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Adrenal fatigue

C Ling, Q Sun, J Khang, M Felipa Lastarria, J Strong, B Stolze, X Yu, T P Parikh, M A Waldman, K Welsh, J Jonklaas, L Masika, S J Soldin
Objectives: To evaluate the reliability of normal Thyroid Stimulating Hormone (TSH) as a thyroid function test and assess the effect of Adrenocorticotropic Hormone (ACTH) on serum TSH concentration. Design and Methods: Patients presenting to the National Institutes of Health Department of Endocrinology outpatient clinic with symptoms consistent with hypothyroidism were identified. Thyroid hormone concentrations were measured by liquid chromatography/tandem mass spectrometry and immunoassay...
2018: Annals of Thyroid Research
Lea Ann Matura, Susan Malone, Rosario Jaime-Lara, Barbara Riegel
Fatigue, a commonly reported symptom, is defined as an overwhelming, debilitating, and sustained sense of exhaustion that decreases the ability to function and carry out daily activities. To date, cancer researchers have been in the forefront in investigating the possible biological mechanisms of fatigue, identifying inflammation, dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis, and activation of the autonomic nervous system. The purpose of this systematic review is to describe fatigue and what is known about the biological mechanisms described in cancer in five chronic, noninfectious illnesses: heart failure, multiple sclerosis, chronic kidney disease, rheumatoid arthritis, and chronic obstructive pulmonary disease...
January 1, 2018: Biological Research for Nursing
Halis Kaan Akturk, Ana Maria Chindris, Jolaine M Hines, Ravinder J Singh, Victor J Bernet
OBJECTIVE: To assess whether dietary supplements that are herbal and/or animal-derived products, marketed for enhancing metabolism or promoting energy, "adrenal fatigue," or "adrenal support," contain thyroid or steroid hormones. METHODS: Twelve dietary adrenal support supplements were purchased. Pregnenolone, androstenedione, 17-hydroxyprogesterone, cortisol, cortisone, dehydroepiandrosterone sulfate, synthetic glucocorticoids (betamethasone, dexamethasone, fludrocortisone, megestrol acetate, methylprednisolone, prednisolone, prednisone, budesonide, and triamcinolone acetonide) levels were measured twice in samples in a blinded fashion...
March 2018: Mayo Clinic Proceedings
S Waqar H Shah, Arshad K Butt, K Malik, Altaf Alam, Adnan Shahzad, Anwaar A Khan
Triple A (Allgrove) syndrome, an autosomal recessive disease is characterized by achalasia, alacrimia and ACTH-resistant adrenal failure with progressive neurological syndrome including central, peripheral and autonomic nervous system impairment, and mild mental retardation. The triple A syndrome gene, designated AAAS, localized on chromosome 12q 13 encodes for a 546 amino acid protein called ALADIN (Alacrimia-Achlasia-Adrenal Insufficiency and Neurologic disorder). This report relates to two sisters, aged 8 and 12 years, who had vomiting, muscle weakness, alacrimia, excessive fatigue and dysphagia...
November 2017: Pakistan Journal of Medical Sciences Quarterly
Olivia C Eller-Smith, Andrea L Nicol, Julie A Christianson
Centralized pain syndromes are associated with changes within the central nervous system that amplify peripheral input and/or generate the perception of pain in the absence of a noxious stimulus. Examples of idiopathic functional disorders that are often categorized as centralized pain syndromes include fibromyalgia, chronic pelvic pain syndromes, migraine, and temporomandibular disorder. Patients often suffer from widespread pain, associated with more than one specific syndrome, and report fatigue, mood and sleep disturbances, and poor quality of life...
2018: Frontiers in Cellular Neuroscience
Toshie Iijima, Takafumi Niitani, Seiichi Tanaka, Kazunori Yanagi, Teruo Jojima, Kunihiro Suzuki, Isao Usui, Yoshimasa Aso
We describe a very rare case of concurrent variant type 3 autoimmune polyglandular syndrome (APS) and pulmonary arterial hypertension (PAH). A previously healthy 65-year-old Japanese woman was referred to our university hospital with a 2-month history of general fatigue and hyperglycemia. Laboratory tests revealed severe hyperglycemia (plasma glucose 543 mg/dL and HbA1c 10.7%) with ketonuria (3+). Glutamic acid decarboxylase (GAD) and IA-2 antibodies were positive, and the serum C peptide level was markedly decreased to 0...
February 16, 2018: Endocrine Journal
Satoshi Yoshiji, Kimitaka Shibue, Toshihito Fujii, Takeshi Usui, Keisho Hirota, Daisuke Taura, Mayumi Inoue, Masakatsu Sone, Akihiro Yasoda, Nobuya Inagaki
RATIONALE: Unilateral adrenalectomy as part of surgical resection of renal cell carcinoma (RCC) is not thought to increase the risk of chronic adrenal insufficiency, as the contralateral adrenal gland is assumed to be capable of compensating for the lost function of the resected gland. However, recent studies have indicated that adrenalectomy might cause irreversible impairment of the adrenocortical reserve. We describe a case of chronic primary adrenal insufficiency in a 68-year-old man who previously underwent unilateral adrenonephrectomy, which was complicated by severe postoperative adrenal stress that involved cardiopulmonary disturbance and systemic infection...
December 2017: Medicine (Baltimore)
Gesine Meyer, Maike Koch, Eva Herrmann, Jörg Bojunga, Klaus Badenhoop
PURPOSE: Several studies have shown a reduced quality of life (QoL) in patients with Addison's disease (AD), but investigations of QoL over a long-term course are lacking. Adrenal crises (AC) are life-threatening complications in AD. The purpose of this prospective study was to test whether the repeated use of QoL-questionnaires can detect prodromal periods of an AC. METHODS: 110 patients with AD were asked to complete the disease specific-QoL questionnaire AddiQoL and a short questionnaire about adverse events once monthly over a period of ten months...
January 31, 2018: Endocrine
Victor Brun Boesen, Thea Christoffersen, Torquil Watt, Stina Willemoes Borresen, Marianne Klose, Ulla Feldt-Rasmussen
INTRODUCTION: Patients with adrenal insufficiency have impaired health-related quality of life (QoL). The dual-release hydrocortisone preparation, Plenadren, has been developed to mimic the physiological cortisol release more closely than conventional hydrocortisone treatment. Plenadren has been shown to improve QoL, in particular fatigue, in patients with primary adrenal insufficiency. However, the effect has not been investigated in patients with secondary adrenal insufficiency; furthermore, no study has taken the diurnal variation of fatigue into account...
January 23, 2018: BMJ Open
Mariko Minami, Tsuyoshi Muta, Masahiro Adachi, Masakazu Higuchi, Kenichi Aoki, Ryosuke Ogawa
We present the case of a 56-year-old man with an upper respiratory infection followed by fatigue, hypotension, and hyponatremia. Bilateral adrenal hemorrhage was confirmed, based on T2-weighted magnetic resonance imaging. The patient had previously undergone allogeneic hematopoietic stem cell transplantation and had been diagnosed with antiphospholipid syndrome (APS) during the development of chronic graft-versus-host disease. A prompt diagnosis and steroid replacement, in addition to anticoagulant therapy, resulted in a favorable outcome...
December 27, 2017: Internal Medicine
Elise Beau Vangeel, Stefan Kempke, Jelena Bakusic, Lode Godderis, Patrick Luyten, Leen Van Heddegem, Veerle Compernolle, Philippe Persoons, Diether Lambrechts, Benedetta Izzi, Kathleen Freson, Stephan Claes
OBJECTIVE: Although the precise mechanisms are not yet understood, previous studies have suggested that chronic fatigue syndrome (CFS) is associated with hypothalamic-pituitary-adrenal (HPA) axis dysregulation and trauma in early childhood. Consistent with findings suggesting that early life stress-induced DNA methylation changes may underlie dysregulation of the HPA axis, we previously found evidence for the involvement of glucocorticoid receptor (GR) gene (NR3C1) methylation in whole blood of CFS patients...
January 2018: Journal of Psychosomatic Research
J Strahler, S Fischer
OBJECTIVE: Vital exhaustion (VE) is characterised by unusual fatigue, increased irritability, and a feeling of demoralisation. It has been found a major risk factor for cardiovascular diseases, and one that is independent of subclinical or clinical manifestations of coronary heart disease or lifestyle-related risk factors. Stress-induced alterations in the hypothalamic-pituitary-adrenal (HPA) axis and sympathetic nervous system may mediate the link between VE and increased cardiovascular risk...
December 20, 2017: Physiology & Behavior
Erina Yuasa-Shibasaki, Sumiyasu Ishii, Shunichi Matsumoto, Takuya Tomaru, Kazuhiko Horiguchi, Aya Osaki, Atsushi Ozawa, Nobuyuki Shibusawa, Tetsurou Satoh, Masanobu Yamada
A 39-year-old woman was admitted to our hospital with symptoms of general fatigue, nausea, and vomiting that appeared three months after she stopped seven years of medroxyprogesterone acetate (MPA) medication for endometrial stromal sarcoma. Laboratory tests demonstrated moderate hypercalcemia. Several tests demonstrated that she was suffering from adrenal insufficiency. Glucocorticoid supplementation decreased her calcium level to a normal range, indicating that hypercalcemia was induced by adrenal insufficiency...
February 15, 2018: Internal Medicine
Flavio A Cadegiani, Claudio E Kater
BACKGROUND: Overtraining syndrome (OTS) results from excessive training load without adequate recovery and leads to decreased performance and fatigue. The pathophysiology of OTS in athletes is not fully understood, which makes accurate diagnosis difficult. Previous studies indicate that alterations in the hypothalamus-pituitary-adrenal (HPA) axis may be responsible for OTS; however, the data is not conclusive. This study aimed to compare, through gold standard and exercise-independent tests, the response of the HPA axis in OTS-affected athletes (OTS group) to healthy physically active subjects (ATL group) and healthy non-active subjects (NCS group)...
December 8, 2017: Sports Medicine—Open
Yasuo Aota, Tadahito Nonaka, Sei Kimura, Tadahiro Honda, Yuko Okuda, Tsubasa Watanabe, Keitaro Fujiwara, Tomohisa Yokoyama, Yukari Wakabayashi, Michio Sakurai, Akihiko Gotoh
A 70-year-old woman was diagnosed with chronic rheumatoid arthritis and treated with methotrexate and prednisolone. She visited our hospital to determine the cause of her continuous fatigue and fever for the past three weeks. She consumed no food orally and was provided antibiotics because free air was found on computed tomography (CT). Intraperitoneal small lymphadenopathy and swelling of both adrenal glands was also found on CT, and MTX-associated lymphoproliferative disorder (MTX-LPD) was suspected. Am adrenal gland biopsy showed diffuse large B-cell lymphoma (DLBCL) associated with MTX-LPD...
2017: Nihon Ronen Igakkai Zasshi. Japanese Journal of Geriatrics
Kristin Plichta, Nathan Camden, Muhammed Furqan, Taher Abu Hejleh, Gerald H Clamon, Jun Zhang, Ryan T Flynn, Sudershan K Bhatia, Mark C Smith, John M Buatti, Bryan G Allen
Purpose: The adrenal glands are a common site of metastases because of their rich blood supply. Previously, adrenal metastases were treated with systemic chemotherapy or, more rarely, with surgical resection or palliative radiation therapy. Stereotactic body radiation therapy (SBRT) has recently emerged as an attractive noninvasive approach to definitively treat these lesions. We present our experience in treating adrenal metastases using SBRT and review the current literature. Methods and materials: This is a single-institution retrospective review of patients who received SBRT to adrenal metastases originating from various primary malignancies...
October 2017: Advances in Radiation Oncology
Adam Szadkowski, Allison J Pollock, Awni M Al-Subu
Addison disease is a rare endocrine disorder, which typically presents with nonspecific symptoms including weight loss, fatigue, and nausea in conjunction with hyponatremia and hyperkalemia. This case demonstrates key diagnostic clues in evaluation of an adolescent who presented with severe hyperkalemia and acute kidney injury that was resistant to insulin, glucose, and sodium polystyrene sulfonate and was found to have primary adrenal insufficiency.
December 1, 2017: Pediatric Emergency Care
Laurence Guignat, Emmanuelle Proust-Lemoine, Yves Reznik, Delphine Zenaty
Patients with adrenal insufficiency require regular, specialised monitoring in order to optimise their replacement therapy, to detect signs of under- and over-dosage, and to examine for possible associated disorders (auto-immune disorders in the case of auto-immune primary adrenal insufficiency either isolated or as part of auto-immune polyendocrinopathy syndrome type 1; illnesses with underlying monogenic causes). The transition period between adolescence and adulthood represents an added risk of a breakdown in monitoring which requires particular attention from medical teams and coordination between adult and pediatric medical teams...
December 2017: Annales D'endocrinologie
Philippe Chanson, Laurence Guignat, Bernard Goichot, Olivier Chabre, Dinane Samara Boustani, Rachel Reynaud, Dominique Simon, Antoine Tabarin, Damien Gruson, Yves Reznik, Marie-Laure Raffin Sanson
A diagnosis of adrenal insufficiency should be suspected in the presence of a number of non-specific symptoms (fatigue, anorexia, weight loss, hypotension, hyponatremia and hyperkalemia amongst adrenal causes of insufficiency). The diagnosis should be considered in case of pituitary disease or a state of shock. Treatment should be commenced immediately without waiting for confirmation from biochemical tests, which rely on cortisol level at 8am (expected to be low) and on ACTH level (expected to be high in the case of primary adrenal insufficiency)...
December 2017: Annales D'endocrinologie
Dongsoo Kim, Chang Yul Kim, Hyojin Koo, Yong Heo, Kicheol Cheon
OBJECTIVE: Predator stress, social defeat stress, and fear conditioning animal models have been applied to investigate combat-related posttraumatic stress disorder (PTSD). However, no animal model psychopharmacological studies have investigated prevention of somatization of increased mental stress and fatigue at the beginning of combat exposure. This study utilized a novel animal model simulating the beginning of combat exposure that aided specification of a set of biomarkers. METHODS: Psychological stress was induced by both inescapable electric foot shock and noise stimuli...
November 22, 2017: Neuroimmunomodulation
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