Is It Adrenal Fatigue?

It has been a stressful time and now you are exhausted. You feel drained. Could it be adrenal fatigue?

Adrenal fatigue has become a controversial topic since the term was first coined by a chiropractor in 1998.

Most medical professionals say adrenal fatigue is not a real disease; yet alternative health practitioners offer many tests and treatments for it.

Adrenal fatigue makes sense on paper. Your adrenal glands produce cortisol, and they produce lots of it when you are under stress. The theory is that when you are under prolonged stress, your adrenals become fatigued and you run out of control.

This then leads to the classic symptoms: dragging tiredness, brain fog, depressive mood, salt and sweet cravings or nervousness.

Yet these could be symptoms of any number of other issues, including low iron, sleep apnoea, auto immune diseases and mental health conditions. They are also common symptoms of stress in general.


What does the research say?

Harvard Health recently reported on a review of 58 studies which concluded, “there is no scientific basis to associate adrenal impairment as a cause of fatigue.” Yet Harvard Health also acknowledged that it is problematic, because there is no formal criteria to define and diagnose adrenal fatigue.

Doctors at the Adrenal Program at Cedars Sinai in the USA are more direct. “Adrenal fatigue is not an actual disease,” says endocrinologist Dr Anat Ben-Shlomo.

“Stress can have an impact on our health, but it doesn’t affect your adrenals this way. When you’re stressed, the adrenal glands actually produce more of the cortisol and other hormones you need. They will give you all that’s necessary.”

Both Harvard Health and Dr Ben-Shlomo warn against taking cortisol supplements for adrenal fatigue.

Harvard Health gives an important word of caution: “some medical professionals prescribe cortisol analogs to treat adrenal fatigue. Cortisol replacement can be dangerous even in small doses. Unintended consequences can include osteoporosis, diabetes, weight gain, and heart disease.”

Dr Ben Shlomo explains further: “the supplement can make you feel good at first because it’s a steroid. But over time, it can actually inhibit your adrenal glands.”


How to manage the symptoms

The treatments usually offered by alternative health practitioners for adrenal fatigue are sensible, and will probably help. This includes cutting down on coffee and alcohol, eating more fruit and vegetables, doing light exercise and prioritising sleep.


What about adrenal insufficiency?

As opposed to adrenal fatigue, adrenal insufficiency is a medically accepted diagnosis, and occurs when your body doesn’t produce enough of the hormone cortisol.

Chronic adrenal insufficiency is measured by a blood test that measures cortisol levels.

Rather than purely a stress response, adrenal insufficiency is most often caused when your immune system attacks your healthy adrenal glands by mistake. Other causes include cancer, tuberculosis and inherited disorders of the endocrine glands.

Primary adrenal insufficiency, also called Addison’s disease, occurs when your adrenal glands are damaged. It’s quite rare but can occur at any age.

If you’re concerned, see your doctor for proper testing.