Maintaining optimum fluid balance is important in achieving general good health. This is especially critical in Adrenal Fatigue Syndrome (AFS), where fluid dysregulation is a common occurrence, especially in the advanced stages.
Fluid imbalance presents in a continuum. Conventional medicine, unfortunately, are versed mostly when fluid imbalance reaches extreme opposites, with severe dehydration on one extreme and massive fluid overload at the opposite pole. Fluid overload clinically results in pulmonary edema, peripheral edema, and congestive heart failure. They are quickly resolved with administration of medications called diuretics that increase urine output to reduce body fluid load. Deficiency in fluid, or clinical dehydration, is clinically treated with fluid replacement.
Little attention is paid when fluid imbalance lies between the two extremes, when symptoms can be evident but laboratory tests are normal. This is especially evident for those in the fluid depletion side of the spectrum. In this subclinical state of dehydration, signs and symptoms are mild and subtle at best. It is often missed and ignored as important contributing factors to ailing health.
Antidiuretic hormone (ADH), also known as arginine vasopressin, is secreted from the posterior pituitary gland. After travelling to the kidneys, antidiuretic hormone binds to receptors on cells in the collecting ducts. It promotes reabsorption of water back into the circulation, reducing water output. Without ADH, water flows freely out in urine, as the collecting ducts are virtually impermeable to water. The most common disease of man and animal related to ADH is diabetes insipidus. This clinical condition arises from either dysfunction in the hypothalamus or in the kidneys. The major sign of either type of diabetes insipidus is excessive urine production, and thus accompanied by dry mouth and thirst. Fortunately, ADH dysregulation is seldom a problem encountered as the root cause of thirst and fluid imbalance in adrenal fatigue.
Urination and Adrenal Fatigue Syndrome
Many AFS sufferers have increased and frequent urination, no matter their amount of hydration. Here are three reasons why:
In the early stages of Adrenal Fatigue Syndrome, aldosterone levels first rise as the body tries to conserve water. As AFS progresses to advanced stages, aldosterone level tends to fall, resulting in low body fluid level. Next, low blood volume results and blood pressure falls. With reduced aldosterone, sodium retention is reduced, and fluid loss increases, leading to increased urine flow.
Severe short term stress increases adrenaline release as the body begins the “fight or flight” alarm response, which in turn increases the rate of urine flow.
Chronic stress increases HPA (Hypothalamic-pituitary-adrenal) axis stimulation to the adrenal glands, resulting in increased cortisol output from the adrenal cortex. Cortisol causes reduction in Anti-Diuretic Hormone (ADH), which increases urine flow as the production of urine is not held back by ADH in the body. To put it simply, high cortisol leads to low ADH.
It comes as no surprise that most sufferers of AFS are in a chronic stage of fluid depletion, either clinically or sub-clinically, with increased urination.
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