The Use Of Adrenal Cortical Extracts In Adrenal Fatigue

By James L. Wilson DC, ND, PhD

Note: The information on this website is not a substitute for the advice of & treatment by a qualified professional.

What Is Hypoadrenia and Adrenal Fatigue?

“With our present partial knowledge of the function of the endocrine chain of glands, it appears as though the suprarenals were the first to show signs of fatigue, for the simple reason that they seem to have most of the work to do in the auto-protective functions.” (McNulty, J., New York Medical Journal, 1921, XCIII, pg. 288)

The purpose of your adrenal glands is to help your body cope with stresses and survive. In this article we will take a look at what happens when your adrenal glands get stressed out and what you can do about it. Normally, the adrenal glands secrete minute, yet precise and balanced, amounts of steroid hormones. But because your adrenals are designed to be so very responsive to changes in your inner physical, emotional and psychological environment, any number of factors can interfere with this finely tuned balance. As a result, physical, emotional and psychological stress can cause a decrease in the output of adrenal hormones, particularly cortisol. This reduction in adrenal activity is called hypoadrenia. “Hypo” simply means lower and so hypoadrenia is a general term referring to the whole range of lowered adrenal activity from zero to almost normal.

The extreme low end of hypoadrenia, Addison’s disease, is named for Sir Thomas Addison, who first described it in 1849. Approximately 70% of this form of hypoadrenia is an auto-immune disease. It is often life threatening if untreated and usually involves actual structural and physiological damage to the adrenal glands. People suffering from Addison’s disease usually have to take corticosteroids for the remainder of their lives in order to function. The other 30% of Addison’s disease cases are not related to auto-immune disease and stem from a variety of causes. John F. Kennedy suffered from this disease as a result of the stress caused by being shot down in his fighter plane during World War II. Luckily, Addison’s disease is the rarest form of hypoadrenia with an occurrence of only about 3 persons per million.

Hypoadrenia more commonly manifests itself within a broad spectrum of less serious, yet often debilitating, disorders that are only too familiar to most people. The more severe end of this spectrum has been known by many names throughout the past century, such as non-Addison’s hypoadrenia, sub-clinical hypoadrenia, neurasthenia, adrenal neurasthenia, adrenal apathy and adrenal fatigue. I prefer the name adrenal fatigue. Not only is it easy to remember, but it most aptly describes this common syndrome whose paramount symptom is fatigue. Adrenal fatigue affects millions of people around the world in many ways and for many reasons.

Adrenal fatigue is not usually severe enough to be featured on a TV hospital show, or to be a medical emergency, as is Addison’s disease. Modern medicine does not seem to even recognize it as a distinct syndrome. Nevertheless, it can wreak havoc with a person’s life.

Although fatigue is a universal symptom of low adrenal function, it is such a common complaint and occurs in so many other conditions, that today’s medical doctors rarely consider pursuing an adrenal-related diagnosis when someone complains of it. In fact, physicians fifty years ago were far more likely than their modern counterparts to correctly diagnose this ailment. Information about non-Addison’s hypoadrenia has been documented in medical literature for over a hundred years but unfortunately, this form of hypoadrenia is missed or misdiagnosed in doctors’ offices every day, even though the patient clearly presents its classic symptoms. Adrenal fatigue is all too often the cause of patients’ run down feeling and inability to keep up with life’s daily demands/. The fact that it usually remains undiagnosed does not diminish its debilitating influence on the health and feelings of well being of these patients.

Adrenal fatigue is a collection of signs and symptoms, known as a “syndrome.” Its sufferers often live with a general sense of unwellness or “gray” feelings. They use coffee, colas and other stimulants to get going in the morning and often to keep going during the day. As there condition worsens, it lays the foundation for other seemingly unrelated conditions, such as fibromyalgia, chronic fatigue syndrome, hypoglycemia, adult onset diabetes, auto immune disorders, more frequent respiratory infections, allergies and a number of other health problems, These people may appear to friends and family as lazy and unmotivated, or to have lost their ambition, when in reality quite the opposite is true; they are forced to drive themselves much harder than people with healthy adrenal function merely to do everyday tasks, never mind accomplish life’s goals.

Low adrenals can also have an effect on mental states producing anxiety and depression. People with adrenal fatigue show a tendency toward increased fears and apprehensions, have intervals of confusion, increased difficulties in concentrating and less acute memory recall. They often have less tolerance than they normally would and are more easily frustrated. When the adrenals are not secreting the proper amount of hormones, insomnia is also one of the likely outcomes.

People who suffer from adrenal fatigue frequently have erratic or abnormal blood sugar levels in some form of hypoglycemia. In fact, people who have functional hypoglycemia are usually suffering from decrease adrenal function. There is also more of a tendency to experience arthritic pain and decreased immune response with low adrenal function. Most women who have hypoadrenia have more premenstrual tension as well as increased difficulty during menopause.

If doctors were to suspect and pursue adrenal fatigue as the basis of their patients’ complaints soon after its onset, it is likely these more serious conditions could be avoided. Adrenal fatigue syndrome is fully recognizable and treatable with natural, safe substances, and in some cases it is totally preventable. The lack of consideration given to it by the medical profession leads to the unnecessarily impaired health of millions of people. Even if you are aware that you have hypoadrenia (adrenal fatigue), you may not find any sympathy or understanding from your doctor.

Who Suffers From Adrenal Fatigue?

Anyone who does not get enough rest and relaxation to enjoy life, who drives him/herself constantly, who is never satisfied or is a perfectionist, who is under constant pressure (especially with few outlets for emotional release), who feels trapped or helpless, who feels overwhelmed by repeated or continuous difficulties, or who has experienced severe or chronic emotional or physical trauma or illness is probably already suffering from some degree of adrenal fatigue.

People from every walk of life, every culture, and every age can suffer from adrenal fatigue. The political leader, the university student, the environmentalist, the farmer, the villager in a war torn country, the Hollywood director, the factory worker on a swing shift, the medical doctor with an HMO, and the teenage mother on welfare probably all have the factors in their lives that can lead to adrenal dysfunction, even though they lead very different lifestyles. The cost is untold in the loss of productive hours, creative ideas, sound business decisions, and other intangibles such as happiness. Some professions are harder on the adrenal glands than others. If you look at actuarial tables of the mortality rates, drug abuse, and number of sick days for different professions, what you are seeing, barring physically dangerous jobs, is the amount of adrenal fatigue experienced in those jobs.

The medical profession is a good example. The average physician dies 10 years younger, has seven times the alcoholism, and 11 times the drug addiction rate of the normal population. In fact, I know one doctor who, after collapsing at the end of her residency, decided to make a career of teaching professionals how to deal with stress. It is a paradox that the adrenal fatigue they do not recognize is responsible for many of their difficulties.

The police force is another profession that is very hard on the adrenals. I have counseled many policemen who are on the verge of collapse because of the stress involved in their job. You might think that it is the danger these people live with day in and day out that produces the stress, but what they tell me is that their main stressors are the demands placed upon them by their commanding officers. If these people are also involved in a weekly rotating shifts, the stress is magnified because their bodies never have a chance to adjust to the new circadian rhythm produced by each sleep change. People on alternating shifts with less than three weeks between shift changes are continually hammering their adrenal glands. Every time the wake/sleep cycle is altered, it takes several days to weeks to establish a normal hormonal pattern for the new wake/sleep cycle.

Middle executives and teachers suffer from what I call “sandwich stress.” This is stress that comes from having to meet the demands and expectations from above and below without the power or authority to make the necessary changes or to do their job effectively. It is frequently the person in the middle who takes the blame when things go wrong but not the credit when things go right. People in this position commonly have more than their share of health problems. They often suffer from Syndrome X (a complex of signs and symptoms that includes glucose intolerance, increased triglycerides, low HDL cholesterol, insulin resistance, hypertension, central obesity, and accelerated atherosclerosis) and have more nervous breakdowns than do others,. These disorders correspond to the effects of an increase in cortisol levels caused by stress that is followed in time by a drop in cortisol levels to below normal as the adrenals fatigue and are less able to respond to stress.

Primary components of lifestyle that leads to adrenal fatigue include lack of rest, poor food choices, using food and drinks as stimulants when tired, staying up late even though fatigued, being constantly in a position of powerlessness, constantly driving yourself, perfectionism to the point of relentlessness, double binds over time.

How Adrenal Function Affects Your Everyday Life

Because the adrenals are “the glands of stress,” it is their job to enable your body to deal with stress from every possible source, ranging from injury and disease to work and relationship problems. How you feel when you get up in the morning, how long you take to fully wake up, how tired you are, how much fatigue interferes in your life, how resilient you are, how quickly you bounce back after emotional or physical trauma, how often you can drive yourself or keep going even when you are tired, and how well you handle daily pressures all depend upon the functioning of your adrenal glands.

The hormones secreted by your adrenals influence all of the physiological process in your body. They closely affect the utilization of carbohydrates and fats, the conversion of fats and proteins into energy, the distribution of stored fat (especially around your waist and at the sides of your face), normal blood sugar regulation, and proper cardiovascular and gastrointestinal function. The protective activity of anti-inflammatories, hormones and anti-oxidants that helps to minimize negative and allergic reactions to alcohol, drugs and foods also depends in part on the precise secretion of adrenal hormones. After mid-life (menopause in women), the adrenal glands gradually become the major source of the sex hormones circulating throughout the body in both men and women. These hormones themselves have a whole host of physical, emotional and psychological effects, from the level of your sex drive to the tendency to gain weight. Every athlete knows that muscular strength and stamina are influenced by the adrenal hormones, known more familiarly as steroids.

Even the kinds of diseases you develop and your ability to respond to chronic illness is influenced significantly by the adrenals. The more chronic the illness, the more important the adrenal response becomes. You cannot live at all without your adrenal hormones and you cannot live well without your adrenal glands functioning properly.

Signs and Symptoms of Adrenal Fatigue

Listed below are some of the most common symptoms of low adrenal function excerpted from my upcoming book on adrenal fatigue. Look at them to see if some of them seem familiar to you or to people you know.
Continuing fatigue not relieved by sleep. Despite getting a good night’s sleep, you still feel tired when you wake up. Refreshed is a foreign word to people with adrenal fatigue

Craving for salt or salty foods. You find yourself eating the whole bag of chips or adding extra salt to foods.

Lethargy (lack of energy). Everything seems like a chore, even the things you used to enjoy.

Easily fatigued. Everything takes more effort. Walking a block sometimes feels like a marathon.

Decreased sex drive. The hottest movie star could be waiting in your bedroom and you would ask for a rain check. Sex is often the last thing on your mind when you hardly have the energy to keep your head up.

Decreased ability to handle stress. Little things that never used to bother you get to you. Road rage, constant anxiety, yelling at your kids, compulsive eating, smoking or drug use are some of the behaviors that let you know your adrenals are crying out for help.

Increased time to recover from illness, injury or traumas. The cold you got in October is still hanging on in December. The cut on your finger takes weeks to heal. Two years after your father died you are still incapacitated by grief.

Mild depression. Why bother making an effort, it sometimes seems so pointless?

Less enjoyment of happiness with life. Not much seems to interest you any more, Work and relationships feel empty and you almost never do something just for fun.

Increased PMS. Bloated, tired, crabby, cramping and craving chocolate does it get any worse than this?

Symptoms increase if meals are skipped or inadequate. You have to drive yourself with snacks, colas and coffee just to keep from collapsing.

Thoughts less focused, more fuzzy. You frequently lose track of your train of thought and it is harder and harder to make decisions.

Light headed when standing up quickly. Sometimes you feel a little woozy or even like you are going to pass out when you get up too fast from the bed or a chair.

Memory less accurate. You’ve become so absentminded, you should be a professor.

Decreased tolerance. People seem a lot more irritating than they used to.

Difficulty getting up in the morning. Three alarms and you still don’t feel awake enough to lift your head off the pillow.

Afternoon low between 3:00 and 4:00 PM. Around 3:00 – ;30 in the afternoon you start to feel like you have been drugged.

Feels better after evening meal. After 6:00 PM or your evening meal, you start to feel alive again.

Decreased productivity. It takes you longer to complete tasks and it is harder to stay on task.

Increased effort to do every day tasks. Everything seems to require much more effort than it should.

No single one of these symptoms gives a definitive diagnosis of hypoadrenia (adrenal fatigue), but taken collectively as a syndrome, they strongly suggest its presence. If many of these seem familiar, then you are probably suffering from some level of adrenal fatigue. Although we have come to accept it as such, adrenal fatigue is not a part of normal life! These symptoms indicate defective adaptation of your adrenal glands to the stresses you are experiencing. They are warnings that something needs to change if you want to feel well again. If you are experiencing more than three of them, you are likely suffering from some form of adrenal fatigue.

Use of Adrenal Cortical Extracts

Adrenal extracts have been recommended and successfully used for a variety of conditions which involve low adrenal function, including asthenia, asthma, colds, burns, depletion from colds, coughs, dyspepsia (atonic), early Addison’s disease, hypotension, infections, infectious diseases, depletion from infectious diseases, convalescence from infectious diseases, neurothenia, tuberculosis, light headed and dizziness and vomiting during pregnancy (Harrower, 1939, pg. 19 22).

The first, and still probably the most reliable, way of rebuilding the adrenals from adrenal fatigue is the use of extracts from liquid or powdered bovine adrenal glands. Historically and in many modern clinics, preparations using adrenal cell extracts have been used extensively and are considered to be the most important aspect of the treatment. The first to use an adrenal extract was Sir William Osler who, in 1896, used a crude preparation of adrenal cells in an unsuccessful attempt to keep a person with Addison’s disease alive and functioning. But the adrenal cell extracts have been a valuable and powerful form of therapy since they first became commercially available in 1918 and have been used by thousands of medical doctors in the treatment of non-Addison’s type of hypoadrenia. By the mid 1930”s, adrenal cell extracts in liquid and tablet forms were produced by several companies. As recently as 1968 they were being made by some of the leading pharmaceutical companies (Upjohn, and Parke-Davis among others) (Roberts 1968).

However, in the early 1950’s synthetic cortisol became available. Because the synthetic hormone produced effects that seemed, at first, so much more dramatic than the effects of adrenal extracts, many physicians switched to cortisol and its synthetic version for treating conditions they had previously treated with adrenal cell extracts. The profit margin of the synthetic corticoids was also many times greater than that of the cell extracts. This quickly made the synthetics the unquestionable favorite of the pharmaceutical industry. Within a few short years, the many detrimental side effects of the synthetics started appearing, but the pharmaceutical industry had made its profitable choice and would never turn back.

It is important to clarify the difference between adrenal cell extracts and the natural and synthetic cortiosteroids. The corticosteroids are replacement hormones. They replace only the hormone they are fashioned after but do not function exactly the same as the natural hormone. Upon entering the body, they suppress adrenal function, shutting down all hormones secreted by the adrenals. If used in excess, which most are, their unfortunate side effects are many and far reaching. The natural form of the hormone (hydrocortisone) is safer than the synthetics, but even the natural hormone shuts down the adrenals while it is being used and for several weeks to months after it is discontinued.

The cell extracts are not replacement hormones, but they contain the constituents of the adrenal cell. The liquid extracts include all the cell constituents fresh frozen after being sterilized by filtration. They contain only a tiny amount of actual hormone. Their action is to support, fortify and restore normal adrenal function. They enhance adrenal activity, not suppress it. These extracts rarely have side effects and have been used orally and as injectables since the end of WWI.

The adrenal cortical extract’s first claim to fame in the United States had to do with the epidemic flu virus of 1918. Respiratory infections are especially hard on the adrenal glands and fatigue them rapidly. This effect was shown by Lucke and his associates in Camp Zachary Taylor in 1919, when he found that adrenal exhaustion was present in 103 of 126 autopsied cases of mortality from the flu epidemic. In 3 cases they found hemorrhages in the adrenals and adrenal glands enlarged to twice their size. In other words, in 106 of 126 patients who died from influenza, the adrenals were actually damaged by the infection. It is not that the adrenal glands were infected per se, but that the effort the adrenals exerted to try to restore balance to the body led them to such exhaustion that it could be detected physically upon autopsy (Lucke, B., et al., Archives of Internal Medicine,August 1919, XXIIII, pg. 154). While this flu epidemic was debilitating and even killing thousands around the world, a few hundred of its victims were given a formula containing liquid adrenal cortical extracts combined with a small amount of thyroid and gonadal extracts. The formula was found to be unusually effective in overcoming many of the asthenic (weak), hypotonic and depleted states that were so common in those afflicted with this deadly flu. It also effectively reduced the serious sequeli that usually followed this particular infection. The benefits to those taking this formula dramatically drew attention to its practical use. The quick and uneventful recovery experienced by those taking this adrenal extract contrasted to the long period of recuperation normally seen in this flu epidemic. These results made many physicians aware of the possibility for recovery from less severe forms of hypoadrenia as well. There was a realization that although textbook cases of endocrine diseases, such as Addison’s exemplify endocrine pathology very well, they seldom provide the most promising opportunities for therapy. By 1919 it became known that the less severe endocrine disorder of adrenal fatigue is infinitely more common and far more likely to respond to therapy than the full blown adrenal failure seen in Addison’s disease (Harrower, 1939, pg. 17). By the late 1930’s adrenal cell extracts in their liquid and tableted forms were being used successfully by tens of thousands of physicians (Harrower, 1933 pg. 111).

I have heard lectures by so-called authorities in medicine who claim that these glandular extracts have no value. The truth is that these physicians must not know how to use these substances correctly or they would never make these claims. Adrenal extracts are the cornerstone of effective therapy for adrenal fatigue. There are several brands available in both tablet and liquid form. The liquid is generally more powerful than the tablet, however, it is more costly. I usually use the liquid in moderate to severe cases, and tablets in milder cases. Dosage for the adrenal cortical extract tablets is 6 12 per day, depending upon severity, taken in three to four intervals throughout the day. Dosage for the liquid form is usually one vial under the tongue 2 to 3 times weekly. In severe cases, it may need to be more frequent. The most common liquids available in the United States come frozen and can be shipped to your door. Although both are classified as dietary supplements, they must usually be purchased through a physician. However, there are a few outlets making them directly available to the public.

Most medical doctors are totally unaware of the existence of this type of therapy and do not know how to use it. Because it is a departure from their usual thinking and protocol, they are often reluctant to even explore it. If a patient asks about cell extracts, they are typically negative about the subject. But as my friend, Dr. Leo Roy, the first holistic physician of Canada, said, “Doctors are down on things they are not up on.” This is especially true of live cell substances and their use.

The doctors who are up on treating adrenal fatigue find significant value in adrenal extracts for alleviating most forms of hypoadrenia (adrenal fatigue). Today, by combining our knowledge of adrenal cortical extracts with lifestyle modifications, dietary supplements and herbal formulas, we can stabilize people with adrenal fatigue and accelerate their recovery more efficiently than ever before. Adrenal extracts are one of the fundamental treatment protocols used effectively for over 80 years, yet ignored by modern medicine.

One of the pleasures of writing my book on adrenal fatigue is that it gives people (including health practitioners) a diagnostic and comprehensive treatment protocol they can use for rehabilitation from this common but unrecognized syndrome.

It is my hope that articles like this one and my upcoming book (Smart Publications, Petaluma California), will make people more aware that many people are suffering unnecessarily when there are many things they can do to help themselves back to health.


Harrower, H.R. (1939). An Endocrine Handbook. The Harrower Laboratory, Inc. 127 pgs.
arrower, H.R. (1933). Endocrine Pointers. The Harrower Laboratory, Inc. Glendale, CA 205 pgs.
Lucke, B., et al. (1919). Archives of Internal Medicine xxiiii, pg. 154.
McNulty, J. (1921). New York Medical Journal. xciii pg. 288.
Roberts, Sam. E. (1868). Exhaustion Causes and Treatment: A New Approach to the Treatment of Allergy, Rodale Books, Inc., Emmas, PA, pg. 76

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