Adrenal Fatigue is Real and it Should be an Accepted Diagnosis

In today’s broadcast we will discuss why Adrenal Fatigue is a real entity affecting millions of Americans, and why this gland has been neglected by our current health care system to date.  We will discuss the most up to date information regarding the adrenals, and how they are intimately involved with depression, anxiety, PTSD, burnout, emotional exhaustion, and those who have perfectionism.  Please enjoy.
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1.Pilot study of adrenal steroid hormones in hair as an indicator of chronic mental and physical stress.
Ullmann E, Barthel A, Petrowski K, Stalder T, Kirschbaum C, Bornstein SR.
Sci Rep. 2016 May 12;6:25842. doi: 10.1038/srep25842.
PMID: 27174654 [PubMed – in process] Free Article
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2.[Stress and psychotic transition: A literature review].
Chaumette B, Kebir O, Mam Lam Fook C, Bourgin J, Godsil BP, Gaillard R, Jay TM, Krebs MO.
Encephale. 2016 May 6. pii: S0013-7006(16)30064-1. doi: 10.1016/j.encep.2015.10.001. [Epub ahead of print] French.
PMID: 27161263 [PubMed – as supplied by publisher]
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3.Reduced hypothalamic-pituitary-adrenal axis activity in chronic multi-site musculoskeletal pain: partly masked by depressive and anxiety disorders.
Generaal E, Vogelzangs N, Macfarlane GJ, Geenen R, Smit JH, Penninx BW, Dekker J.
BMC Musculoskelet Disord. 2014 Jul 9;15:227. doi: 10.1186/1471-2474-15-227.
PMID: 25007969 [PubMed – indexed for MEDLINE] Free PMC Article
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4.Increased cortisol awakening response was associated with time to recurrence of major depressive disorder.
Hardeveld F, Spijker J, Vreeburg SA, Graaf RD, Hendriks SM, Licht CM, Nolen WA, Penninx BW, Beekman AT.
Psychoneuroendocrinology. 2014 Dec;50:62-71. doi: 10.1016/j.psyneuen.2014.07.027. Epub 2014 Aug 12.
PMID: 25179322 [PubMed – indexed for MEDLINE]
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5.Corticotropin-releasing hormone and the hypothalamic-pituitary-adrenal axis in psychiatric disease.
Naughton M, Dinan TG, Scott LV.
Handb Clin Neurol. 2014;124:69-91. doi: 10.1016/B978-0-444-59602-4.00005-8.
PMID: 25248580 [PubMed – in process]
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6.Hypothalamic-pituitary-adrenal axis activity in older persons with and without a depressive disorder.
Rhebergen D, Korten NC, Penninx BW, Stek ML, van der Mast RC, Oude Voshaar R, Comijs HC.
Psychoneuroendocrinology. 2015 Jan;51:341-50. doi: 10.1016/j.psyneuen.2014.10.005. Epub 2014 Oct 12.
PMID: 25462906 [PubMed – indexed for MEDLINE]
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7.GABA Signaling and Neuroactive Steroids in Adrenal Medullary Chromaffin Cells.
Harada K, Matsuoka H, Fujihara H, Ueta Y, Yanagawa Y, Inoue M.
Front Cell Neurosci. 2016 Apr 18;10:100. doi: 10.3389/fncel.2016.00100. eCollection 2016. Review.
PMID: 27147972 [PubMed] Free PMC Article
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8.Clinical Potential of Neurosteroids for CNS Disorders.
Reddy DS, Estes WA.
Trends Pharmacol Sci. 2016 May 5. pii: S0165-6147(16)30004-9. doi: 10.1016/ [Epub ahead of print] Review.
PMID: 27156439 [PubMed – as supplied by publisher]
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9.Peripartum neuroactive steroid and ?-aminobutyric acid profiles in women at-risk for postpartum depression.
Deligiannidis KM, Kroll-Desrosiers AR, Mo S, Nguyen HP, Svenson A, Jaitly N, Hall JE, Barton BA, Rothschild AJ, Shaffer SA.
Psychoneuroendocrinology. 2016 May 9;70:98-107. doi: 10.1016/j.psyneuen.2016.05.010. [Epub ahead of print]
PMID: 27209438 [PubMed – as supplied by publisher]
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10.Blood allopregnanolone levels in women with polycystic ovary syndrome.
Saito K, Matsuzaki T, Iwasa T, Miyado M, Saito H, Kubota T, Irahara M, Ogata T, Fukami M.
Clin Endocrinol (Oxf). 2016 Apr 8. doi: 10.1111/cen.13080. [Epub ahead of print]
PMID: 27061737 [PubMed – as supplied by publisher]
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11.Elevated cortisol in healthy female adolescent offspring of mothers with posttraumatic stress disorder.
Liu K, Ruggero CJ, Goldstein B, Klein DN, Perlman G, Broderick J, Kotov R.
J Anxiety Disord. 2016 May;40:37-43. doi: 10.1016/j.janxdis.2016.04.003. Epub 2016 Apr 4.
PMID: 27088877 [PubMed – in process]
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12.Short-term environmental enrichment is sufficient to counter stress-induced anxiety and associated structural and molecular plasticity in basolateral amygdala.
Ashokan A, Hegde A, Mitra R.
Psychoneuroendocrinology. 2016 Apr 11;69:189-196. doi: 10.1016/j.psyneuen.2016.04.009. [Epub ahead of print]
PMID: 27128967 [PubMed – as supplied by publisher]
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13.Anxiety- and Depression-Like States Lead to Pronounced Olfactory Deficits and Impaired Adult Neurogenesis in Mice.
Siopi E, Denizet M, Gabellec MM, de Chaumont F, Olivo-Marin JC, Guilloux JP, Lledo PM, Lazarini F.
J Neurosci. 2016 Jan 13;36(2):518-31. doi: 10.1523/JNEUROSCI.2817-15.2016.
PMID: 26758842 [PubMed – indexed for MEDLINE]
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14.The association of post-stroke anhedonia with salivary cortisol levels and stroke lesion in hippocampal/parahippocampal region.
Terroni L, Amaro E Jr, Iosifescu DV, Mattos P, Yamamoto FI, Tinone G, Conforto AB, Sobreiro MF, Guajardo VD, De Lucia MC, Moreira AC, Scaff M, Leite CC, Fraguas R.
Neuropsychiatr Dis Treat. 2015 Feb 3;11:233-42. doi: 10.2147/NDT.S73722. eCollection 2015.
PMID: 25678790 [PubMed] Free PMC Article
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15.The impact of social isolation on HPA axis function, anxiety-like behaviors, and ethanol drinking.
Butler TR, Ariwodola OJ, Weiner JL.
Front Integr Neurosci. 2014 Jan 2;7:102. doi: 10.3389/fnint.2013.00102. eCollection 2014.
PMID: 24427122 [PubMed] Free PMC Article
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16.Salivary cortisol levels and the 2-year course of depressive and anxiety disorders.
Vreeburg SA, Hoogendijk WJ, DeRijk RH, van Dyck R, Smit JH, Zitman FG, Penninx BW.
Psychoneuroendocrinology. 2013 Sep;38(9):1494-502. doi: 10.1016/j.psyneuen.2012.12.017. Epub 2013 Jan 11.
PMID: 23313277 [PubMed – indexed for MEDLINE] Free Article
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17.The relationships of working conditions, recent stressors and childhood trauma with salivary cortisol levels.
Holleman M, Vreeburg SA, Dekker JJ, Penninx BW.
Psychoneuroendocrinology. 2012 Jun;37(6):801-9. doi: 10.1016/j.psyneuen.2011.09.012. Epub 2011 Oct 13.
PMID: 22000684 [PubMed – indexed for MEDLINE] Free Article
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18.Cortisol responses on the dexamethasone suppression test among women with Bulimia-spectrum eating disorders: associations with clinical symptoms.
Bruce KR, Steiger H, Israël M, Groleau P, Ng Ying Kin NM, Ouellette AS, Sycz L, Badawi G.
Prog Neuropsychopharmacol Biol Psychiatry. 2012 Aug 7;38(2):241-6. doi: 10.1016/j.pnpbp.2012.04.006. Epub 2012 May 1.
PMID: 22575215 [PubMed – indexed for MEDLINE]
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19.Chronic overexpression of corticotropin-releasing factor from the central amygdala produces HPA axis hyperactivity and behavioral anxiety associated with gene-expression changes in the hippocampus and paraventricular nucleus of the hypothalamus.
Flandreau EI, Ressler KJ, Owens MJ, Nemeroff CB.
Psychoneuroendocrinology. 2012 Jan;37(1):27-38. doi: 10.1016/j.psyneuen.2011.04.014. Epub 2011 May 26.
PMID: 21616602 [PubMed – indexed for MEDLINE] Free PMC Article
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20.Cortisol dysregulation in school teachers in relation to burnout, vital exhaustion, and effort-reward-imbalance.
Bellingrath S, Weigl T, Kudielka BM.
Biol Psychol. 2008 Apr;78(1):104-13. doi: 10.1016/j.biopsycho.2008.01.006. Epub 2008 Feb 2.
PMID: 18325655 [PubMed – indexed for MEDLINE]
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21.Vasopressin and the regulation of hypothalamic-pituitary-adrenal axis function: implications for the pathophysiology of depression.
Scott LV, Dinan TG.
Life Sci. 1998;62(22):1985-98. Review.
PMID: 9627097 [PubMed – indexed for MEDLINE]
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22.[Neuro-endocrine correlates of burnout].
Verhaeghe J, Van Den Eede F, Van Den Ameele H, Sabbe BG.
Tijdschr Psychiatr. 2012;54(6):517-26. Review. Dutch.
PMID: 22753184 [PubMed – indexed for MEDLINE] Free Article
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23.Exhaustion and endocrine functioning in clinical burnout: an in-depth study using the experience sampling method.
Sonnenschein M, Mommersteeg PM, Houtveen JH, Sorbi MJ, Schaufeli WB, van Doornen LJ.
Biol Psychol. 2007 May;75(2):176-84. Epub 2007 Feb 20.
PMID: 17379387 [PubMed – indexed for MEDLINE]
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24.The role of BDNF and HPA axis in the neurobiology of burnout syndrome.
Onen Sertoz O, Tolga Binbay I, Koylu E, Noyan A, Yildirim E, Elbi Mete H.
Prog Neuropsychopharmacol Biol Psychiatry. 2008 Aug 1;32(6):1459-65. doi: 10.1016/j.pnpbp.2008.05.001. Epub 2008 May 8.
PMID: 18541357 [PubMed – indexed for MEDLINE]
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25.Emotional exhaustion and overcommitment to work are differentially associated with hypothalamus-pituitary-adrenal (HPA) axis responses to a low-dose ACTH1-24 (Synacthen) and dexamethasone-CRH test in healthy school teachers.
Wolfram M, Bellingrath S, Feuerhahn N, Kudielka BM.
Stress. 2013 Jan;16(1):54-64. doi: 10.3109/10253890.2012.683465. Epub 2012 May 16.
PMID: 22564145 [PubMed – indexed for MEDLINE]
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26.Elevated diurnal salivary cortisol in nurses is associated with burnout but not with vital exhaustion.
Wingenfeld K, Schulz M, Damkroeger A, Rose M, Driessen M.
Psychoneuroendocrinology. 2009 Sep;34(8):1144-51. doi: 10.1016/j.psyneuen.2009.02.015. Epub 2009 Mar 24.
PMID: 19321266 [PubMed – indexed for MEDLINE]
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27.Chronic psychosocial factors and acute physiological responses to laboratory-induced stress in healthy populations: a quantitative review of 30 years of investigations.
Chida Y, Hamer M.
Psychol Bull. 2008 Nov;134(6):829-85. doi: 10.1037/a0013342. Review. Erratum in: Psychol Bull. 2009 Sept;135(5):793.
PMID: 18954159 [PubMed – indexed for MEDLINE]
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28.Perfectionism and the cortisol response to psychosocial stress in men.
Wirtz PH, Elsenbruch S, Emini L, Rüdisüli K, Groessbauer S, Ehlert U.
Psychosom Med. 2007 Apr;69(3):249-55. Epub 2007 Apr 9.
PMID: 17420440 [PubMed – indexed for MEDLINE]
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29.Burnout and risk of cardiovascular disease: evidence, possible causal paths, and promising research directions.
Melamed S, Shirom A, Toker S, Berliner S, Shapira I.
Psychol Bull. 2006 May;132(3):327-53. Review.
PMID: 16719565 [PubMed – indexed for MEDLINE]
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30.Actual stress, psychopathology and salivary cortisol levels in the irritable bowel syndrome (IBS).
Patacchioli FR, Angelucci L, Dellerba G, Monnazzi P, Leri O.
J Endocrinol Invest. 2001 Mar;24(3):173-7.
PMID: 11314746 [PubMed – indexed for MEDLINE]
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31.Relationships between exhaustive mood state and changes in stress hormones following an ultraendurance race.
Odagiri Y, Shimomitsu T, Iwane H, Katsumura T.
Int J Sports Med. 1996 Jul;17(5):325-31.
PMID: 8858402 [PubMed – indexed for MEDLINE]
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32.Effects of hyperactivity of the maternal hypothalamic-pituitary-adrenal (HPA) axis during pregnancy on the development of the HPA axis and brain monoamines of the offspring.
Fameli M, Kitraki E, Stylianopoulou F.
Int J Dev Neurosci. 1994 Nov;12(7):651-9.
PMID: 7900547 [PubMed – indexed for MEDLINE]
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33.Stress contagion in the classroom? The link between classroom teacher burnout and morning cortisol in elementary school students.
Oberle E, Schonert-Reichl KA.
Soc Sci Med. 2016 Apr 24;159:30-37. doi: 10.1016/j.socscimed.2016.04.031. [Epub ahead of print]
PMID: 27156042 [PubMed – as supplied by publisher]
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34.Burnout Is Associated with Reduced Parasympathetic Activity and Reduced HPA Axis Responsiveness, Predominantly in Males.
de Vente W, van Amsterdam JG, Olff M, Kamphuis JH, Emmelkamp PM.
Biomed Res Int. 2015;2015:431725. doi: 10.1155/2015/431725. Epub 2015 Oct 18.
PMID: 26557670 [PubMed – in process] Free PMC Article
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35.[The physiological features of overstrain formation in mental work and its prevention].
Bukhtiiarov IV, Iushkova OI, Matiukhin VV, Kuz’mina LP, Kapustina AV, Poroshenko AS, Kalinina SA, Oniani XT.
Ross Fiziol Zh Im I M Sechenova. 2014 Nov;100(11):1324-34. Russian.
PMID: 25665411 [PubMed – indexed for MEDLINE]
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36.The medical perspective on burnout.
Kakiashvili T, Leszek J, Rutkowski K.
Int J Occup Med Environ Health. 2013 Jun;26(3):401-12. doi: 10.2478/s13382-013-0093-3. Epub 2013 Sep 10. Review.
PMID: 24018996 [PubMed – indexed for MEDLINE] Free Article
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37.Overtraining, Exercise, and Adrenal Insufficiency.
Brooks K, Carter J.
J Nov Physiother. 2013 Feb 16;3(125). pii: 11717.
PMID: 23667795 [PubMed] Free PMC Article
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38.A two-year follow-up study of salivary cortisol concentration and the risk of depression.
Grynderup MB, Kolstad HA, Mikkelsen S, Andersen JH, Bonde JP, Buttenschøn HN, Kærgaard A, Kærlev L, Rugulies R, Thomsen JF, Vammen MA, Mors O, Hansen AM.
Psychoneuroendocrinology. 2013 Oct;38(10):2042-50. doi: 10.1016/j.psyneuen.2013.03.013. Epub 2013 Apr 15.
PMID: 23597874 [PubMed – indexed for MEDLINE]
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39.Cortisol responses to naturalistic and laboratory stress in student teachers: comparison with a non-stress control day.
Wolfram M, Bellingrath S, Feuerhahn N, Kudielka BM.
Stress Health. 2013 Apr;29(2):143-9. doi: 10.1002/smi.2439. Epub 2012 Aug 9.
PMID: 22888074 [PubMed – indexed for MEDLINE]
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40.A follow-up of cognitive performance and diurnal salivary cortisol changes in former burnout patients.
Österberg K, Karlson B, Malmberg B, Hansen ÅM.
Stress. 2012 Nov;15(6):589-600. doi: 10.3109/10253890.2011.648972. Epub 2012 Jan 24.
PMID: 22168599 [PubMed – indexed for MEDLINE]
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41.A clinical allostatic load index is associated with burnout symptoms and hypocortisolemic profiles in healthy workers.
Juster RP, Sindi S, Marin MF, Perna A, Hashemi A, Pruessner JC, Lupien SJ.
Psychoneuroendocrinology. 2011 Jul;36(6):797-805. doi: 10.1016/j.psyneuen.2010.11.001. Epub 2010 Dec 3.
PMID: 21129851 [PubMed – indexed for MEDLINE]
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42.The role of corticosteroids and stress in chronic pain conditions.
McEwen BS, Kalia M.
Metabolism. 2010 Oct;59 Suppl 1:S9-15. doi: 10.1016/j.metabol.2010.07.012. Review.
PMID: 20837196 [PubMed – indexed for MEDLINE]
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43.Inflammation as a psychophysiological biomarker in chronic psychosocial stress.
Hänsel A, Hong S, Cámara RJ, von Känel R.
Neurosci Biobehav Rev. 2010 Sep;35(1):115-21. doi: 10.1016/j.neubiorev.2009.12.012. Epub 2009 Dec 22. Review.
PMID: 20026349 [PubMed – indexed for MEDLINE]
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44.Suppressed neuroendocrine stress response in depressed women on job-stress-related long-term sick leave: a stable marker potentially suggestive of preexisting vulnerability.
Wahlberg K, Ghatan PH, Modell S, Nygren A, Ingvar M, Asberg M, Heilig M.
Biol Psychiatry. 2009 May 1;65(9):742-7. doi: 10.1016/j.biopsych.2008.10.035. Epub 2008 Dec 5.
PMID: 19058782 [PubMed – indexed for MEDLINE] Free PMC Article
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45.Cortisol in burnout and vital exhaustion: an overview.
Kudielka BM, Bellingrath S, Hellhammer DH.
G Ital Med Lav Ergon. 2006 Jan-Mar;28(1 Suppl 1):34-42.
PMID: 19031555 [PubMed – indexed for MEDLINE]
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46.Cognitive performance in patients with burnout, in relation to diurnal salivary cortisol.
Osterberg K, Karlson B, Hansen AM.
Stress. 2009 Jan;12(1):70-81. doi: 10.1080/10253890802049699.
PMID: 18951245 [PubMed – indexed for MEDLINE]
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