Addressing fatigue, the scourge of our times 01-08-2008   Just about every patient I see is suffering from fatigue.  The July 2008 edition of the health magazine Townsend letter www.townsendletter.com has a very interesting article on female fatigue written by American health journalist and naturopathic physician Tori Hudson. She highlights the importance of investigating adrenal function when focusing on the kind of fatigue that troubles a lot of women.  This can lead to difficulties with getting out of bed in the morning and all sorts of problems with finding enough energy to start off the day.  If your adrenals are struggling to provide you with enough cortisol you might become moody, irritable, argumentative, anxious, absentminded and find it difficult to cope with stress.  You will become excessively sensitive to pain and crave salty or sweet foods.  Your physician might find that you have a low blood pressure and you might be very tender when he palpates your abdomen.   Be careful if your physician wants to give you growth hormone if your body is not producing sufficient amounts of cortisol as growth hormone antagonises cortisol and this kind of treatment will make you more fatigued.  You need to find a physician who takes a comprehensive history, finds the time to examine you and then performs the appropriate investigations to identify the underlying cause of your hormonal and nutritional imbalances.   The best ways to measure cortisol levels is via a 24-hour urine collection or salivary hormone assays done over the course of the day.  The key to managing any hormone dysfunction is bringing hormones into balance.  Tori Hudson mentions utilising nutrients like vitamins B5 and B6, magnesium, zinc and vitamin C to boost adrenal function as well as herbs like ginseng, withania, rhodiola and shisandra.  This is a kind and gentle way of enhancing adrenal function. Another way is to take small amounts of cortisol in the form of hydrocortisone but this will have to be prescribed by your physician when appropriate.