Adrenal Fatigue For Dummies
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In the advanced stages of adrenal fatigue, low blood pressure is common. You may need a prescription medication to increase your blood pressure. In cases of adrenal exhaustion, you may need to add supplementation of an adrenal steroid hormone to help keep your blood pressure in a normal range.

In some people, the blood pressure meds can raise blood pressure even at low doses; this occurs in patients who still have some degree of adrenal reserve. You should monitor your blood pressure on a regular basis with a blood pressure cuff and call your healthcare provider if you notice your blood pressure numbers increasing beyond a normal range. Your medication and/or supplement program may need to be adjusted.

How to use midodrine with adrenal fatigue

Midodrine (ProAmitine) is a prescription medication taken orally. It works on the blood vessels to help normalize blood pressure. How does it work? It stimulates alpha receptors on your blood vessels, causing the arteries to narrow. This narrowing, called vasoconstriction, helps increase your blood pressure.

Because midodrine is a short-acting medication, you typically take it several times a day. Common times are 8:00 a.m., 1:00 p.m., and 6:00 p.m. Because everyone responds differently to this medication, it's often prescribed first at a low dose (normally 2.5 milligrams two to three times a day) and increased slowly. The maximum dose is 10 milligrams three times a day.

Avoid taking midodrine late at night before you go to bed. In some people, it can cause supine hypertension, in which your blood pressure increases quickly when you're lying flat. If you're taking midodrine, lie down with the head of your bed elevated at 30 degrees to avoid supine hypertension.

Midodrine can dramatically increase the risk of developing very high blood pressure while you're sleeping, so many healthcare practitioners prescribe that midodrine be taken no later than 6 p.m.

How to use salt tablets with adrenal fatigue

Salt craving is a symptom of adrenal fatigue. Sometimes the salt craving can be so bad and the blood pressure so low that supplementing with salt is necessary. Salt raises blood pressure and blood volume.

One option for replacing the body's salt deficit is through salt tablets. Some practitioners prescribe tablets of sodium chloride (yes, table salt) when the blood pressure is very low and the person isn't able or likely to increase salt intake on his or her own.

The most common prescribed starting dosage of sodium chloride is 1 gram a day. A person may eventually be prescribed 2 or 3 grams of salt a day, often to be taken in divided doses during the day (usually half in the morning and half in the evening).

If you're on salt tablets, monitor your blood pressure on a daily basis. If you notice higher than normal blood pressure readings, contact your healthcare practitioner to see whether the dose needs to be adjusted.

About This Article

This article is from the book:

About the book authors:

Dr. Richard Snyder, DO, is board certified in both internal medicine and nephrology, as well as a clinical professor at the Philadelphia College of Osteopathic Medicine.

Wendy Jo Peterson, MS, RD, is a registered dietitian with a master’s degree in nutritional sciences as well as a specialist in sports dietetics. She is the coauthor of Mediterranean Diet Cookbook For Dummies.

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