As a Naturopathic Doctor, of course, I believe in holistic healing. I look at the entire body and everything in that person’s life. It all counts.
But in addition to my belief in holistic healing, I utilize a version of a naturopathic hierarchy for treatment.
This Naturopathic Hierarchy of Treatment is a perfect guide. With it, patients are treated on all levels, not superficially or symptomatically.
The lower the treatments on the pyramid, the more important they are to holistic healing. At the foundation of the pyramid are Lifestyle and Diet. These two are so important that I devote many articles and videos to them. You may find them by searching this site and my Youtube channel.
For this article, I will start with “Balance,” the third foundation in my pyramid of holistic healing.
Balance within the Physical Body: Holistic Healing for Adrenal Fatigue
The third level is “Balance” after we’ve worked on the pyramid’s foundation with lifestyle and diet modifications. This level is purposefully ambiguous and open-ended. You are the only one who knows what needs balancing in your life.
Balance must exist in the physical realm. Chiropractic treatment to balance the structural integrity of the skeletal system is sometimes appropriate. Massage of the muscles in the body can assist metabolism by clearing metabolic byproducts. That can also relieve detrimental muscular imbalances developed over time through poor habits or posture.
For some, acupuncture can bring balance through manipulating our meridian systems. Practices of Eastern origin, like Yoga, Tai Chi, and Qigong. are also useful. They bring balance into our beings on all levels, especially to our muscles, tendons, and inner organs.
General Support with Supplementation
The next level of holistic healing treatment is that of general support. This level supports the patient’s overall well-being from a supplemental point of view. Typically, this involves supporting the body through a high-quality, easily-absorbed multivitamin. They supply nutrients where our less-than-perfect diet may leave holes in our nutritional status.
The brand of vitamins used is crucial, as different companies have different quality control standards. I have found that many products need to be improved and thus produce inferior results. With extensive research, I have found the most natural, cleanest, highest potency supplements. Each of these supplements have been tested in a clinical setting for efficacy.
Antioxidants are also important in the treatment. Increased oxidative stress (free radicals) resulting from chronic stress response activation places more demand on your antioxidant status.
Essential fatty acids (EFAs) make up most of your cell membranes and help communicate between one cell and another. The efficiency of this process is critical to ensure adequate healing. EFAs exist in many forms. From my research and experience, the primary EFA deficiency is in that of the omega-3 fatty acids.
Omega-3 fatty acids exist primarily in fish. The omega-3 oils in fish oils are more bioavailable to us than those in plant sources, such as flaxseed oil. Above and beyond fish oil, I recommend Royal Cod Liver Oil by Green Pasture. In addition to the all-important omega-3 oils EPA and DHA, Royal Cod Liver Oil also contains the fat-soluble vitamins A and D. Those vitamins are chronically low in adrenal patients.
System Support: Help for Immune, Digestive, and Thyroid
The next level of the therapeutic pyramid is the support of bodily systems. This support must be individualized for each patient. Everyone is unique in presentation, group of symptoms, genetics, and biochemistry.
Typical systems that require support or strengthening in patients with Adrenal Fatigue are the stress response system. The stress response system consists of the limbic system in the brain, nerves (ANS), and hormones (HPA Axis including the adrenals. The digestive, immune, reproductive, and cardiovascular systems may also require support. Thyroid function and metabolism are also often compromised.
As mentioned previously, some of these dysfunctions are secondary. They still may need extra support to reduce the total stress load on the body. I support these systems in the most natural yet effective way. I do this so as not to further offset the balance of the body. We must still focus primarily on diet, lifestyle, and balance, the foundations of my pyramid.
Symptom Support: Calming Our Bodies Before True Healing Can Begin
In my patients, I handle system support with care. Symptoms are merely messages from the body of underlying dysfunction. Our job is to listen to these messages and interpret them properly.
Suppose you were to shut off the message, for example, with an analgesic like Tylenol for a headache. In that case, you can no longer assess the intervention for the headache and will have difficulty determining the underlying cause. It may have been low blood sugar or dehydration, but we cannot evaluate it if we keep masking it.
This is not to say that I would allow a headache or any other symptom to fester uncontrolled. I would want to use the most gentle, targeted intervention. This way, the feedback we obtain from therapeutic success or failure provides us with information.
In addition, by masking the symptoms, we may have fixed one problem, but you may have created another. Certain symptoms must warrant attention for the person with Adrenal Fatigue to have a chance at healing.
Symptoms like insomnia and anxiety are good examples of this. These symptoms often result from the same underlying problem: an up-regulated or “trigger-happy” stress response. This leads to an output of stress hormones that is often excessive and released at inopportune times.
We must quiet this up-regulated stress response system. Otherwise, it’s like trying to repair a car’s engine while driving it down the road. It’s much easier to shut off the engine and put it up on blocks somewhere safe in a garage. At that time, you can grab the right tools, and with experience and study, you can make the appropriate repairs.
My Stance on Bio-identical Hormone Replacement Therapy (BioHRT)
Bioidentical hormone replacement therapy (BioHRT or BHRT) involves using hormones that are the same as your body’s substances. Doses typically replace a deficiency in a certain hormone. Hormones vary in their strength and function. Even with replacement doses, we can be gentle yet effective. This greatly reduces the risk of side effects and the suppression of the individual gland targeted.
Typical hormones I target for temporary replacement include Pregnenolone and DHEA. These are two major adrenal hormones that act as precursors or building blocks to many other adrenal hormones. When indicated, I may also suggest BHRT or other “steroid” hormones, such as progesterone, testosterone, or estrogen. These are typically not a first line of intervention.
General treatment of the adrenal glands and a gentle BioHRT can support the system. This can make BioHRT or other stronger hormones unnecessary. The approach allows us to treat the system on a deeper level, working to repair the problem. We are not simply replacing what is missing without paying any attention as to why it’s missing.
I always recommend using physiologic doses (identical to the body’s production level) of these hormones. This approach greatly reduces or eliminates the ultimate risk of suppression of the individual gland. In addition, I recommend patients start with low doses of one hormone. Then we can gradually increase dosages over time to minimize any side effects possibly due to cell receptor sensitivity changes.
Research gives us clues on how much hormone to use in some situations, but these protocols must be individualized and specific to each patient. I have refined these protocols over years of research and experience with over 6,000 patients.
Last Resort: Prescription Drugs and Surgery
At the very top of our pyramid—the tiniest piece—are the tools of our current conventional medicine model. I often do not have to reach the top and treat at this level. I spend so much effort emphasizing the bottom levels, which affect change and healing at a deeper level.
While I am not against the use of pharmaceutical drugs and surgery – we are fortunate to have many of them – I am against the overuse and misuse of these medications and techniques. When drug use worsens the overall condition, although it may temporarily relieve a symptom, it is counterintuitive to the overall healing process.
Using drugs and surgery as treatment modalities works primarily for acute injury and trauma care. However, these modalities do little good and yet have much potential for harm in cases of chronic disease.
Here is a final note regarding the treatment hierarchy described may be helpful to put it all into perspective. The higher you move up the pyramid, the more interventions become increasingly specific and targeted. They are also typically more expensive, come with more risk, and are more invasive. They require much less responsibility and personal investment from the patient, which makes them easier to employ.
When you treat from the bottom up, we ultimately save time, money, and energy. We also effect change for the long term. We use this pyramid daily when my coaches and I work with patients in our healing programs with the Trilateral Approach.
