Editor’s note: Dr. Keith Horinouchi is a doctor of Public Health whose practice specializes in lifestyle wellness counseling, natural hormone balancing, integrative nutritional therapies, and metabolic testing. He has been working on Guam for the past 15 years and his clinic is located on Chalan San Antonio, Tamuning.

NEARLY 26 years ago, I had just arrived on the beautiful island of Kauai, Hawaii. I had been working in California where I had also completed my training in Lifestyle and Nutritional Medicine. Hawaii was home for my parents and I wanted to experience the island lifestyle. So who could argue about that reason to move to Hawaii?

But since jobs in Wellness were hard to come by in those days, I took a job as a hospital administrator. Little did I know that the stresses of being a hospital administrator eventually would take their toll on my health, particularly a condition I found out I had called adrenal fatigue. Working as an administrator was very stressful, with early-hour meetings, long days of dealing with problems and management issues, and just trying to make everyone happy.

My first day on the job, I found myself between two laboratory employees arguing over some petty issue. What a taste that was of dealing with problems over the next 10 years as a hospital administrator in Hawaii. I was involved with a nurse’s labor strike from one of the unions, and had to continue providing care to the patients in spite of the lack of nursing personnel. My hospital in Kauai had significant damage from Hurricane Iniki in 1992. Lack of communications, water, electricity and supplies made it difficult to take care of hospital patients.

But what I found most stressful about being a hospital administrator was the fact that there were many “bosses” to whom I had to listen. Usually having only one boss is the standard of any business. My “bosses” included the hospital board, a corporate office in Honolulu, the doctors, the unions, district legislators, payers, Medicare/Medicaid, accreditation bodies, and finally, the community. When I was first hired, it was implied that I would have to close the hospital because they were losing too much money. But in the end, the community demonstrated the need to have a community hospital in a remote location in Hawaii.

After many years of stress, I gradually grew tired, lacked vitality, and was overweight – or as we commonly call it, I got “burned out.” Medically speaking, this is where we over-use our adrenal glands until they can no longer produce the normal flow of stress hormones, including cortisol and DHEA, that give us energy and vitality every day. Chronic stress or even a large single acute case of stress, poor nutrition and poor lifestyle habits, like drinking too much caffeine and alcohol, can bring on adrenal fatigue.

In my practice of lifestyle and nutritional medicine on Guam, I assist many patients with recovering from adrenal fatigue, also called adrenal hypofunction. A simple blood test of adrenal hormones can be done to find out where you are. Then making a change in diet and nutritional supplements can be used to regain your energy and feel like you’re back to normal. Adrenal fatigue also worsens the menopausal or andropausal (for men) symptoms that we go through in the later years of life.