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What Is Adrenal Fatigue?

Find out if adrenal fatigue is real and what you can do about it in this article.
What Is Adrenal Fatigue?
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One of the most common reasons people seek care from their doctor is low energy and feeling chronically exhausted. While this problem afflicts many people, it can be a rocky road to finding a solution. Why? Because there are so many health conditions that can cause fatigue. Therefore, many people undergo a slew of blood tests and physical exams to find the cause of their fatigue. When there is no obvious answer from testing, some providers arrive at the diagnosis of adrenal fatigue. Here is what we can tell you about this newer theory as a potential cause for why you feel tired all the time.

Is adrenal fatigue "real?"

The adrenal glands are two small endocrine or hormone-secreting glands that sit on top of your kidneys. Cortisol, your stress hormone, is one of the main hormones secreted by the adrenal glands, and this hormone is secreted whenever we are faced with a stressor. 


Behind the theory of adrenal fatigue is the thought that chronic stress leads to chronically high cortisol levels. High levels of cortisol can have health consequences such as high blood pressure, weight gain or weight loss, brain fog, feeling depressed, and lightheadedness. It may also affect your adrenal function overall. Essentially, the symptoms associated with adrenal fatigue are usually quite vague and difficult to isolate. 


While the theory sounds attractive and may have some plausible insights, adrenal fatigue is not currently accepted as a valid medical condition by the Endocrine Society or any other medical specialty. 


The problem behind the theory is that there is no objective, concrete scientific evidence supporting a link between adrenal impairment and fatigue. What is more, there is no accepted plan of diagnosis and treatment of this condition. For example, some providers may use salivary testing, whereas others may use blood testing. And the time of day may affect the results.


When these testing methods were analyzed in a systematic review of 58 studies, the results were conflicting and led to invalid conclusions about a patient's health. 

What is adrenal insufficiency?

Unlike adrenal fatigue, adrenal insufficiency is a recognized medical problem affecting your adrenal function. Addison's disease is a disorder that falls under the category of adrenal insufficiency and is a condition where the adrenal glands do not make enough of certain hormones, including cortisol. Adrenal insufficiency is a relatively uncommon disorder, and it is characterized by the following symptoms that develop slowly over several months:

  • Extreme fatigue
  • Poor appetite
  • Unexplained weight loss
  • Low blood pressure
  • Low blood sugar
  • Gastrointestinal symptoms
  • Darkening skin (some people get a tan hue)
  • Loss of body hair
  • Depression
  • Muscle and joint pain
  • Salt cravings


To diagnose adrenal insufficiency, doctors use specific blood tests and medical imaging like a CT scan of your abdomen to check for any abnormalities in your adrenal glands. Blood tests may include checking cortisol, adrenocorticotropic hormone levels, sodium, and potassium. Your doctor may also assess a blood sugar level by ordering an insulin-induced hypoglycemia test. 


How to navigate symptoms of adrenal fatigue

Anyone who has symptoms of adrenal fatigue will undoubtedly be frustrated at not finding a concrete diagnosis behind their chronic fatigue. The symptoms can completely disrupt daily life, and unfortunately, many people feel dismissed by their health care provider when they do not find an apparent clinical answer. 

The fact is symptoms of adrenal fatigue likely have multiple causes, and it may take addressing several different things in your health and your life to help you start feeling better. After all, the stress levels that accompany our lives today may be enough to cause many of the symptoms you are experiencing. Therefore, some areas you will want to start looking into as potential sources you can control include your:

  • Sleep habits
  • Causes of chronic stress (including emotional stress and physical stress)
  • Diet and gut health
  • Relationships
  • Exercise habits
  • Environment
  • Self-care
  • Alcohol and caffeine intake


Next, you will want to work with your medical professional to rule out an underlying issue with your health, including:

  • Metabolic syndrome
  • Anemia
  • Nutrient deficiencies
  • Autoimmune diseases
  • Thyroid problems
  • Pituitary gland dysfunction

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Many people who struggle to find answers using traditional medicine go down the alternative medicine route, which can offer certain benefits, including more thorough patient visits and more holistic care. Some people may succeed in healing through a complementary medicine approach. Still, it is essential to be cautious of buying into expensive protocols that are not validated or approved by the FDA.


Furthermore, some providers may use prescriptive cortisol to treat your symptoms. However, cortisol analogs can be dangerous even in small doses. Therefore, these drugs should only be prescribed by a medical doctor treating you for a condition like Addison's disease or adrenal insufficiency (not adrenal fatigue). 

A note from Paloma Health

If you find yourself fitting the profile of a person with adrenal fatigue, start by addressing some lifestyle factors and rule out potential causes like hypothyroidism (underactive thyroid) with an at-home thyroid test kit. Many of the symptoms of adrenal fatigue fit the symptoms of hypothyroidism, which is a very treatable condition. Our thyroid doctors use a holistic approach to help treat your whole person, not just your numbers.  


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Julia Walker, RN, BSN

Clinical Nurse

Julia Walker, RN, BSN, is a clinical nurse specializing in helping patients with thyroid disorders. She holds a Bachelor of Science in Nursing from Regis University in Denver and a Bachelor of Arts in the History of Medicine from the University of Colorado-Boulder. She believes managing chronic illnesses requires a balance of medical interventions and lifestyle adjustments. Her background includes caring for patients in women’s health, critical care, pediatrics, allergy, and immunology.

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