17

votes

Does Adrenal Fatigue Exist?

Answered on September 12, 2014
Created April 20, 2011 at 12:13 AM

"Adrenal Fatigue" is a diagnosis that gets thrown around a lot. Does it exist or is this yet another "catch-all" term that is used by "alternative" doctors when they don't know what the hell is wrong with you but want to deplete your wallet. Dr. Harris, Ray Peat and others claim it is a bogus diagnosis, like the "Lyme Disease" epidemic we are allegedly experiencing (mind you, Lyme disease does exist of course, but there are a lot of mountebanks out there talking about an epidemic).

Could somebody here give a scientific defense or repudiation of this diagnosis? (Not just, I am tired all the time and read the book "Adrenal Fatigue" by James Wilson.)

03fa485bfd54734522755f47a5e6597e

(3944)

on February 16, 2012
at 01:53 PM

Yep, applied kinesiology. I'm not convinced it's real either, but I also can't explain why multiple practitioners would hit the same 'weak' spots on me over the years. I've come to wonder if the experienced ones just get good at recognizing from symptoms and body language where the problems are, and (consciously or unconsciously) push harder when they hit those points. Because I've tried it myself, on my wife and vice versa when I was married, and it didn't work at all.

D5d982a898721d3392c85f951d0bf0aa

(2417)

on February 16, 2012
at 06:06 AM

Muscle testing? As in "applied kinesiology"? Because I'd buy the reality of some sort of adrenal fatigue any day over that pseudo-science.

425aa4bfb79556ed50ea693c3edd7e13

(609)

on July 01, 2011
at 02:33 AM

This is why we can't have nice things. Tip off: the "adrenal fatigue" test you took was just DHEA and cortisol. Diagnosing "adrenal fatigue" from such a test is a bogus action by an unconscionable practitioner.

667f6c030b0245d71d8ef50c72b097dc

(15976)

on July 01, 2011
at 02:33 AM

All these torso pics - nice

C4f80b8d42e013583c404bdd939c0bbc

on June 29, 2011
at 06:01 PM

I can't help but point out that a diagnosis of "clinical depression" (a condition you mentioned being similar to AF) is diagnosed strictly based on symptoms (often using multiple choice tests). In this way, the two diagnoses are very similar

77877f762c40637911396daa19b53094

(78467)

on May 17, 2011
at 01:14 PM

But do: adrenals increase their size and secretory capacity with stressors commonly assoc. with adrenal hormone secretion?

77877f762c40637911396daa19b53094

(78467)

on May 17, 2011
at 01:09 PM

Maybe the book should be taken 'cum grano salis'? Why salt? something to do with Iodine...?

77877f762c40637911396daa19b53094

(78467)

on May 17, 2011
at 01:07 PM

Hi guys: just wondering re: adrenal fatigue post: where the cutoff point would be situated with respect to cortisol secretion through exercise stimulus such that it would cease to be beneficial? I had queried along these lines in my post re: 'over-training'. Is it really the case (and could some evidence be cited) that hypersecretion of cortisol leads to elevated levels of glucose from fat stores and concomitatn decrease in test leevls? What determines eustress and distress here? Where is the line that divides them where weight-trainng is concerned?

77877f762c40637911396daa19b53094

(78467)

on April 21, 2011
at 04:09 PM

I do heavy weightlifting. I only found out what metcon is when I joined here (I usually disparage CrossFit...it seems cute and trendy to me). I almost never do anything that would count as aerobic.

Ed71ab1c75c6a9bd217a599db0a3e117

(25477)

on April 20, 2011
at 10:14 PM

We look at free testosterone levels to cortisol levels its very instructive to how overtraining can kill you. What happens in big overtrainers is the exercise spikes the cortisol and the spike is so severe and chronic it causes a long term spike of glucose from liberation of fat stores. that in turn cause a severe change in free testosterone levels but often not the total testosterone levels. This ratio really helps us diagnosis it. Most commonly we find it in marathoners and crossfitters. If youre strict paleo you really need to avoid metcon work outs/IF and stick to heavy lifting n sleep

77877f762c40637911396daa19b53094

(78467)

on April 20, 2011
at 04:09 PM

Melissa, a D.O. did the labs. The lab itself was done by Genova Diagnostics.

9d43f6873107e17ca4d1a5055aa7a2ad

on April 20, 2011
at 03:03 PM

you should have a blog Matthew, you are a true voice for rationality here!

Ed71ab1c75c6a9bd217a599db0a3e117

(25477)

on April 20, 2011
at 01:59 PM

there is a syndrome like this.......all based upon labs and symptoms

Fe87afa634afe26f4f6fd956abe0b46a

(565)

on April 20, 2011
at 01:45 PM

"Adrenal Fatigue" huh? Those sound more like symptoms of eating a crappy western diet.

667f6c030b0245d71d8ef50c72b097dc

(15976)

on April 20, 2011
at 01:54 AM

I lift heavy with back squats presses and dead lifts and I've never experienced this at all.

77877f762c40637911396daa19b53094

(78467)

on April 20, 2011
at 01:12 AM

I've got that book and it seems to be the book everybody cites as "evidence". Eat more salt, vitamin C and get more sleep. Great, can I have my money back now? :)

77877f762c40637911396daa19b53094

(78467)

on April 20, 2011
at 01:10 AM

Consider yourself lucky for being properly diagnosed AND whoever only had to pay $29.99 for the adrenal supplement got off relatively cheap.

9d43f6873107e17ca4d1a5055aa7a2ad

on April 20, 2011
at 01:08 AM

what type of doctor did the labs?

77877f762c40637911396daa19b53094

(78467)

on April 20, 2011
at 12:30 AM

I don't know either, even though I have a lab report from a few years ago that says that I have it! I am open to the idea that it may exist, though I have my suspicions. The thing about non-existent maladies is that you can never get over that which doesn't exist. And that's money somebody can take to the bank.

Medium avatar

(5136)

on April 20, 2011
at 12:14 AM

i don't know but upvoted because i've wondered the same thing.

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14 Answers

11
0bc6cbb653cdc5e82400f6da920f11eb

(19235)

on April 20, 2011
at 10:59 AM

You can try searching http://www.ncbi.nlm.nih.gov/pubmed/ the National Institutes of Health database of references and abstracts on life sciences and biomedical topics. It now contains more than 20 million citations for biomedical literature from MEDLINE, life science journals, and online books.

A search of pubmed for "adrenal fatigue" brings up only three results.

The first is an interview with a doctor. This has no article linked to it.

The second is a review article from the Alternative Medicine Review journal on Nutrients and botanicals for treatment of stress.

The third is an abstract of a paper on the Adrenal responses to chronic and acute water stress in Japanese quail

There are many good reasons for studying cortisol in all sorts of conditions and adrenal insufficiancy is a well researched disease. Pubmed is full of papers looking at cortisol and adrenal function related to all kinds of health problems. However "adrenal fatigue" as a condition does not currentlly appear to have any research to back it up.


This is the first website that comes up searching google.co.uk for "adrenal fatigue".

http://www.adrenalfatigue.org/

This quote on the front page caught my eye:

Are You Experiencing Adrenal Fatigue?*

  • Tired for no reason?
  • Having trouble getting up in the morning?
  • Need coffee, colas, salty or sweet snacks to keep going?
  • Feeling run down and stressed?

If you answered "yes" to one or more of these questions, you may be experiencing adrenal fatigue.*

Seriously?

If you tell people to reorganise their life, reduce their stress levels, eat a better diet and get more sleep it is not unlikely that they will feel better. Of course if you can invoke a disease like "adrenal fatigue" requiring you to buy books, cds, salivary cortisol tests and a range of expensive dietary supplements you can make a lot more money from people.

Fe87afa634afe26f4f6fd956abe0b46a

(565)

on April 20, 2011
at 01:45 PM

"Adrenal Fatigue" huh? Those sound more like symptoms of eating a crappy western diet.

9d43f6873107e17ca4d1a5055aa7a2ad

on April 20, 2011
at 03:03 PM

you should have a blog Matthew, you are a true voice for rationality here!

7
7a75987d21ac9e7cbaf98de88d62878e

on April 20, 2011
at 01:54 AM

My understanding is that what is commonly referred to as adrenal fatigue is a state where your hormones adrenalin and cortisol are abnormal, but not to the point of more several hormonal disorders such as Addison's. When my cortisol was tested over a day by a saliva test, I received a diagnosis of adrenal fatigue because the levels were half of what they should have been over the entire day.

In the 2001 bestseller mentioned above, the author points out that AF is a general diagnosis. According to the book, AF is caused by stress, blood sugar instability (high insulin), lack of sleep . . . basically factors that lead you to be tired and chronically unwell. The best medicine for AF is diet that stabilizes blood sugar, ample sleep at night, reduced stress, and decent exercise. AF is becoming almost too popular of a diagnosis, however this might not be bad if there is some recognition that the high stress, awful diet, no sleep lifestyle is one that leads to hormonal imbalances and poor health.

4
03fa485bfd54734522755f47a5e6597e

(3944)

on April 20, 2011
at 01:36 AM

I've been diagnosed with it (based on symptoms and muscle testing), but I'm not certain it exists either -- at least as a root condition and not a symptom. Obviously it makes sense that the adrenals could suffer dysfunction like any other part of the body. But the laundry list of symptoms blamed on adrenal fatigue could fit so many other things, like hypothyroidism, clinical depression, sleep apnea, etc. So who really knows? If I rub my adrenals (or the spots on my stomach that I was told represent them) they're very sore, but are they the cause or the symptom? In other words, if my adrenals are fatigued, is that the root of the problem, or a sign that something else going wrong is overworking them?

Recently, I'm seeing talk about dysfunctional cortisol rhythm, where it's not that the adrenals can't keep up, but that they produce too much cortisol at some times and too little at others, sometimes backwards from what the body needs. Maybe that's caused by inflammation, so it's really "inflamed adrenals" rather than "adrenal fatigue."

C4f80b8d42e013583c404bdd939c0bbc

on June 29, 2011
at 06:01 PM

I can't help but point out that a diagnosis of "clinical depression" (a condition you mentioned being similar to AF) is diagnosed strictly based on symptoms (often using multiple choice tests). In this way, the two diagnoses are very similar

D5d982a898721d3392c85f951d0bf0aa

(2417)

on February 16, 2012
at 06:06 AM

Muscle testing? As in "applied kinesiology"? Because I'd buy the reality of some sort of adrenal fatigue any day over that pseudo-science.

03fa485bfd54734522755f47a5e6597e

(3944)

on February 16, 2012
at 01:53 PM

Yep, applied kinesiology. I'm not convinced it's real either, but I also can't explain why multiple practitioners would hit the same 'weak' spots on me over the years. I've come to wonder if the experienced ones just get good at recognizing from symptoms and body language where the problems are, and (consciously or unconsciously) push harder when they hit those points. Because I've tried it myself, on my wife and vice versa when I was married, and it didn't work at all.

3
C4f80b8d42e013583c404bdd939c0bbc

on February 16, 2012
at 03:21 AM

This is a hot topic and I would like to add my $0.02.

My answer to the question, "Does adrenal fatigue exist?" is "Yes, but..."

About 10 years ago, I started experiencing various fatigue and depression symptoms. First, it was daytime sleepiness. Then, it was depression and poor short-term memory. Over the years, it got worse. This all happened in my early 20s, the time when I should be at my peak.

I saw numerous doctors and therapists of different stripes, both mainstream and "alternative" with almost no relief to speak of what-so-ever.

Finally, about two years ago, I saw a doctor who recommended James Wilson's "Adrenal Fatigue: The 21st Century Stress Syndrome." I tried the high dose vitamin C, adrenal glandular, and some of the herbs he recommends. However, I did not respond to them very well.

As far as lab measurements, the my testosterone was low-normal and my white-blood-count was low normal. My doctor said that this was cause for concern. Also, I noticed that my body temperature was consistently low (in the 95s to 97s), just as James Wilson said it would likely be in the case of adrenal fatigue.

Later on, I got in touch with another doctor who seemed to have more experience with this sort of thing. He recommended a test called the CD57. This test came back way low which he said is a sign of chronic Lyme disease. (I realize that this is yet another non-mainstream diagnosis.) Unlike some other doctors who treat Lyme disease, he recommends treating Lyme herbally.

I tried the herbal regimen that he recommends: the "Buhner Protocol". Within a few months, I suddenly became very sick for a few days (a herx reaction, perhaps?). I was mostly bedbound for the worst of it. Within a few more months, I was consistently feeling somewhat better, but not 100% healthy. I was still experiencing my symptoms, but the symptoms were less severe.

Over a year later, the doctor suggested adding some things to my herbal protocol. He suggested that I could have a Babesia co-infection; other herbs can treat that. He recommended another herb called cryptolepis and a multi-herb formula known as "A-Bab". I recently started with these, and have been feeling somewhat better.

I'm certain that some folks would say that this is all likely a placebo effect, but I disagree. For starters, I feel much better and I can tell a big difference vs. trying things that didn't work. Finally, now that I'm feeling somewhat better, I find that my body temperature consistently measures higher (high 97s to low 98s).

James Wilson did say in his book that many cases of adrenal fatigue may be caused by another underlying condition, so my experience is consistent with what he has to say.

I realize that my story cannot provide a complete answer to the question being asked here, but I hope that it will be useful!

3
4bf5827bfb7df85c5b4b485db0945e64

(1386)

on April 20, 2011
at 12:31 AM

This is valid question that I'd like to see substantiated. The scientific literature is lacking on the topic. I've tried to research this myself and came up with nothing substantial. It seems very hypothetical to me. One thing I am aware of that is somewhat related is with the over-usage of glucocorticoids (i.e. prednisone) where the adrenals can atrophy so adrenal fatigue is plausible, also similar in a way to beta-cell burnout in the pancreas via insulin over-secretion.

2
4c10e254b4fd6a29f751bde27a2837d8

(323)

on April 20, 2011
at 08:38 AM

Are we distinguishing between adrenal insufficiency and adrenal fatigue?

I believe the former can be detected by orthodox testing and is often treated with low-dose hydrocortisone at levels that aren???t supposed to atrophy the adrenals glands.

Dr Lam???s site has some compelling articles, however none of his information is referenced or backed up by studies.

http://www.lammd.com/articles/adrenalexhaustion.asp?page=1

Despite sounding impressive and believable there is a financial engine behind it, like so many alternative practitioners.

So I???m a bit undecided. Dr Walsh???s theory, which sounds a little more compelling is that there is a signaling problem from the hypothalamus resulting in too high or too low cortisol, rather than a genuine ???wearing out??? of the adrenal glands.

I???m not too convinced of the at home saliva test. I think it has the potential to worry people who???s health isn???t that bad (bit like the food intolerance testing) or conversely for those that are quite sick with chronic illness, doesn???t offer a complete enough picture.

shrugs

2
9d43f6873107e17ca4d1a5055aa7a2ad

on April 20, 2011
at 12:54 AM

Hypothalamic???pituitary???adrenal axis dysfunction is a real condition that scientists study. Adrenal fatigue seems to have been made up by alternative health practitioners reading papers about it, particularly about Addison's disease and they seem to posit a mild form of that. There is some clinical evidence from abnormal cortisol readings. When I had symptoms of so-called adrenal fatigue I was tested for Addison's and I didn't have it. Proponents of adrenal fatigue typically claim such tests aren't sensitive enough to detect adrenal fatigue, which is awfully convenient. Oh, and they have some supplements that treat it for only $29.99! If I had been treated by one of those quacks I'd probably still be sick, luckily I worked with a real doctor and was diagnosed with severe hypotension and started treating that with great success.

77877f762c40637911396daa19b53094

(78467)

on April 20, 2011
at 01:10 AM

Consider yourself lucky for being properly diagnosed AND whoever only had to pay $29.99 for the adrenal supplement got off relatively cheap.

1
Af3e3615beba642bcafd0f21d64d74f7

on February 16, 2012
at 03:56 AM

Anything biologically driven will suffer from fatigue if pushed perpetually. This goes all the way down to the mitochondria. Just like the pancreas fails after being slave driven while holding the world on it's shoulders. However, this will lead to an argument over aliens existing.

1
458f8986e45d8fa43ab14939fcfca337

on September 01, 2011
at 10:43 AM

Just a thought...people are very quick to accuse complementary therapists of being driven by money...uhh what about the pharmaceutical companies? that is much bigger business! I have been diagnosed with depression caused by work related stress for the last 2 years, and am now on an antidepressant that will improve my noradrenalin function- the 'latest' effective meds (SNRIs rather than SSRIs) for depression. Thing is, I haven't had negative thoughts for ages, just totally fatigued- so is it actually depression any more, or is it just my body being totally wiped out by the constant fight flight state I was in. I will be very interested to see how my body responds to the new meds.

1
C2ad96801ec1e22d2bf62475b6e52751

(1416)

on April 20, 2011
at 12:44 AM

Amazon reviewers have gone nuts for this 2001 book, but I wouldn't put too much stock in that myself. When I see "alternative medicine," I'm already out the door.

77877f762c40637911396daa19b53094

(78467)

on April 20, 2011
at 01:12 AM

I've got that book and it seems to be the book everybody cites as "evidence". Eat more salt, vitamin C and get more sleep. Great, can I have my money back now? :)

77877f762c40637911396daa19b53094

(78467)

on May 17, 2011
at 01:09 PM

Maybe the book should be taken 'cum grano salis'? Why salt? something to do with Iodine...?

0
77877f762c40637911396daa19b53094

(78467)

on July 01, 2011
at 02:28 AM

It's just a way to explain this:

Tired for no reason? Having trouble getting up in the morning? Need coffee, colas, salty or sweet snacks to keep going? Feeling run down and stressed? If you answered "yes" to one or more of these questions, you may be experiencing adrenal fatigue.*

0
Medium avatar

on June 30, 2011
at 09:21 PM

Looking for proof on hypoadrenia, have you looked at the book Safe Uses of Cortisol by William Jeffries? By the way I sent you an email yesterday.

667f6c030b0245d71d8ef50c72b097dc

(15976)

on July 01, 2011
at 02:33 AM

All these torso pics - nice

0
8f4ff12a53a98f3b5814cfe242de0daa

(1075)

on April 20, 2011
at 12:43 AM

My guess would be that it is a basically made up condition used to convince people to buy into alternative products / services. The condition and definition are to vague to really be useful or pin down, which is used to evade having to specifically demonstrate it.

-1
77877f762c40637911396daa19b53094

(78467)

on April 20, 2011
at 01:36 AM

A little anecdotal but not scientifically verified evidence: Intense weight-training increases 'localized' feelings of secretion from that region. Now don't laugh, I'm speaking from the trenches: you actually feel a greater amount of activity in this region(often to the extent of its causing a pained and hyper-alert feeling possibly attributable to adrenaline) when the load is very intense, say high volume in the form of higher reps/sets/minimal rest between/weight. According to "the Iron Guru" Vince Gironda who led me to this topic which I had previously posted about, this 'syndrome' is a reality and one should limit weight-training to a macro-cyclic 2 weeks on 1 week off schedule. During intense periods of weight-training I will often feel a euphoria and exhaustion, with that old 'localized' feeling of secretion from the adrenals(the 'supra-renal' glands above the hips). This has led me to believe more strongly in adrenal fatigue if not exhaustion than not. However, Further anecdotal/from a forgotten source evidence states that the adrenals increase their size and secretory capacity with stressors commonly assoc. with adrenal hormone secretion. Again this is anecdotal. I also would like to knwo any science behind this weird scientific hypothsizin'

667f6c030b0245d71d8ef50c72b097dc

(15976)

on April 20, 2011
at 01:54 AM

I lift heavy with back squats presses and dead lifts and I've never experienced this at all.

77877f762c40637911396daa19b53094

(78467)

on May 17, 2011
at 01:14 PM

But do: adrenals increase their size and secretory capacity with stressors commonly assoc. with adrenal hormone secretion?

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