If you suffer from hypoglycemia (irritability when hungry), "crash" with stress, or if you have recurrent infections that take a long time to resolve, you may have underactive adrenal glands — particularly if the symptoms started suddenly after a viral infection.  Other symptoms include fatigue, achiness and low blood pressure.  About two-thirds of my severe chronic fatigue patients have underactive or marginally functioning adrenal glands.

If you think back to your biology classes in high school, you may remember something called the fight-or-flight response. This is a physical reaction that occurs during times of stress. During the Stone Age, when a caveman met an animal that wanted to eat him, the caveman's adrenal glands activated multiple systems in his body that prompted him to either fight or run. This reaction helped the caveman survive. But in those days, people probably had a couple of weeks or months to recover before facing the next major stress. In today's world people often experience stress reactions every few minutes, and I suspect that many suffer from adrenal gland exhaustion.

The adrenal glands, which sit on top of the kidneys, are actually two different glands in one. The center of the gland makes epinephrine (also known as "adrenaline" for the adrenaline junkies out there) and is under the control of the autonomic nervous system.  Although it is known that this part of the nervous system is also on the fritz in chronic fatigue patients, it is not understood if or how this ties into the adrenal's ability to make adrenaline in CFS/FMS.  More likely, adrenaline deficiency is a central brain problem.

I have found that most people with hypoglycemia have under active adrenal glands. This makes sense because the adrenal glands' responsibilities include maintaining blood sugar at an adequate level during stress. Sugar is the only fuel that the brain can use. When a person's blood sugar level drops, he or she feels anxious, irritable, and then tired.

Treating an underactive adrenal problem with low doses of adrenal hormone usually quickly banishes the symptoms of low blood sugar. I like to begin with natural hydrocortisone such as Cortef (by prescription at most pharmacies) or, better yet, sustained release hydrocortisone from a compounding pharmacy. This immediately gives your body the support that your adrenal gland is unable to give, and may help you feel much better very quickly. The added cortisol also takes some of the strain off your adrenals so that they can heal.

There are many natural therapies that can help support your adrenal glands while also naturally raising your body's cortisol level.  These include:

• Supplementing with adrenal glandulars can supply the raw materials that your adrenal glands need to heal.

• Vitamin C is critical for adrenal function. Your body's highest levels of vitamin C are found in the adrenal glands and brain tissues, and the urinary excretion of vitamin C is increased during stress.

• Pantothenic acid (a B vitamin) also supports adrenal function, as Pantothenic acid deficiency causes shrinking of your adrenal glands.

• Licorice slows the breakdown of adrenal hormones in your body. It also helps in the treatment of indigestion.  But don’t take it if you have high blood pressure, as too much licorice can cause excess adrenal function and worsen high blood pressure.

• Chromium can help decrease the symptoms of low blood sugar.