No, You Do Not Have Adrenal Fatigue

Vishnu Garla, MD, Ricardo Correa, MD, Sina Jasim, MD, Michael Irwig, MD, and Irina Bancos, MD
exhausted woman trying to work but too tired

"Adrenal fatigue" ­— you have probably come across this term online or in an advertisement that features a diet or supplement that claims to improve your quality of life and relieve all the “symptoms” associated with adrenal fatigue. A precursory internet search for the word "adrenal fatigue" reveals over a million results, and there are several hundred adrenal supplements for sale on the web. In this article, we explore the problematic issues surrounding this dubious diagnosis and what you can do about your symptoms.

Myths about adrenal fatigue:

  • Constant high stress makes the adrenals fatigued and unable to produce enough cortisol. There is no evidence to suggest that high levels of "stress" in everyday life impair the ability of adrenal glands to produce cortisol. In fact, in sick patients, adrenal glands produce more cortisol in response to stress.
  • Diagnosis of adrenal fatigue can be made by answering questionnaires and laboratory tests. None of existing questionnaires or laboratory tests have been evaluated rigorously using standard research protocols. Furthermore, these tests are not even remotely consistent (<50%), even in patients labeled as having "adrenal fatigue."
  • Dietary supplements can revive the adrenal glands naturally. Various dietary supplements have been touted for "adrenal support," but none of these have proven efficacy or a pathophysiological basis. Barring a few exceptional cases, most patients do not have a deficiency of these so-called supplements. In fact, adverse events detailed below can cause more harm than good.

"The symptoms purported to be secondary to adrenal fatigue are quite non-specific. They overlap with a variety of disorders."

Your symptoms are real; adrenal fatigue is not.

We understand that you may have seen multiple providers and are frustrated as there have not been any clear answers regarding your symptoms. The symptoms purported to be secondary to adrenal fatigue are quite non-specific. They overlap with a variety of disorders (see previous EmPower article in volume 11, issue 2). Due to this, several referrals and extensive testing may be needed before a diagnosis is made. A few tips to expedite the process are:

  • Creating a “symptom diary,” where you detail the onset, duration, and variability of the symptoms. This may be very helpful in making a diagnosis.
  • To avoid redundancy, make sure previous medical records are sent to the provider's office before your appointment.
  • Be proactive and voice any concerns or questions you may have about your treatment plan with your providers.
  • Lastly, use this time as an opportunity to adopt healthy lifestyle changes (diet, exercise, and sleep), which have proven to be effective at alleviating fatigue.

Adverse effects of untested over-the-counter supplements:

  • Several of the marketed adrenal supplements contain varying amounts of steroids and/or steroid precursors or thyroid hormone. The safety of these supplements is unknown. Besides their adverse effects on health and ineffectiveness, these supplements and the associated laboratory tests can be very expensive.
  • Also, investing in these unproven therapies may delay the finding of an actual medical condition and could adversely affect prognosis.

If you have any doubts, please consult your physician for more information.