More From Dr. nco.

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This Dr. nco to me is a great man.

A cut & paste of a post he did today at MESO.

Phil

Adrenal Glands

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Quote:

Originally Posted by love_en

I am curious to know, why is this not required reading for doctors

of internal medicine and endocrinologists? The knowledge presented

in this book is important to anyone interested in optimal function

of the body. It has been said by many that cortisol is the hormone

of life and death.

The problem of adrenal dysfunction is that is mimics so many other

illnesses. Each specialist then looks at the symptoms from their

point of view - completely missing the underlying dysfunction of the

adrenal glands - attributing the symptoms to an illness they

understand instead in their field. For example, when a person

complains about joint pain, an internist may think about arthritis.

When a person complains about sexual dysfunction, the primary care

physician may think about hypogonadism at best, Viagra at most, not

about adrenal fatigue (look at how many people on this board post

their testosterone and estrogen levels but have no progesterone,

DHEA, or cortisol levels done). When a person has anxiety, mood

swings, depressed mood, insomnia, irritability, lack of energy,

impaired concentration, the usual psychiatrist sees an anxiety or

depressive disorder, completely missing adrenal fatigue. The

endocrine tests, except for thyroid hormone, are rarely if at all

routinely done by psychiatrists (amazingly since textbooks always

talk about how depression and anxiety are linked to hypothalamic-

pituitary-adrenal axis dysfunction). Often, when a person has

chronic fatigue, internists do not think about adrenal fatigue -

given how it is not recognized as an illness by endocrinologists.

Endocrinologists haven't helped because they have limited their

specialty to only the extremes of endocrine illnesses (e.g. Adrenal

dysfunction = 's Disease and Cushing's Disorder). I think the

problem for Endocrinologists is that they do not link hormonal

dysfunction to the function of other systems. For example, they have

no idea how hormones affect the brain since their knowledge about

the brain stops at the hypothalamus.

Only by practicing integrative medicine - where the physician

practices a fusion of specialties - does the physician see the

forest before the trees - i.e. see how everything is hooked together

in function.

In a way, the problem of conventional medicine is that too many

practitioners stay within the box of their own specialty - never

linking with ideas from other specialties to form a whole or global

concept of functioning and illness. For example, psychiatrists often

cannot accept an endocrine or immune system explanation of mental

illness because it is thought to be " outside " the brain and is thus

a physical rather than mental illness. To me, mental illnesses

always have a physical component. This is a very different point of

view of what mental illness is.

Another problem is that " Integrative Medicine " practitioners do not

integrate knowledge of system functioning. Rather, they integrate

conventional medicine with alternative medicine treatments - herbal

medicines, various forms of meditation/physical therapy, etc.

From my point of view, I integrate sociology, psychology,

psychiatry, neurology, endocrinology, and immunology because the

nervous system, endocrine system, and immune system are really one

integrated information processing system who's function is to adapt

to external and internal stresses in order to promote survival of

the organism (i.e. one's individual identity and functioning - where

identity can even extend to the notion of family and societal

group).

In order to see the forest before the trees, one also has to have

both depth and breadth of knowledge. That is actually difficult to

achieve. One has to understand things from the atomic, organic

chemistry, biochemistry level to organ system functioning, to the

functioning of the individual in society. That is a huge area to

cover. One of my friends, who is an assistant professor of

psychiatry at a major medical school told me that if what I do is

taught to medical residents, it would extend psychiatry residency by

several years.

Remember that Jeffries only has depth of knowledge in cortisol and

adrenal function. How much knowledge does he have about pancreatic,

thyroid, gonadal hormone function? How does he tie it in together

with brain function? As one of my attending physicians told me - " If

you only talk about what you know, you will look like a genius. "

Family practice has a chance to do integrative medicine that

recognizes endocrine relationships such as adrenal fatigue. The

problem is that manage care has warped the field by allowing only 6

minutes per patient visit in order to break even.

The field which has the best chance of doing integrative medicine is

the Anti-Aging medicine field. An Anti-Aging doctor recognizes

hormone imbalances easily because it is built-in in the field.

Unfortunately, because some of its prominent practitioners use

questionable science, I don't think it will become an officially

sanctioned board-certified specialty. This is too bad because

conventional medicine practitioners will only look at the field

as " voodoo medicine " , with suspicion. In this way, the anti-aging

doctors have only hurt their field. The anti-aging doctors also tend

to advertise the anti-aging way as a way to make a lot of money -

rather than trying to spread the knowledge into conventional

medicine.

Conventional medicine is slowly realizing hormone relationships -

slowly. I see the growth in knowledge in practitioners. It is

excruciatingly slow in coming however. This is why I think it won't

become part of normal practice for at least 15-20 years. As an

example of how psychiatry is slowly recognizing adrenal dysfunction

in mental illness: the abortion pill, RU486, is in phase 3 trials as

a treatment of psychotic depression. RU486 is a cortisol-receptor

blocker and progesterone-receptor blocker. By blocking cortisol, it

can reduce an overactive adrenal gland as a cause of psychotic

depression. The adrenal gland is hardly mentioned, however. Just the

blocked cortisol. Adrenal fatigue will still be missed in diagnosis

since RU486 will actually make depression due to adrenal fatigue

worse. Oh, well. At least it is a step in the right direction.

__________________

Any statement I make on this site is for educational purposes only

and is subject to change. It does not constitute medical advice,

does not substitute for proper medical evaluation from physician,

does not create a doctor/patient relationship or liability. If you

want medical advice, you will have to pay for it. Thank you.