Dr. Casey Greene, PharmD, IFMCP
Chronic stress, both physical and emotional, has been linked to adrenal dysfunction (often called adrenal fatigue), which can be a significant contributing factor to other health issues like thyroid impairment. Unfortunately, commercialized medications aren’t necessarily the best fit for all patients struggling with adrenal dysfunction, which can leave them dealing with debilitating stress, fatigue, and sleep issues.
However, a personalized medicine approach with compounded medication could be worth exploring for patients and providers to address adrenal health when commercial medications fall short.
What is Adrenal Dysfunction? Reviewing Causes and Symptoms
We’ve all experienced stress in some capacity throughout our lives. However, chronic stress is an entirely different beast, as regular stress is typically more short-lived. According to Yale Medicine, chronic stress is considered a consistent sense of pressure and feeling overwhelmed for a prolonged period of time (even as long as years), often resulting from sustained triggers and marked by symptoms like aches and pains, difficulty focusing, weakness, digestive issues, irritability, and difficulty sleeping. In some cases, dealing with chronic stress can involve psychology or psychiatry, even changes in lifestyle, but in other cases medication is pursued.
Adrenal dysfunction is a term used to describe a group of symptoms that include tiredness, sleep problems, craving sugar and/or salt, low blood pressure, and a loss of appetite, just to name a few. Mayo Clinic explains that some individuals recognize a tie between adrenal dysfunction and chronic stress, with the thought that adrenal glands can't keep pace with the “fight-or-flight” response, which is driven by the release of cortisol and adrenaline during chronic stress events. The old adrenal fatigue term is a bit of a misnomer, as it’s really thought that the adrenal’s maladapt to the neverending stress, which can eventually lead to a flatlined cortisol curve. This is where the old term “adrenal fatigue” comes from.
In the end, the tie between chronic stress and adrenal dysfunction is very strong, and without some level of psychological or medical intervention, it can be very challenging to navigate daily life.
Role of Compounded Medications in Adrenal Dysfunction
In cases where medication is deemed the best course of action under a provider’s recommendation, the compounding approach may present a powerful and positive opportunity. Compounding for chronic stress allows pharmacists to deliver medications that target affected physiological pathways (assessing things like ingredients used, patient allergies, dosage needs, dye aversions, delivery needs, etc.), allowing for a more holistic approach to care that could include adaptogens to help a person better deal with stress and enjoy a sense of relaxation and calm.
Some compounded medications available to address adrenal dysfunction, may include:
DHEA (Dehydroepiandrosterone): This is a hormone naturally produced in the adrenal gland and creates other hormones, such as testosterone and estrogen, which is valuable in specific cases of adrenal fatigue.
Pregnenolone: This is a naturally produced hormone by the adrenal gland and is the starting hormone in the production of testosterone, progesterone, cortisol, and estrogen, among others. Since chronic stress can result in excessive use of pregnenolone to build cortisol, it can potentially take away from available building blocks for the other hormones. This is often called the “cortisol steal”.
Corticosteroids: In some cases of extreme, long-term adrenal dysfunction a person’s cortisol output can suffer. This is what we would call stage 3 adrenal dysfunction, but has also been termed “adrenal fatigue”, even though it’s a maladaptation of the adrenal system. Short-term, low-dose corticosteroids might be a good supportive option in these cases.
Learn the various signs of stress and the ways to address it: https://revelationpharma.com/blog/post/stress-determining-the-signs-and-tips-for-addressing-it
Disclaimer
The FDA does not review any compounded medication for safety or efficacy. The information contained in this article is not meant to diagnose or treat a specific healthcare condition but should be used as educational-only material.
