Debunking Adrenal Fatigue
Jan 16, 2018 Cedars-Sinai Staff
Feeling tired for no reason? Craving coffee, soda, and junk food just to keep going? Feeling stressed and struggling to keep up with all your daily demands? Are symptoms of depression going up while your sex drive takes a nose dive?
Adrenal fatigue is the notion that our adrenal glands get overworked by stress and stop producing the hormones we need, including cortisol. It's a medical myth.
You may have a legitimate health issue, but it's definitely not adrenal fatigue, says Dr. Anat Ben-Shlomo, an endocrinologist at the Cedars-Sinai Adrenal Program. Adrenal fatigue is the notion that our adrenal glands get overworked by stress and stop producing the hormones we need, including cortisol. It's a medical myth.
A medical myth
Multiple peer reviewed studies have debunked the adrenal fatigue diagnosis. Still, it remains a trendy topic online and in alternative medicine circles. It started with a book published in 2001. The condition was soon accepted by several so-called medical societies—none of which are recognized by the Association of Medical Colleges or the American Board of Medical Specialties.
"Adrenal fatigue is not an actual disease," says Dr. 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."
Symptoms often blamed on adrenal fatigue include:
- Feeling tired and fatigued every day
- Difficulty waking up in the morning
- Difficulty handling stress
- Craving salty food or sweets
- Higher levels of energy in the evening
- Consuming too many stimulants, like caffeine
- A weak immune system
"When you're not feeling well, it's understandable to want a name for what's happening," says Dr. Ben-Shlomo. "Rather than latch onto this diagnosis, talk to your doctor about your symptoms with an open mind, and explore treatments that may improve your quality of life and uncover any underlying medical conditions—such as depression or sleep disorders."
If the symptoms above sound familiar, Dr. Ben-Shlomo has these tips:
- Nurture your mental health. We all experience big life changes at some point, as well as daily pressures. Having routines to manage that stress is useful when something happens to increase stress.
- Don't ignore a serious condition. Medical conditions like depression and anxiety can affect mood and energy levels. They can cause some of the symptoms frequently associated with adrenal fatigue and should be addressed by a medical professional.
- Manage your blood sugar. Blood sugar that is too high or two low could be the culprit behind some of these symptoms. Have your doctor check your blood sugar levels and work with you to help keep them balanced.
- Don't forget sleep hygiene. Getting enough sleep is crucial to our health. Maintaining a regular sleep routine, limiting caffeine, and exercising regularly are all promote healthy sleep. Use your bed only for sleep, and don't stay awake in bed for more than a few minutes. Reduce stimuli (like internet and TV use) near bedtime.
"If you're finding you have a lot of symptoms that are hurting your quality of life, definitely see your doctor and find some answers," says Dr. Ben-Shlomo. Just don't expect adrenal fatigue to be part of the explanation.
Dr. Ben-Shlomo notes that people are often misdiagnosed by homeopathic practitioners, who make a diagnosis based on a faulty test, then sell very expensive but useless—and potentially damaging—glandular adrenal supplements.
"I see such patients in my clinic all the time, and I'm struggling to persuade them," she says. "The supplement can make you feel good at first because it's a steroid. But over time, it can actually inhibit your adrenal glands."
"This is an industry that nourishes itself," says Dr. Ben-Shlomo. "They issue a diagnosis for a disease that doesn't exist, then treat you with pricey supplements that aren't regulated."
"When you're stressed, the adrenal glands actually produce more of the cortisol and other hormones you need."
Note that adrenal fatigue should not be confused with chronic adrenal insufficiency, a verified medical problem. In addition to fatigue, that condition is marked by weight loss, joint pain, vomiting, anorexia, nausea, diarrhea, low blood pressure, and dry skin.
To diagnose it, doctors use a blood test that measures cortisol levels. If the initial test warrants it, a second test is ordered. Here, doctors inject a synthetic compound that mimics a hormone made by the pituitary gland. After 30 minutes, the cortisol levels are measured again. This is the only testing method in the US that accurately diagnoses adrenal insufficiency.