Adrenal fatigue is a sub-clinical condition in which the adrenal glands are unable to produce the requisite hormones to optimally sustain your body’s functions. This typically happens when the adrenals have been stressed for a while. In advanced stages of Adrenal Fatigue Syndrome (AFS), you may experience electrolyte imbalance symptoms, such as dehydration, excessive thirst, cardiac symptoms, breathlessness, and sensitivity to salt and potassium. You may feel sick enough to go to the hospital, where you will likely be treated for dehydration with IV electrolyte fluids. Your laboratory electrolyte values may be normal throughout this experience, or they be outside the normal range if adrenal weakness is severe. Normally, you will be sent home with no clear answers and no help for future episodes. After all, the lab results are normal.
Electrolyte imbalance symptoms can occur even when lab results are in the normal range, because what is normal for a healthy person may not be normal for adrenal fatigue sufferers. Unfortunately, there is no absolute laboratory value chart for AFS sufferers. So what is happening? Your adrenal glands produce a hormone called aldosterone, which regulates sodium in the body. When your adrenals are overly stressed, your aldosterone levels can be reduced, resulting in reduced sodium retention. The body tends to lose sodium and water, leading to dehydration and excessive thirst. Water alone does not contain the vital minerals that regulate electrolyte function (the electrical charge that creates energy in the cells), so it is possible to have further electrolyte imbalance even if you drink a lot of water, in a condition known as dilutional hyponatremia. When your body loses fluids and your adrenal glands are not properly regulating mineral function, your sodium levels drop, and levels of the opposing mineral, potassium, will rise. In extreme cases, you could experience tachycardia and cardiac arrhythmias due to potassium imbalance. Although increasing your salt intake may help you feel better, you may not be able to tolerate any added potassium, such as a banana. Even with all of these symptoms, your lab results can still be within the normal range. This might be due to your lab values dropping from the high to the low side of the normal range and your body being sensitive enough to feel a big difference. However, conventional doctors just look at the normal range when considering electrolyte imbalances. No one denies you are feeling horrible, but the labs don’t match, so the dehydration diagnosis sticks without any determination of why.
Mineral salts create an electrical charge, moving water in and out of your cells, creating energy. The essential electrolyte minerals are sodium, potassium, chloride, sulfate, magnesium, calcium, and phosphate. Sodium and potassium are the minerals that are the most critical for adrenal function, and the delicate balance of these minerals is just as vital as their presence. Sodium functions outside of the cells, while potassium functions inside of the cells, determining electrolyte dynamics. So when there is an imbalance, particularly with sodium depletion and excess potassium, you will experience diminished adrenal function.
When your adrenal glands are severely fatigued, such as in advanced stages of AFS, the smallest movement to either end of the normal spectrum can trigger electrolyte imbalance symptoms. A small amount of salt or potassium may be overwhelming. In this very fragile state, you cannot tolerate even the smallest movements in the balance of sodium and potassium. Such movements can often lead to adrenal crashes.
Although there is not currently a clear reason for this phenomenon, electrolyte imbalance symptoms are increasingly common in adrenal fatigue sufferers. The imbalance occurs in the adrenal glands is actually related to the rest of the body through the NeuroEndoMetabolic (NEM) Stress Response. This response enlists other organs, systems, chemical reactions, and pathways in your body to support the adrenal glands so that your body does not go into disarray. Normally, this whole-body response to stress is working around the clock. When there is an imbalance to part of the system, however, things go haywire and your body’s systems go into overdrive. In the case of reduced aldosterone production in the adrenal glands, the situation is complicated by neurotransmitters and the sympathetic nervous system, which can exacerbate the electrolyte imbalance, causing a cardionomic response that can trigger a lot of additional symptoms. Disruption of the cardionomic response (comprised of the adrenals, heart, and autonomic nervous system) is what causes blood pressure fluctuations, heart palpitations, cardiac arrhythmia, dizziness, and shortness of breath. Without adequate rest and repair, the resulting symptoms can become serious in people with advanced adrenal fatigue (stage 3 and beyond).
This presentation of symptoms with normal lab results is the very reason it is imperative for you to listen to your body at all times. If you are experiencing sensitivity to electrolytes, your body is crying out to force you to rebalance this delicate system. Normally, healthy people can handle a slight swing in the balance of sodium and potassium, but in the advanced stages of AFS, you will experience serious electrolyte imbalance symptoms. Electrolyte balance must be closely monitored in adrenal fatigue sufferers to prevent problems with blood pressure. Although this area needs more research to determine the reasons why the body cannot tolerate a swing in the balance of sodium and potassium while adrenal function is diminished, learning to be in tune with your body so you can make adjustments to your diet and keep your electrolytes in balance can greatly aid in your recovery from AFS.
© Copyright 2017 Michael Lam, M.D. All Rights Reserved.