious condition.

I am one of those who would resist the docs giving me any diagnosis of anything with the word fatigue in it or related conditions because I feel it is a cop out - as the underlying problems - be they hormonal, lifestyle etc need investigating - and treating and labelling patients - especially women - does nothing to help them!

Brightlight - I am totally with you on holistic approach and I am a passionate advocate of total lifestyle evaluation and changes if necessary to promote health and well-being into old age! Also I agree emotional well-being is absolutely vital! And - yes it all should be part of main-stream health-care especially as far as women are concerned. Only a few weeks ago or so we were discussing on here that there should be well-woman centres everywhere, where we can go and discuss and be advised on everything, as we enter the peri-menopausal years.

I hope I am practising all of this - my diet is very healthy - almost no processed foods and not much fat or refined carbs, a few selected supplements now and again, trying to keep my weight down ( a struggle at 61!), limited alcohol, limited stress ( sometimes life events make this difficult though), some low dose bio-identical HRT, and 3 x 1 hour exercise classes a week and walks on some other days, being out in the fresh air etc.

I still feel for you regarding your fertility issues and I can see you may have some working through of this and with your partner even at the same time that you are struggling with possible menopause approaching too.

I agree also we need plenty of Vitamin C - I eat lots of fresh fruit and veg including juice and large orange each day. Most people do not have enough fruit and veg in their diet.

Hurdity x

[BrightLight]

SilverLady - I look at Dr Lams website too and pick up some basic tips, most of it is a bit confusing for me - but I have adopted eating small amounts regularly, something before bed, vitamin c, B's and magnesium and plenty of water in an effort to stave off low energy.

Hurdity - sounds to me like you have a good balancing regime going on   I am certain there used to be well woman clinics, or maybe I made that up  

For me - my doctors didn't even mention Chronic Fatigue Syndrome or anything else - in my 20's and again in my 30's I experienced low energy despite rest and admittedly there were big life events around these times, but still, they weren't that interested in helping.  This is where complementary medicine works best in my opinion and why I have continued to use it and avoid the Dr altogether unless it's a chronic/clinical situation.  To be fair Dr's don't have time to integrate their thinking, they triage - look at symptoms, medicate or refer.  They are beginning to recognise low level chronic conditions but overall I think you have to wait untill it becomes acute.

Thank you regards my fertility issues, it's been a horrible few years or more and quite challenging to find my way  - I'll get there.

[honorsmum]

I've found that taking high doses of vitamin C, vitamin D, vitamin B12, vitamin B5 and vitamin B complex, magnesium and iron seems to have made an impact on my fatigue issues.

My GP told me she considers adrenal fatigue, ME, CFS and thyroid issues as a dumping ground for patients whose blood tests show up nothing, but who can't accept a diagnosis of anxiety.  . In response, I'd say that anxiety is a dumping ground for GP s who can't be bothered to look further than blood test results...

[CLKD]

Are you talking about GPs here?  If GPs do the blood tests required relative to patient symptoms then what more should they do?  If a patient returns complaining then they shoudl be refereed to the appropriate Consultant. However, many patients go away and complain to others instead of going back to their GP for resolution. 

I was always aware of my body.  Because of my phobia I have always known what upsets me even when I have been unable to avoid those situations  ……… whilst a person feels fine they get on with whatever, it's when they become more aware of bodily functions and upsets that questions are asked.  I always had event anxiety, it was in the 1990s that it took over completely and I was aware of every breath I took ……..

We had Domestic Science ……… basic 1950s cookery skills, cleaning regimes; we didn't realise have a Class which taught health subjects apart from PE which focussed more on sports rather than the whole person, i.e. diet, hydration, avoiding injury …… we never warmed up for anything, straight onto the field or into the pool  or cross country  … I think sexual education should be followed with body awareness, I suppose that would be biology   but at age 16 did I want to look forwards to how my body might be in my 30s, 60,s 70s ……… it was so far away! and anything I was taught got lost in the mists of time - some of what has been discussed above is vaguely in the back of my mind

[CLKD]

Your GP sounds like she's in the wrong job  ………. if we didn't have problems we wouldn't need GPs  .

My GP could see how my anxiety affected me, I virtually crawled into the surgery …….. he never dismissed my symptoms but worked with me to assist.  When one is feeling ill one is vulnerable and may not 'come across' clearly, but then it is surely up to the GP to work with that person  …….

Is our GP aware that a thyroid function test can come back as 'within normal limits' but that there can still be thyroid dis-function? Her time will come   

[honorsmum]

If, being the operative word,CLKD!
Also, there is the issue of blood test result being taken as absolute. I was told that "blood tests don't lie" and treated for anxiety, when in fact I was very ill with Crohn's. Some blood tests just aren't sensitive enough to be accurate.
Also, some blood test "normal" ranges, eg thyroid, are outdated. Plus, the scope of blood tests offered by GPs is limited - if your basic thyroid test come back as "normal", ie within range, they will not test antibodies which may then diagnose Graves/Hashimoto' s.
And "normal" blood results can be a long way off "optimum", since the acceptable range is so wide, for example, for something like iron.

Then there is the example of something like the FSH test, which may be taken once, on a random day in the cycle, and deemed "normal."

Of course, all of the above assumes that the GP will exhaust the full range of blood tests that the symptoms suggest, before declaring a diagnosis of anxiety...However, more likely that a GP might run a few standard tests (thyroid, kidney and liver function, CRP, FBC) and that will be all.

[CLKD]

Then they should refer to the appropriate Consultant!  I expect many patients come over as anxious in the surgery because they don't know how their complaint will be handled 

[honorsmum]

Then they should refer to the appropriate Consultant!  I expect many patients come over as anxious in the surgery because they don't know how their complaint will be handled 

Agree!
My GP picked up on my tachycardia back in July, while listening to my chest. She commented on it, and I told her I was happy and relaxed. So, she said she'd test my thyroid...results were "normal" and she never looked any further.Fast forward 4 months, and my tachycardia has become unpleasant - a different GP refers me to cardiology immediately.

[CLKD]

Different ways of dealing with patients  or scared of being sued ?

[honorsmum]

Different ways of dealing with patients  or scared of being sued ?

I like to think that one only goes by "computer says..." and the other looks further than just blood tests.
The worst thing is that GP A knows she misdiagnosed my Crohn's as anxiety, yet insists on still trotting out the anxiety line, no matter what symptoms she's presented with!

[cheekygal]

I have had blood tests come back as normal only to receive a phone call 8 weeks later saying actually my white cell count was raised indicating infection and to pick up a prescription for an antibiotic, this was 13 years ago.   However after taking the antibiotic my symptoms resolved.  As it happens some of the symptoms I am having now are like they were back then, aware of my heart beating, chest discomfort, yeuky taste in mouth and headache at one side. 

Also back in April when I had all that stomach pain, my tests were again 'normal' but as some of you will maybe remember I was suffering from a severely inflammed gallbladder, which I have now had removed, can't understand why my white cell count and/or CRP levels weren't raised back then, one GP even suggested I had pulled a muscle!  5 months of horrendous pain and eventually calling an ambulance, WCC was at 18.5, normal range is around 10!

I reckon we all know our own bodies, and if anyone feels they are being fobbed off, go to another GP within the practice.

CG x