Does Adrenal Fatigue exist? Kevin takes a look at the current evidence.
Does Adrenal Fatigue exist? Kevin takes a look at the current evidence.
Get-Fit Guy is hosted by Kevin Don. A transcript is available at Simplecast.
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This is Kevin Don, the Get-Fit Guy. Welcome back regular listeners and welcome to new listeners. Have you ever thought about how hard it is to come up with something new to say about a topic every week? It’s hard! I believe that this is why we see many ‘influencers’ and ‘creators’ suffering either from burnout or doing a switcheroo on their claims. Due to the pressure to make new content, one can end up bowing to that pressure, rather than sticking to one’s guns on the message. For me, I often find that I am compelled to write about something I have seen and think ok, I think that is misinformed, I will address this. And this week is a good example of that. I was looking for a supplement I use online and I saw another supplement recommended. This being one for ‘adrenal fatigue’. The top review said “This supplement is amazing. My primary care provider won’t treat me for the things I believe I have and so this supplement has been a life changer for me.” I found this to be quite an interesting review. I certainly don’t believe that all physicians have the ability to help us as they would like. An example was a few months back, I wasn’t feeling good and I am probably fairly typical in that I don’t like ‘bothering’ the doctor. So, I had ignored a bunch of small but related symptoms until I felt the need to go see the doctor. When I sat down and started talking, I was told: “I have to stop you there Mr. Don, these appointments are limited to 10 minutes, so we can only discuss one symptom”. This is not the choice of the doctor, it’s administrative, because the doctors simply don’t have the time in the day to see all the patients they have. However, just because they don’t have the time, doesn’t equal the fact that their multi year medical school attendance is suddenly less than your googling. The doctor isn’t going to be able to treat you for the ailments you ‘believe’ yourself to have.
Sadly, this is usually where supplements come in. They are not regulated by any governing body and therefore, a supplement exists for every ailment you can imagine (and they frequently are exactly that). Without regulation, they make all sorts of claims and are often no better than placebo in terms of efficacy. Which brings me to what this supplement was claiming to cure: Adrenal Fatigue. So, let’s check in with WHAT that is and if it can be helped by eating the powdered adrenal glands of cattle. I mean that’s how the body works, right? If I dilute some bullets in distilled water to the concentration of 2 parts per million and take it as a tincture everyday, I will eventually become bulletproof. (Note: this was dry humour, do NOT do this).
Adrenal fatigue is a term that's been floating around in health circles for quite some time now. It’s one of those buzzwords that seem to promise an explanation for why so many of us feel perpetually tired, stressed, and just not ourselves. But here’s the million-dollar question: Does adrenal fatigue actually exist according to current science?
First things first, let’s get a grip on what adrenal fatigue is supposed to be. The concept was popularized by a chiropractor named James Wilson in 1998. He described it as a condition where chronic stress wears down the adrenal glands, which are small glands located on top of your kidneys. According to this theory, the adrenal glands become unable to produce adequate levels of hormones like cortisol, leading to symptoms such as fatigue, body aches, sleep disturbances, and digestive problems.
It sounds pretty straightforward, right? Chronic stress leading to exhausted adrenal glands, and voila, you’re tired all the time. But here’s where things get a bit murky.
The Science Behind Adrenal Function
To understand if adrenal fatigue holds water, we need to take a closer look at how our adrenal glands actually work. The adrenal glands are part of the endocrine system and play a crucial role in producing hormones that help regulate metabolism, immune system, blood pressure, and response to stress. The most well-known hormone they produce is cortisol, often called the “stress hormone.”
When you encounter stress, whether it’s running late for an important meeting or facing a life-threatening situation, your body’s hypothalamus sends a signal to the pituitary gland, which then signals the adrenal glands to release cortisol. This process is known as the hypothalamic-pituitary-adrenal (HPA) axis. Cortisol helps your body manage the stress by increasing blood sugar levels for a quick energy boost, enhancing brain function, and curbing non-essential functions.
In healthy individuals, once the stressful situation is over, cortisol levels drop back to normal. However, proponents of adrenal fatigue argue that chronic stress keeps the HPA axis activated, eventually leading to the adrenal glands’ inability to keep up with the demand for cortisol. This supposed chronic low-level adrenal insufficiency is what they refer to as adrenal fatigue.
What Do the Experts Say?
Here’s where things start to get a bit contentious. Mainstream medical professionals and institutions like the Endocrine Society and Mayo Clinic don’t recognize adrenal fatigue as a legitimate medical condition. They argue that while the symptoms people report are very real, the idea that these symptoms are caused by underperforming adrenal glands due to chronic stress is not supported by scientific evidence.
A major point of contention is the lack of reliable diagnostic criteria. There’s no standardized test to diagnose adrenal fatigue. Blood tests, saliva tests, and urine tests measuring cortisol levels can indicate if you have adrenal insufficiency (a serious condition known as Addison’s disease), but they don’t provide evidence for the much subtler supposed adrenal fatigue.
Adrenal Insufficiency vs. Adrenal Fatigue
It’s important to differentiate between adrenal insufficiency and adrenal fatigue. Adrenal insufficiency, including Addison’s disease, is a recognized medical condition where the adrenal glands do not produce enough hormones. This can be life-threatening and is diagnosed through specific tests showing significantly low cortisol levels. Symptoms include severe fatigue, weight loss, low blood pressure, and darkening of the skin. It requires medical intervention, often involving hormone replacement therapy.
On the other hand, adrenal fatigue is proposed to be a milder, chronic condition without the hallmark severe hormonal deficiencies seen in adrenal insufficiency. Critics argue that this gray area lacks empirical support and might lead people to overlook other potential underlying causes of their symptoms.
The Role of Chronic Stress
While the concept of adrenal fatigue itself is debated, the impact of chronic stress on overall health is well-documented. Chronic stress can lead to a range of health issues, including anxiety, depression, digestive problems, heart disease, sleep problems, weight gain, and memory and concentration impairment. These symptoms often overlap with those attributed to adrenal fatigue.
Stress affects nearly every system in the body. It can alter immune function, lead to chronic inflammation, and disrupt the balance of hormones beyond cortisol, including insulin and thyroid hormones. While adrenal fatigue as a specific diagnosis might be controversial, the idea that chronic stress can wreak havoc on your body is not.
The Placebo Effect and Lifestyle Changes
Many people who believe they have adrenal fatigue and follow lifestyle changes recommended by alternative health practitioners report feeling better. These changes often include improved diet, regular exercise, better sleep hygiene, stress management techniques like yoga or meditation, and sometimes supplements. But here’s a thought – could it be that these improvements are not necessarily treating adrenal fatigue but are simply promoting better overall health?
The placebo effect, where people feel better because they believe they’re being treated, can’t be ignored. If someone thinks they have adrenal fatigue and takes steps to address it, the psychological benefit alone might lead to perceived improvements. Moreover, the lifestyle changes recommended for adrenal fatigue are generally beneficial and could alleviate symptoms of chronic stress and other common conditions.
The Importance of a Holistic Approach
Given the overlap between the symptoms of adrenal fatigue and those of chronic stress and other health issues, a holistic approach to health might be the key. Instead of focusing solely on the adrenals, it’s essential to look at the bigger picture. How is your overall health? Are you getting enough sleep, eating a balanced diet, exercising regularly, and managing stress effectively?
Addressing these aspects can lead to significant improvements in how you feel. It’s also crucial to consult healthcare professionals who can rule out other potential causes for your symptoms. Conditions like thyroid disorders, depression, anxiety, sleep apnea, and others can present with similar symptoms and require different treatments.
What Does Recent Research Say?
Recent research continues to explore the impact of chronic stress on health, but there’s still no consensus supporting adrenal fatigue as a distinct medical condition. Studies often focus on the HPA axis and how it’s affected by chronic stress, but the findings don’t necessarily support the idea that the adrenal glands themselves become fatigued in the way adrenal fatigue proponents suggest.
For instance, a study published in the British Medical Council (BMC) Endocrine Disorders reviewed multiple studies on the topic and concluded that there’s no substantial evidence supporting adrenal fatigue. The researchers pointed out that while chronic stress does impact the HPA axis, the concept of adrenal fatigue lacks clear diagnostic criteria and is not recognized by endocrinologists.
Practical Steps to Manage Stress and Fatigue
Regardless of the debate over adrenal fatigue, if you’re feeling constantly tired and stressed, there are practical steps you can take to improve your well-being:
So, does adrenal fatigue exist according to current science? The consensus among medical professionals and researchers is that adrenal fatigue, as described by its proponents, is not a recognized medical condition. The symptoms attributed to it are real but result from other factors, including chronic stress, lifestyle choices, and other health conditions.
Whilst the term “adrenal fatigue” might not hold up to scrutiny, the importance of addressing chronic stress and maintaining overall health cannot be overstated. By focusing on holistic health practices and consulting with healthcare professionals, you can tackle the underlying issues contributing to fatigue and improve your quality of life. Remember, your health is nuanced, and a balanced approach is often the most effective path to feeling your best.
Any questions, email me at getfitguy@quickanddirtytips.com
Get-Fit Guy is a Quick and Dirty Tips podcast. Thanks to the team at Quick and Dirty Tips Morgan Christianson, Holly Hutchings, the director of podcasts Brennan Goetchuss and Davina Tomlin. I’m your host, Kevin Don. If you have a question for me, leave me a voicemail at 510-353-3104 or send me an email at getfitguy@quickanddirtytips.com. For more information about the show, visit quickanddirtytips.com, or check out the shownotes in your podcast app.