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Adrenal Fatigue: Fact or Fiction?

Medically Approved by Dr. Edward Salko

Table of Contents

Now and then a lay concept surfaces to explain complex medical symptoms. One prominent example is adrenal fatigue. While it may sound like an actual clinical term, this alternative medicine theory remains unfounded as a medical diagnosis. 

Adrenal fatigue is riddled with myths. However, the symptoms can be real. But they are likely due to other health conditions. Learn more about the truth behind this long-standing lay concept when you read on. 

What Is Adrenal Fatigue? 

Adrenal fatigue(1) is a non-clinical or medically unrecognized term for a cluster of symptoms. These include extreme exhaustion, sleeping problems, brain fog, anxiety, headaches, muscle weakness, increased cravings for salt and sugar, as well as notable weight changes. 

The concept of adrenal fatigue points out that chronic stress, which constantly triggers the production of hormones like cortisol, leaves the adrenal glands tired and worn out.  As a result, its functions diminish, causing a decrease in energy.

History of the adrenal fatigue theory

James L. Wilson was the proponent of adrenal fatigue. He discussed the concept through his book, Adrenal Fatigue: The 21st Century Stress Syndrome. Wilson is a naturopath and champions alternative medicine. He also formulated 16 dietary supplements to address adrenal fatigue. 

Reasons why adrenal fatigue is a disputed concept

Although adrenal fatigue was first introduced in 1998, it remains a theory outside conventional medicine. Those who perform adrenal fatigue treatment are commonly those practicing alternative medicine. The lack of clinical backup for the said condition can be traced to the following reasons.

  • Lack of scientific backing: No credible or sufficient clinical studies back up the theory of adrenal fatigue. In particular, its mechanism of development that underscores chronic stress as the primary instigator of adrenal exhaustion has no specific test parameters to prove its accuracy.
  • Adrenal symptoms are too general: The symptoms involved in adrenal fatigue mimic other health conditions, like thyroid disorders, chronic fatigue, and depression.
  • No established test protocol: While an adrenal health assessment is available to check if the glands work properly, there is no specific lab protocol to identify adrenal fatigue.

Endocrine Society, a respected organization composed of hormone specialists, does not recognize adrenal fatigue as a true medical condition(2). Instead, the healthcare body encourages people to undergo proper diagnosis first by a primary care provider rather than turning to alternative medicine. 

Adrenal Fatigue Vs. Adrenal Insufficiency

While adrenal fatigue is not a recognized health condition, adrenal insufficiency is. Also known as Addison’s disease, adrenal insufficiency(3) is characterized by impaired adrenal glands, causing them to produce inadequate hormones, like cortisol.

Both conditions may seem similar, but adrenal insufficiency has a scientifically established pathology. Unlike adrenal fatigue, wherein chronic stress is to blame (allegedly), in adrenal insufficiency, the causes of the organ defect may include genetic disorders, autoimmune disease, infections, and suddenly stopping the use of steroids. 

Adrenal insufficiency can lead to fatigue, irritability, appetite loss, weight changes, low blood pressure (hypotension), irritability, nausea, and vomiting. Treating the condition involves hormone replacement therapy.  

How to Fix Adrenal Fatigue Naturally?

women doing yoga

Adrenal fatigue may not be a medical condition, but the symptoms exist. In fixing what you think is adrenal fatigue, it’s crucial to be mindful of the specific symptoms. Aside from seeking medical attention and getting properly diagnosed, you can improve the functions of your adrenal glands through the following actions. 

Pro tip: Be cautious of adrenal fatigue supplements being advertised to address chronic fatigue and other symptoms. Most products have no approved therapeutic effect due to insufficient proof supporting effectiveness. They could also bring more harm than good. 

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Frequently Asked Questions

What are the stages of adrenal fatigue?

Theoretically, the four stages of adrenal fatigue are alarm, resistance, exhaustion, and burnout. 

The alarm stage covers the normal response of the adrenal glands to stress. The resistance stage is when you experience chronic stress, and the adrenal glands’ ability to produce hormones is reduced. During the exhaustion stage, the adrenal glands won’t be able to produce enough hormones anymore. Finally, in the burnout stage, several bodily functions are affected by adrenal dysfunction.

How do I check my adrenals?

The most effective and cost-efficient way to check your adrenal health is through a proper medical screening. Your doctor will evaluate your symptoms and check if they relate to adrenal problems – not necessarily adrenal fatigue, as it is not a medical diagnosis to begin with.

You may have to undergo an imaging procedure, urine tests, and blood tests for adrenal hormones, like the cortisol blood test and aldosterone blood test.

What hormone causes adrenal fatigue?

In alternative medicine, cortisol is the focal hormone linked to adrenal fatigue. Cortisol is dubbed as the stress hormone and is produced by the adrenal glands. In a stressful situation, cortisol is released and influences energy expenditure. According to the adrenal fatigue theory, recurring stress can degrade the ability of the adrenal glands to secrete cortisol. 

The Bottom Line

The adrenal glands play a crucial role in regulating many functions of the body by producing essential hormones like cortisol. However, problems surrounding the adrenal glands cannot be discounted into theories, especially if they don’t pass the gateways of science. To truly understand any fatigue-related symptom, consult your primary care provider and spare yourself from the dangers of self-diagnosing on the internet

Sources:

1 Ross IL, Jones J, Blockman M. We are tired of ‘adrenal fatigue’. S Afr Med J. 2018 Aug 28;108(9):724-725. doi: 10.7196/SAMJ.2018.v108i9.13292. PMID: 30182895.

2 Cadegiani FA, Kater CE. Adrenal fatigue does not exist: a systematic review. BMC Endocr Disord. 2016 Aug 24;16(1):48. doi: 10.1186/s12902-016-0128-4. Erratum in: BMC Endocr Disord. 2016 Nov 16;16(1):63. PMID: 27557747; PMCID: PMC4997656.
3 Lewis A, Thant AA, Aslam A, Aung PPM, Azmi S. Diagnosis and management of adrenal insufficiency. Clin Med (Lond). 2023 Mar;23(2):115-118. doi: 10.7861/clinmed.2023-0067. PMID: 36958832.

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