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Oct. 29th, 2010 09:45 amAlaina very kindly pointed me to to this article ( http://www.hormone.org/Public/upload/Adrenal-Fatigue-Web.pdf ), in which some official The Hormone Foundation and The Endocrine Society declare that Adrenal Fatigue (i.e. the mild drop in production of the adrenal glands after prolonged stress, causing a variety of non-specific symptoms) doesn't exist. Adrenal Insufficiency exists, and it is known by a drop in cortisol production and a variety of (more serious) non-specific symptoms, but you see, it's flatly impossible to have a mild version of a more serious problem. Can not happen.
There are some questions about the tests for adrenal fatigue/hypoadrenia/mild adrenal fatigue. My doctor says the saliva test is more precise than the blood test, but maybe she's wrong. But either they're saying the adrenal gland is binary and can only produce two distinct levels of hormone, or they're admitting the current test is only sensitive enough to pick up major drops. Medicine, I know you want to be a Science, but you can't get there by pretending to have more accurate measurement tools than you do.
Or maybe they're simply questioning that mild adrenal insufficiency can be brought on by stress. That seems like sort of a weird proclamation to make. Stress can do all kinds of things. Underestimating stress is a good way to get your name of the idiot side of a conflict in the history books. And it's much easier to come up with a story explaining why stress hurts your adrenal glands than why it hurts your heart, and we know it hurts your heart, so really, why rule it out. Which isn't to say adrenal fatigue is definitely caused by stress: the book I read made a good case for it, but I didn't track down all the studies it cited, nor have I done a literature search to see if they were cherry picking data. But saying "stress can't cause this, therefore it doesn't exist" seems a lot like saying "Demons don't cause disease, therefore I don't have to wash my hands between autopsies and childbirth." The fact that a proposed mechanism is disproven doesn't mean the effect it was trying to explain doesn't exist.
They go on to take some pot shots at compounding pharmacies. Now it's just sort of sad. I'm sure there are occasional rogue compounding pharmacists who get dosages wrong, with serious side consequences, but I'm also sure that a lot of people are taking sub-optimal dosages of medications with negative side effects because it's too hard to cut 6/7ths of a pill. The whole idea of "standard" dosages is stupid. I'm sure there explanations other than a desperate need to herds of patients to explain their hatred of compounding pharmacists, but I'm disinclined to look for them right now.
There are some questions about the tests for adrenal fatigue/hypoadrenia/mild adrenal fatigue. My doctor says the saliva test is more precise than the blood test, but maybe she's wrong. But either they're saying the adrenal gland is binary and can only produce two distinct levels of hormone, or they're admitting the current test is only sensitive enough to pick up major drops. Medicine, I know you want to be a Science, but you can't get there by pretending to have more accurate measurement tools than you do.
Or maybe they're simply questioning that mild adrenal insufficiency can be brought on by stress. That seems like sort of a weird proclamation to make. Stress can do all kinds of things. Underestimating stress is a good way to get your name of the idiot side of a conflict in the history books. And it's much easier to come up with a story explaining why stress hurts your adrenal glands than why it hurts your heart, and we know it hurts your heart, so really, why rule it out. Which isn't to say adrenal fatigue is definitely caused by stress: the book I read made a good case for it, but I didn't track down all the studies it cited, nor have I done a literature search to see if they were cherry picking data. But saying "stress can't cause this, therefore it doesn't exist" seems a lot like saying "Demons don't cause disease, therefore I don't have to wash my hands between autopsies and childbirth." The fact that a proposed mechanism is disproven doesn't mean the effect it was trying to explain doesn't exist.
They go on to take some pot shots at compounding pharmacies. Now it's just sort of sad. I'm sure there are occasional rogue compounding pharmacists who get dosages wrong, with serious side consequences, but I'm also sure that a lot of people are taking sub-optimal dosages of medications with negative side effects because it's too hard to cut 6/7ths of a pill. The whole idea of "standard" dosages is stupid. I'm sure there explanations other than a desperate need to herds of patients to explain their hatred of compounding pharmacists, but I'm disinclined to look for them right now.
