Posted by bleauberry on December 19, 2007, at 18:16:52
In reply to Things turn 'on' around 7:00, posted by linkadge on December 18, 2007, at 20:49:31
The pattern everyone here has described is experienced by practically everyone who has adrenal fatigue. Cortisol fluctuates and follows a curve through the circadian rhythme. But stress, illness, hidden infections, poor diet, and psychiatric illnesses put so much stress on the adrenal glands that the cortisol curve gets thrown out of sync. It is quite common for there to be an afternoon dip that is worse than any other time of day, usually between 1pm and 4pm. The morning and daytime fatigue and glum mood is the low cortisol; the evening bounce is cortisol on the rise...but at the wrong time.
I had this pattern too. It was so perplexing. Really tired and glum all day. For 2 years every single day the pattern repeated...morning fatigue and depression, a bad sinking in mid afternoon, and a nice bounce in the evening, usually at 7pm, but on rare ocassions when I stayed up later it was even better by midnight. This pattern has mellowed somewhat, but it is still there.
It can be diagnosed with a 24 hour saliva test (4 samples) of salivary cortisol. You can see your curve plotted on a graph and see where the hills and valleys are and how they correlate almost exactly with your mood and energy.
Treatment is tough. Diet is an important basic. Very little sugar. Eliminate or reduce coffee. Focus on meats and veggies, cut down on carbs. But those just set the stage for healing. I've seen in books where doctors heal patients with just diet, but it takes 2 to 3 years.
Adrenal cortex (NOT adrenal glandular) extracts are helpful and usually essential to support the adrenal glands. Allergy Research or Thorne make good ones. Adrenal cortex during the day. Some doctors will prescribe phsyiological replacement doses of hyrdocortisone ranging from 5mg to max 20mg per day. If cortisol is too high at night, phosphatidyle serine will tame it down. The symptoms of it can also be tamed down with gabaergic things like valerian, passion flower, and benzodiazepines.
Though the evening bounce feels good, it is ultimately destructive. As long as that curve is not right, it stresses the entire body and brain in terms of immune response, mood, energy, digestion, and sensitivities.
Some of the psych meds we are all familiar with actually correct the cortisol curve. Some make it worse, such as stimulants or Prozac. Some of our drugs might have even caused it. If you were ever on a drug that caused you longterm anxiety or akathisia, your adrenal glands were taxed to the max. The ones that in research have normalized the cortisol curve are Nardil, Lexapro, Nortriptyline, and St Johns Wort. The common adrenal balancers such as ginsengs and rhodiola mostly tend to reduce cortisol but not balance it. It is my guess that a lot of the antidepressant effect of antidepressants is not due to the direct action on neurotransmitters, but rather the longterm normalizing of the adrenal gland/cortisol axis and its relation to circadian curve as an indirect result of the action on the neurotransmitters. But this takes in the neighborhood of 3 months to occur, so many people who have not improved on their drug by then have long dropped out already and never saw the benefit just around the corner.
I sometimes think of Scott who was a longtimer here. He suffered for so long waiting for Nardil to kick in. What, it must have been 3 months or something like that? Long time. It did finally kick in. I can't help but lean toward the belief that his adrenal/cortisol/circadian axis was at the root of it all and Nardil fixed it. Adrenal problems take time to correct, usually 3 months to 2 years.
Anyway, it is no secret that the adrenal/cortisol/circadian curve is involved in most mood disorders. And it is no surprise that everyone in this thread including me is experiencing a version of the same thing. It's called adrenal fatigue. Easily recognizable, easily diagnosed, correctable but takes time and dedicated strategy. When the curve is right and normalized, that evening bounce we all get is what normal healthy people feel all day long. When the curve is right, everything in our body and brain works. When it isn't, nothing works right.
Sorry so long. Basically, the pattern of daytime fatigue with an evening recovery is typical in almost 100% of people with adrenal fatigue or hypoadrenalism.
poster:bleauberry
thread:801508
URL: http://www.dr-bob.org/babble/20071213/msgs/801626.html