Since its conception in the late 1990s, supporters of adrenal fatigue have claimed that the disorder affects millions of people on a global scale.
In this article, we will look at how the term "adrenal fatigue" came into being, the role of the adrenal glands and some medical issues that do impact the adrenal glands.
Here are some key points about adrenal fatigue. More detail and supporting information is in the main article.
- According to scientists, there is no evidence that adrenal fatigue exists
- Adrenal fatigue proponents claim that the condition is due to overworked adrenal glands producing too little hormones
- The adrenal glands sit on top of the kidneys
- Adrenal glands are vital for homeostasis
- There are a number of disorders that do affect the adrenal glands
- Some supplements prescribed for adrenal fatigue might be dangerous
- Adrenal fatigue was described by James Wilson in 1998
- The Endocrine Society say "'adrenal fatigue' is not a real medical condition"
- Alleged symptoms of adrenal fatigue are tiredness, craving salt and loss of body hair.
What is adrenal fatigue?
In 1998, the chiropractor and naturopath James Wilson first coined the term "adrenal fatigue" in his book of the same name.
According to adrenal fatigue's proponents, it strikes people who endure long stretches of mental, physical or emotional stress.1
People who are allegedly more likely to contract adrenal fatigue are shift workers, single parents, drug addicts and those with stressful jobs.
However, as mentioned above, there is no scientific evidence that such a condition exists.
The Endocrine Society, representing the opinions of 1,400 of endocrinologists, released an official statement regarding adrenal fatigue:
"'Adrenal fatigue' is not a real medical condition. There are no scientific facts to support the theory that long-term mental, emotional, or physical stress drains the adrenal glands and causes many common symptoms."
Adrenal fatigue proponents suggest that medical science will eventually "catch up," but despite more than a decade having elapsed since its "discovery," no evidence has been forthcoming.
Despite this, there are certainly genuine conditions that affect the adrenal glands; we will discuss some of them briefly on the next page.2
Adrenal fatigue is one of the most controversial topics in endocrinology.
The symptoms of adrenal fatigue are said to include:
- Trouble getting to sleep and waking up
- Craving salt and sugar
- Unexplained weight loss
- Reliance on stimulants such as caffeine
- Loss of body hair
- Skin discoloration.3
All of the above symptoms are relatively generic but could indeed signal some type of illness. On the other hand, many of the symptoms could also be due to nothing more than a busy life and a lack of sleep, or, alternatively, a caffeine addiction, bad nutrition or heightened stress levels.
The theory behind adrenal fatigue is that the adrenal glands, which are activated during stress, are overworked. According to believers, long-term stress causes these glands to become fatigued and unable to keep up with the demands of the body.
Certain alternative health practitioners might take blood samples or use "stimulation" tests to prove whether or not an individual has adrenal fatigue. But, as the illness does not exist, there are no real ways to diagnose it.
Believers in adrenal fatigue claim in their defense that modern scientific techniques are not sensitive enough to pick up the diminished functioning of the adrenal glands, but that our bodies still feel the effects.
To understand adrenal fatigue, and the real condition - adrenal insufficiency - here is a brief introduction to the functions of the adrenal glands:
Adrenal gland function
There are two adrenal glands in the human body, one on top of each kidney.4
The outer section of the adrenal gland - the adrenal cortex - produces cortisol and aldosterone. The inner section - the adrenal medulla - produces adrenaline and norepinephrine.
These hormones carry out a number of vital tasks including:
- Maintaining metabolism, including the management of inflammation and blood sugar levels
- Regulating salt and water balance via mineralocorticoids and glucocorticoids
- Maintaining pregnancy
- Signaling the start of sexual maturation and controlling its progress through puberty
- Controlling the stress-related "fight or flight" response.
Adrenal insufficiency is the medical term applied to conditions where the adrenal glands do not release adequate quantities of their products. Most often, cortisol is worst affected.5
The symptoms of adrenal insufficiency can include:
There are a number of serious adrenal gland disorders, including Addison's disease and Cushing's disease.
- Ongoing fatigue
- Muscle weakness
- Loss of appetite and weight
- Abdominal pain, nausea and diarrhea
- Low blood pressure
- Depression and irritability
- Salt cravings
- Excessive sweating
- Irregular menstruation and loss of libido in women.6
In worst case scenarios, adrenal insufficiency can become a life-threatening adrenal crisis with symptoms including:
- Sudden, intense pain in the lower back, legs or abdomen
- Severe diarrhea or vomiting
- Loss of consciousness.
If untreated, adrenal crisis can be fatal.
Below are some medically proven adrenal gland disorders. Most of these can lead to adrenal insufficiency if not treated correctly:
- Adrenal tumors: including adrenal adenoma, adrenocortical carcinoma and adrenal incidentaloma
- Addison's disease: in this condition, the adrenal glands do not produce enough mineralocorticoids. Symptoms include abdominal pain and weakness. John F. Kennedy had this disorder; some believe Osama bin Laden also suffered from the condition7
- Congenital adrenal hyperplasia: a group of disorders that involve mutations in genes that code for enzymes responsible for the production of cortisol in the adrenal glands. Normally, these conditions affect the development of primary and secondary sex characteristics
- Adrenoleukodystrophy: a genetic disorder causes damage to the myelin sheaths that coat nerves. Very long chain fatty acids accumulate in the brain and adrenal glands. This build-up causes adrenal insufficiency8
- Cushing's disease: cortisol levels produced by the adrenal glands are increased due to disturbance in either the pituitary or hypothalamus9
- Hyperaldosteronism: too much aldosterone is produced by the adrenal glands, leading to low potassium in the blood and an increased excretion of hydrogen ions, causing an overly alkaline internal milieu
- Hypoaldosteronism: too little aldosterone is produced by the adrenal glands, leading to decreased sodium levels and hypotension (low blood pressure).
Many alternative practitioners will start "treating" adrenal fatigue by recommending quitting alcohol, drugs, caffeine and cigarettes. They will also recommend eating healthily, exercising more and sleeping better. All of these changes will, of course, make anyone feel better.
Despite adrenal fatigue being unsubstantiated by medical science, there is a range of products available to relieve its "symptoms." These products are often in the form of supplements and vitamins.
Because the US Food and Drug Administration (FDA) does not regulate these types of supplements, they have not been tested for safety and there is no guarantee that what a tablet claims to contain is entirely accurate.
Taking adrenal hormone supplements without an underlying medical condition can be dangerous. The kidneys can become reliant on the supplements and, if they are stopped, the adrenal glands might not begin working again for some time. This can cause adrenal insufficiency and become potentially life-threatening.
For anyone experiencing symptoms that are worrying to them, it is important to take advice from a medical professional in the first instance. Although it can be frustrating having symptoms that defy diagnosis, taking advice from untrained practitioners can be ineffective at best and dangerous at worst.
As a general rule, if a website both diagnoses an illness and sells the cure, you should be wary.