Adrenal Fatigue: What It Is and How to Treat It

Many seeking treatment for common nonspecific symptoms are led to believe they are suffering from some sort of hormonal deficiency. “Adrenal fatigue” is the prototypical example. Chiropractor-coined in 1998, the invented diagnosis has since been embraced by naturopaths, functional medicine, and anti‐aging doctors. But does adrenal fatigue even exist? The alleged condition is said to result from chronic stress leading to an “overuse” of the adrenal glands and their eventual functional failure. Symptoms supposedly include fatigue, body aches, sleep issues, and digestive problems (at least according to the websites not so coincidentally selling a suite of supplements to remedy it). It will come as no surprise that the originator of the term sells supplements on his website to treat it for $200 a month. But it may not be an actual medical condition.

The symptoms people have are real, but they just may be caused by something else, for example, sleep apnea, chronic fatigue syndrome, or fibromyalgia. Saliva tests for adrenal hormone levels are not reliable, with studies showing so-called “adrenal fatigue” patients having higher levels than controls, similar levels, or lower levels, “an almost systematic finding of conflicting results.”

There is an actual disease of adrenal insufficiency known as Addison’s disease, which is diagnosed with an ACTH stimulation test. You inject people with adrenocorticotropic hormone, the signal your brain uses to get your adrenal glands to pump out the stress hormone cortisol, and if your adrenals don’t respond, that shows your adrenal glands must be in trouble. But inject those presumed to be suffering from chronic stress and fatigue with ACTH and sometimes you even get a greater rise in cortisol, disproving the notion that stress causes the adrenals to “burn out.”

But wait, you were diagnosed with “AF,” given corticosteroids, and now you feel great, so it must have been real. That’s the thing about corticosteroids, though. One of the side effects is a euphoric sense of well-being. The problem is that even low doses can increase the risk of osteoporosis, psychiatric and metabolic disorders, muscle damage, glaucoma, sleep disturbances, and cardiovascular diseases.

But wait, you took some quote-unquote “adrenal support” supplements, checked the labels, confirmed they don’t have any hormones, and still felt better. They lie. Researchers checked the 12 most popular dietary supplements, and every single one contained hidden hormones, none of which were declared on the product labels. All contained thyroid hormone and most a steroid hormone as well (pregnenolone, budesonide, androstenedione, progesterone, cortisone, or cortisol).

Adrenal fatigue reminds me of what used to be called “electromagnetic hypersensitivity,” now referred to in the medical literature as “idiopathic environmental intolerance attributed to electromagnetic fields”—unspecific symptoms supposedly triggered by things like cell phones. There have been at least 46 studies involving more than 1,000 people who claim to be affected, yet when put to the test in blinded trials the studies near universally failed to show that anyone could even detect the fields. Why don’t journalists covering these stories mention the data? Because there are snake-oil salesmen profiting off the perceived condition, selling all matter of so-called “protective” gadgets that viciously attack anyone for even daring to mention the science, accusing them of denying the reality of people’s symptoms. But it’s arguably the opposite. They are the ones hindering sufferers from getting to the bottom of what is actually causing their symptoms. Similarly, hawking unproven tests and treatments for adrenal fatigue could delay the diagnosis of a real, treatable condition.