Drs. Dino Pappas and Marie Tholl-Pappas discuss the causes and remedies to chronic fatigue, a medical condition which plagues a great many Americans today.

1. FATIGUE
Dr. Marie Tholl-Pappas
Dr. Dino Pappas

2. Adrenal Fatigue “Bible”
• Scope of the Problem
– “It is estimated that 80%
of adult Americans suffer
some level of adrenal
fatigue at some time
during their life, yet it
remains one of the most
under-diagnosed illnesses
in the US.” – James
Wilson, ND, DC, PhD
(Adrenal Fatigue Expert)
• Patient Friendly Text on
the Topic

3. Key Organs That Respond To Stress

4. General Adaptation Syndrome
• Phase 1 = Acute Stress
• Phase 2 =Coping,
Resistance &
Adaptation
• Phase 3 = Exhaustion
(body can’t cope)
– Fatigue Sets In
– Open Window Theory
• An open window for
chronic disease (Diabetes,
Fibromyalgia, Chronic
Fatigue Syndrome,
Thyroid Disease, Cancer,
Etc.)

5. The Importance of Kidney & Adrenal Hormone Balance
• Role of Kidney & Adrenal Hormones (Cortisol, Steroid
Hormones & Epinephrine)
– Control swelling & inflammation
– Treat allergy symptoms
– Cancer treatment & prevention
– Assist with infection management
– Immune & Auto-immune Disorders
– Affect use & storage of carbs, proteins & fats
– Assist with blood sugar regulation
– Blood pressure regulation
– Electrolyte Balance
– Anti-oxidant function
– Assist with sex hormone production (ex: menopausal women)
– Sex Drive
– Performance (Athletic, Academic, Recreational, Etc.)

6. Overwhelmed Stress Response

7. End Result of Chronic Stress = Disease
• Other Conditions
– PMS
– Severe Menopause
Symptoms
– Insomnia
– Frequent Infections
– Hypoglycemia
– Alcoholism

8. Signs & Symptoms of Adrenal Fatigue
• Difficulty getting up in the • Mild depression
morning • Increased PMS
• Fatigue not relieved by sleep • Increased symptoms with
• Craving salty foods, sugary skipped meals
foods or stimulants (caffeine) • Less focused thoughts
• Lack of energy • Hard time remembering things
• Increased effort to do every day • Decreased tolerance
tasks • Don’t wake up till 10:00 AM or
• Decreased sex drive later
• Decreased ability to handle stress • Afternoon (after lunch) “blues”
• Increased time to recover from • Feel better after evening meal
illness, injury or trauma • Decreased productivity
– *** Key Tip Off: Chronic
• Light headed when getting up
respiratory infections with a
longer recovery period ***

9. Steps to Identification & Recovery
• Step 1: Adrenal • Step 3: Lab Testing (As
Fatigue Questionnaire Needed)
http://www.canhealyourself.com/adrenaltest.pdf Testing
– Saliva Hormone
• Step 2: – Urinalysis
Comprehensive Exam – Blood Work
– Physical • Step 4: Formulate a
– Orthopedic Treatment Plan
– Neurological • Step 5: Implement Specific
– Special Tests (Postural Recommendations
Blood Pressure &
Pupil Contraction)
• Step 6: Re-evaluate

10. Step 3: Laboratory Testing As Needed
• Saliva Hormone Testing
– Can be used to measure cortisol, steroid & sex
hormones
– Best single lab test for adrenal fatigue
– Indicative of the actual hormone in the cell where
reactions take place & not the bloodstream
– Easy to perform & Non-invasive
– Can be used to test & retest
– Recommended at least 4 Tubes (Morning, Noon,
Afternoon & Night)
• Date & time of collection are written on all tubes & kept
in a journal
• More tubes may be used to measure “lows” & “highs”

11. Saliva cortisol
levels are low
in the morning
and high at
night. This
person has
trouble waking
up, is just fine
in the middle of
the day and
can’t sleep at
night.

12. Saliva cortisol levels
are just fine in the
morning, fine in the
afternoon and high at
night. This patient
has trouble falling
asleep at night.

13. Saliva cortisol
levels are fine in
the morning, dip
middle of the day
and return to
normal at night.
This patient has
the afternoon
blues.

14. Saliva cortisol levels
are low in the
morning, low middle
of the day and normal
at night. This patient
has trouble getting up,
has the afternoon
blues, low energy in
the evening and goes
to sleep exhausted.

15. Questions
• Contact Info
– 9442 W. 179th Street –
Tinley Park, IL 60487
– Office: 708-532-CFIM
(2346)
– Email:
• Office: thecfim@gmail.com
• Dr. Marie:
marie.tholldc@gmail.com
• Dr. Dino:
drdinopappas@gmail.com