Postural Hypotension and Functional Hypoadrenia

By Dr. George Goodheart

Summary: In 1920 Los Angeles medical doctor D.C. Ragland published a remarkably simple test he used to assess his patients’ adrenal health. All that was required to perform the test was a means for measuring the patient’s blood pressure and a place where he or she could lie down and then stand up. The procedure took all of a few minutes and quickly revealed whether the patient might be suffering from adrenal fatigue. The medical community, dismissive of the entire notion of subclinical adrenal deficiency, ignored Dr. Ragland’s new assessment tool. The test was readily adopted by a number of chiropractors, however, who recognized the phenomenon of “adrenal burnout” as real and were glad to have an easy method of determining its likelihood. In this 1965 article, famed chiropractor Dr. George Goodheart, the “father of Applied Kinesiology,” discusses Ragland’s assessment in detail, explaining its procedure, the physiology and anatomy behind the test, and various treatments for the condition of “functional hypoadrenia” that it all too often reveals. While the paper is written for a chiropractic audience, the information presented is invaluable to anyone interested in the subject of adrenal health. From the Digest of Chiropractic Economics, 1965. Reprinted by the Lee Foundation for Nutritional Research.

The following is a transcription of the original Archives document. To view or download the original document, click here.

Postural Hypotension and Functional Hypoadrenia[spacer height=”20px”]

The clinical significance of postural changes in blood pressure often escapes the attention of the doctor, who feels that if the blood pressure is within normal limits, then no further investigation is needed in this area. A simple screening test for hypoadrenia, which measures the body’s ability to compensate for the hydrostatic effects of gravity, takes very little time—perhaps a minute or two—yet this simple test affords the clue to many problems we face every day.

The patient who is dizzy upon change of position, especially upon rising, the patient who can’t get going in the morning, the patient who feels best as the day goes on then suddenly seems to collapse around 7:00 or 8:00 PM is an example of the hypoadrenia patient. And this patient will have perhaps a normal blood pressure sitting or lying, but upon assuming the upright position, there is a drop in the systolic pressure of as much as 40 mm. The usual amount of abnormal drop is about 10 to 15 mm, but any drop is abnormal.

The splanchnic veins have no valves and as a result are dependent on the autonomics of the nervous system for their function, and the tone of the splanchnic nerves is under the control of the adrenal system. The tone of the blood vessels of the abdomen therefore is under the control of the splanchnic nerves, and when the patient stands up from a lying or a sitting position, there should be a rise in the systolic blood pressure of 4–10 mm from the recumbent to the erect position. Generally speaking, there should also be a rise of at least 6 mm from the sitting to the standing position. The patient who dates his trouble of tiredness and loss of interest following an attack of “flu” and who must force himself or herself to do everything very often will have a systolic recumbent BP of 124, with an erect BP of 100.

In the normal person, the systolic blood pressure is 4 to 10 mm higher in the standing erect position than it is in the lying position. This rise is due to the so-called “G” effect. When we stand, all the blood rushes to our feet due to the effect of gravity, but the receptors in the aorta and other blood vessels communicate this new position to the nervous system, and just as a fighter pilot wears a “G suit” or “leg squeezer” to counter the effects of gravity on a fast pullout from a vertical dive, so also do we have our own G suit, which causes a redistribution of blood from the splanchnic area to heart and muscles when we assume the erect position.

This G suit mechanism is controlled by the splanchnic nerves. These splanchnic nerves are controlled by the adrenal system, since the weak adrenals, which should provide the actual chemical substance that allows this redistribution or compensation, hamper the mechanism by not providing enough “sympathin” to influence the valveless splanchnic veins’ compensatory mechanism.

The same sympathin chemical substance causes the contraction of the iris to light, and when it is in short supply, as in hypoadrenia, the usual contraction of the pupil to light is not sustained. If the examining light is shone on the eye for 30 to 40 seconds, there will occur a paradoxical dilation of the pupil to light or, as is often seen, an alternating contraction and dilation, with the pupil getting larger following each alternation while the examining light is kept on the eye. Like the postural hypotension, this is a sign of weak adrenals and explains why some patients can’t stand bright lights or have accommodation defects that defy the usual optometric or ophthalmological efforts.

These two signs—a dropping blood pressure upon standing and a paradoxical dilation of the pupil to light—are two easy, quick, simple yet valid indicators of weak-functioning adrenals.

People who suffer from headache and/or dizziness in the erect position or who complain of weakness that is unrelated to blood count, blood pressure, or blood sugar levels many times have this adrenal dysfunction as the basis for their complaints. This condition of hypoadrenia often accompanies a low blood sugar with the associated hyperinsulinism. In this regard it is interesting to note that just as low blood sugar symptoms can occur in a diabetic—because sometimes it is not the actual level of the blood sugar but the rate of drop that causes the symptoms, so also can there be falling blood pressure in a person who has high blood pressure when he assumes the erect position. So it is best to be alert for this condition in all varieties of patients.

[Photo with caption:] Dr. Goodheart.[spacer height=”20px”]

Following severe illness associated with fever and also following anesthesia, alcoholism, prolonged worry, focal infections, toxic conditions, and fractures—to name a few instances I have observed in my own practice to set the stage for a run on the reserves of the adrenal bank account—along with the usual patterns of modern life, with all its tensions, quickly “overdraw” the adrenal reserve and produce the characteristic pattern of fatigue. Since the adrenals have been closely associated with stress, it is only natural that stress, when excessive, can deplete them. Because we cannot avoid stress, it is best to prevent the effects of stress on the body or, failing that, to recognize the condition and take appropriate treatment measures to balance the system.[spacer height=”20px”]

One primary effect of adrenal stimulation is the release of glycogen from the liver and possibly the musculature. When the blood sugar becomes lowered, as was discussed in the article “Hyperinsulinism,” this mechanism of “fight or flee” activity may be continually forced into action to vainly try to keep converting glycogen into usable blood sugar, when low blood sugar levels occur due to hyperinsulinism—or even, perhaps, due to the newly discovered reaction to the protein factor leucine, which also triggers a low blood sugar pattern.

Often these two conditions, hyperinsulinism and hypoadrenia, are found together, so that the hyperinsulinism diet is needed along with support to the flagging adrenals.

The same “fight or flee” mechanism that enabled primitive man to escape the saber-toothed tiger causes him to react to stress. But the stress now is often illness or toxemia or severe trauma, and instead of perching safely though exhausted on a branch of a tree higher than the tiger could leap, breathing hard and pumping much blood—brought on by the sudden effort through the recently activated adrenal system—and thereby allowing the adrenals to return to normal, man now uses this adrenal system just as if he were being chased by the tiger, but he has no feedback mechanism to revive the overworked adrenal system. And so the adrenals go down to a depleted state with the previously mentioned diagnostic findings.

Since the adrenals are concerned with body chemistry, water metabolism, and electrolyte levels, it is reasonable to expect a correlation between blood pressure and body chemistry. The clinical basis for a low sodium diet has been pretty well established in a high blood pressure condition, but the mineral management of the hypotensive, especially the postural hypotensive, has been pretty well neglected, as have other measures designed to help this condition of postural hypotension and low adrenals.[spacer height=”20px”]



Potassium Increased Decreased
Sodium (chloride) Decreased Increased
Cholesterol Decreased Increased
Glucose Decreased Increased
[spacer height=”20px”]As you can see by the chart, the patient should avoid excessive-potassium foods, and in general the high-sodium foods should be increased, using the urinary chlorides as a guide. High intake of natural vitamin C complex along with the natural G complex and cytotrophic extracts of adrenal is also valuable, as is calcium. Coffee should be avoided, and the hyperinsulinism diet should be followed, with restriction of the high-potassium foods, such as bananas, cocoa, dried fruits, molasses, olives, potatoes, veal, and asparagus.[spacer height=”20px”]

The failure of the liver-kidney-adrenal system to detoxify excess foods causes an adrenal type of halitosis that is most pronounced with stress and fatigue, so when the capacity of the digestive tract is exceeded, we have an internal stress that only conformity to its limitations will help. An elimination of meats for a day or two will help in this aspect of adrenal dysfunction.

Many clinical states have their origin in hypoadrenia. Asthma is a classic example. The overactivity or facilitation of the second to the fourth dorsal segments, due to subluxations there, “sets up” the patient. Then, when he comes in contact with a so-called allergic substance or excessive carbohydrate or even constipation, the nervous system is thrown out of balance, and the “fight or flee” mechanism is activated. In order for this to operate, glucose must be mobilized. To cover this added glucose, insulin production is increased.

Now, normally the adrenal glands inhibit any excess insulin. But since they are already under stress, the added stimulation results in a suppression of their function, so there is little stimulation of the adrenal cortex by the nonexistent adrenalin. The sodium retention factor is lost by way of the urine. Since the available adrenalin and sympathin are reduced, the parasympathetics become dominant, escaping the sympathetic balance; bronchial arteries dilate, and congestion of the bronchial vascular bed results in edema. This narrows the bronchiolar openings, and wheezing with labored breathing begins. This causes accessory muscles of respiration to be brought into play, with an additional glucose need for their contraction, increasing the production of insulin. Doesn’t this start to sound a bit familiar?

As a result of the loss of the gas exchange in the lungs and the increased sodium loss in the urine, an acidosis develops, with an increase in serum potassium. This then alters the activity of ATP at the muscle fibers, so all the muscles of respiration go into spasm. This vicious cycle then perpetuates itself. The key is a subclinical hypoadrenalism.

Careful analysis and vigorous adjusting of segments nine through eleven yields good results. A good general approach is to use a hard index and adjacent finger pressure adjacent to the lamina of all the spinal vertebrae starting at cervical one and continuing down to the sacral area, taking care that this pressure remains even and constant. This should create a red mark along the spine that should begin to fade after a minute or two. In postural hypotension using a sharp snappy thrust over the segment that stayed red the longest exerts a very favorable effect on the problem. This technic was originally used by Erdman in 1921 and is still good today.

Caffeine, the bromine in tea, and chocolate all cause an excretion of sodium, and since this element is in short supply, it is wise to reduce these substances in the diet. In chronic cases a quart of water and two teaspoons of plain salt, taken as an enema immediately following a bowel movement every other day during the first week, is very useful. In severe cases a tupelo-honey-and-water fast for a few days helps cleanse the system. Use a tablespoon in four ounces of warm water as often as needed throughout the day. Tupelo honey is high in levulose [fructose], which does not require insulin for its metabolic use, therefore the patient feels well during this initial period. This routine is only necessary in severe or resistant cases.

This key will unlock many doors that often only open by accident. These patients sometimes have a mid-sleep insomnia, awakening after about four hours of sleep and having difficulty getting back to sleep again. There is a type of adrenal patient who is stimulated by activity and finds it almost impossible to leave a party, and there are types who, as is seen in some infants, seem to get their days and nights mixed up. This also is hypoadrenia. All these conditions respond to intelligent management and frequent chiropractic treatment. Correction of this condition by, first, detection and, second, treatment is just one more way the chiropractic physician can be of service to his patient and to chiropractic.

Copies of the hyperinsulinism diet mentioned in this article are available from author without charge. Please enclose a stamped self-addressed envelope. [Note: Retained for historical purposes only. Diet is not available.]

By Dr. George J. Goodheart, 542 Michigan Building, Detroit, Michigan 48226. Reprinted from the Digest of Chiropractic Economics, May/June 1965, Vol. 7, No. 6, by the Lee Foundation for Nutritional Research. 

Form VH-185

Note: The above article is reported as a professional service by Standard Process Laboratories. Certain persons considered experts may disagree with one or more conclusions and opinions expressed by the author, but the same are considered nevertheless to be of current interest to chiropractic physicians. Reporting of such article shall not be construed as a recommendation concerning use of any specific product or products, nutritional or other procedures employed being a matter for the doctor’s professional knowledge and judgment depending on his evaluation of the individual involved.


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