Is It Adrenal Fatigue or Are You Just Exhausted?

You’ve having trouble falling asleep, and then struggling to wake up in the morning. You’re relying on caffeine and salty and sugar snacks to get through the day. Simply put—you’re tired.

Search these symptoms online and odds are that you’ll find sources describing a condition called “adrenal fatigue.” But while this term is popular, is it based in evidence?

The Basics of Your Body’s Stress Response

The adrenal glands are grape-sized glands located on top of each kidney. Among other hormones, the adrenals produce cortisol and adrenaline (epinephrine). Together, cortisol and adrenaline are primary players in the body’s hormonal response to stress—the “fight or flight” reaction of the nervous system.

Signals from areas in the brain called the hypothalamus and pituitary gland dictate how much cortisol the adrenal glands produce. Together, these three glands are called the HPA (hypothalamic-pituitary-adrenal) axis.

When the HPA axis is activated and cortisol and epinephrine levels increase, your heart rate, blood pressure and blood sugar increase. These are all helpful shifts if you need to respond quickly to a perceived danger.

Your body also experiences a natural rhythm of rising and falling cortisol, which plays an important role in maintaining your sleep and wake cycles, managing inflammation, and getting your body ready for activity.

Cortisol levels are at their highest in the morning as you wake from sleep, and are at their lowest as you wind down in the evening hours and prepare for sleep.

The Unproven Theory of Adrenal Fatigue

The term “adrenal fatigue” is used by the media and some professionals to describe a scenario where chronic stress leads to “burnout” of the HPA axis. Essentially, high levels of chronic stress cause the adrenal glands to produce such high levels of cortisol for so long that the HPA axis stops responding. The loss of this signaling pathway causes the adrenals to stop producing cortisol altogether.

The symptoms attributed to adrenal fatigue include a lack of energy, trouble falling asleep or waking up, craving salt and sugar, and needing caffeine to get through the day.

Odds are that as a busy adult, you’ve felt these symptoms before. They’re both normal parts of life as well as non-specific symptoms that occur in a wide range of recognized medical conditions. Alone, they do not clearly indicate any one underlying condition.

While the concept of adrenal fatigue is popular, it’s not a proven diagnosis and is not recognized by medical science.

The claims about adrenal fatigue are not backed by objective, measurable data and there are no confirmed and validated methods for screening for the condition. The studies that have been done to investigate this hypothesis typically are poorly designed and have inconsistent results.

On the surface, it may seem harmless to pursue an adrenal fatigue diagnosis. Many people are told to start with improving their lifestyle habits around exercise, diet, sleep and stress. Regardless of your medical diagnosis, these steps are almost guaranteed to make you feel better.

The true risks of the myth of adrenal fatigue are the supplements and medications that are also frequently prescribed to treat it. Supplements and vitamins are unregulated and do not have to prove their safety or efficacy before entering the market. Taking adrenal hormone supplements when you don’t need them can create serious and potentially life-threatening health risks.

Furthermore, following an adrenal fatigue diagnosis means that you lose the opportunity to get care for any recognized medical conditions that are contributing to your symptoms. You could be experiencing the result of a lifestyle that isn’t working well for you, or you could have a treatable diagnosis that a reputable healthcare provider can help you uncover.

Adrenal Insufficiency

Adrenal fatigue should not be confused with the well-recognized diagnosis of adrenal insufficiency (also known as Addison’s disease). This is a chronic, progressive disease of the adrenal glands that impairs the ability of the adrenal glands to produce cortisol and another hormone aldosterone. Adrenal insufficiency is often linked to autoimmune diseases and prolonged use of corticosteroids.

Symptoms of adrenal insufficiency include:

• Extreme fatigue
• Weight loss and loss of appetite
• Low blood pressure
• Low blood sugar
• Darkened skin
• Irritability and depression

While adrenal fatigue is not a recognized medical condition, adrenal insufficiency and other adrenal gland disorders are conditions that require medical attention. If you have some of the symptoms described in this article, talk to your healthcare provider or visit an endocrinologist trained in adrenal gland disorders.