Dr. Marie Tholl-Pappas

Dr. Dino Pappas

FATIGUE

Adrenal Fatigue “Bible”

• Scope of the Problem– “It is estimated that 80%

of adult Americans suffer some level of adrenal fatigue at some time during their life, yet it remains one of the most under-diagnosed illnesses in the US.” – James Wilson, ND, DC, PhD (Adrenal Fatigue Expert)

• Patient Friendly Text on the Topic

Key Organs That Respond To Stress

General Adaptation Syndrome

• Phase 1 = Acute Stress• Phase 2 =Coping,

Resistance & Adaptation

• Phase 3 = Exhaustion (body can’t cope)– Fatigue Sets In– Open Window Theory

• An open window for chronic disease (Diabetes, Fibromyalgia, Chronic Fatigue Syndrome, Thyroid Disease, Cancer, Etc.)

The Importance of Kidney & Adrenal Hormone Balance

• Role of Kidney & Adrenal Hormones (Cortisol, Steroid Hormones & Epinephrine)– Control swelling & inflammation– Treat allergy symptoms– Cancer treatment & prevention– Assist with infection management– Immune & Auto-immune Disorders– Affect use & storage of carbs, proteins & fats– Assist with blood sugar regulation– Blood pressure regulation– Electrolyte Balance– Anti-oxidant function– Assist with sex hormone production (ex: menopausal women)– Sex Drive– Performance (Athletic, Academic, Recreational, Etc.)

Overwhelmed Stress Response

End Result of Chronic Stress = Disease

• Other Conditions– PMS– Severe Menopause

Symptoms– Insomnia

– Frequent Infections– Hypoglycemia– Alcoholism

Signs & Symptoms of Adrenal Fatigue• Difficulty getting up in the

morning• Fatigue not relieved by sleep• Craving salty foods, sugary

foods or stimulants (caffeine)

• Lack of energy

• Increased effort to do every day tasks

• Decreased sex drive

• Decreased ability to handle stress

• Increased time to recover from illness, injury or trauma– *** Key Tip Off: Chronic

respiratory infections with a longer recovery period ***

• Mild depression• Increased PMS

• Increased symptoms with skipped meals

• Less focused thoughts

• Hard time remembering things

• Decreased tolerance

• Don’t wake up till 10:00 AM or later

• Afternoon (after lunch) “blues”• Feel better after evening meal• Decreased productivity

• Light headed when getting up

Steps to Identification & Recovery• Step 1: Adrenal

Fatigue Questionnaire http://www.canhealyourself.com/adrenaltest.pdf

• Step 2: Comprehensive Exam – Physical– Orthopedic– Neurological – Special Tests (Postural

Blood Pressure & Pupil Contraction)

• Step 3: Lab Testing (As Needed)– Saliva Hormone Testing

– Urinalysis– Blood Work

• Step 4: Formulate a Treatment Plan

• Step 5: Implement Specific Recommendations

• Step 6: Re-evaluate

Step 3: Laboratory Testing As Needed

• Saliva Hormone Testing – Can be used to measure cortisol, steroid & sex

hormones – Best single lab test for adrenal fatigue– Indicative of the actual hormone in the cell where

reactions take place & not the bloodstream– Easy to perform & Non-invasive– Can be used to test & retest– Recommended at least 4 Tubes (Morning, Noon,

Afternoon & Night)• Date & time of collection are written on all tubes & kept

in a journal• More tubes may be used to measure “lows” & “highs”

Saliva cortisol levels are low in the morning and high at night. This person has trouble waking up, is just fine in the middle of the day and can’t sleep at night.

Saliva cortisol levels are just fine in the morning, fine in the afternoon and high at night. This patient has trouble falling asleep at night.

Saliva cortisol levels are fine in the morning, dip middle of the day and return to normal at night. This patient has the afternoon blues.

Saliva cortisol levels are low in the morning, low middle of the day and normal at night. This patient has trouble getting up, has the afternoon blues, low energy in the evening and goes to sleep exhausted.

Questions

• Contact Info– 9442 W. 179th Street –

Tinley Park, IL 60487– Office: 708-532-CFIM

(2346)– Email:

• Office: thecfim@gmail.com• Dr. Marie:

marie.tholldc@gmail.com• Dr. Dino:

drdinopappas@gmail.com