Adrenal fatigue: facts and fictions

I frequently get calls from prospective clients asking if I can help them with adrenal fatigue. I then invite them to briefly describe their experience, how long they have been suffering, and if there are other health issues they are currently facing. Adrenal fatigue typically requires an extended conversation, this blogpost covers some aspects of this conversation.

Fatigue: first steps

Anyone who has suffered from debilitating fatigue and the devastating effect it has on your life can tell you that it’s real.

There are many possible contributors to fatigue, including: insufficient sleep, substance abuse, prescription drugs, shiftwork, insufficient or excess exercise, anemia, thyroid underfunction, sleep apnea, depression, hormonal fluctuations and chronic pain. (For a more extensive explanation of these causes of fatigue, please see the blogpost “Fatigue: navigating from exhaustion to energy”).

If you are experiencing fatigue, it’s important that you investigate if any of these is at the root of it.

Adrenal fatigue: the conventional medical perspective

Adrenal fatigue has for several years not been a diagnosis recognized in the conventional medical community. This view was bolstered by a major study published in 2016[i] that concluded “there is no substantiation that ‘adrenal fatigue’ is an actual medical condition”.

That said, adrenal insufficiency, a separate condition, is medically recognized and results from an inability of the adrenal glands to make the life-essential hormones aldosterone and/or cortisol, with symptoms that include fatigue, belly pain, nausea, vomiting, diarrhea and joint aches[ii].

Adrenal insufficiency is diagnosed following a test known as ACTH stimulation and is a serious and relatively rare condition: only 11 cases in 100,000 people.

Many conventional medical providers believe that what is known as adrenal fatigue is a mild form of adrenal insufficiency caused by chronic anxiety or stress[iii].

The naturopathic perspective

Naturopaths and other integrative health providers think differently about this. They propose that the hypothalamus-pituitary-adrenal (HPA) axis is a poorly understood complex mechanism that can be disrupted by chronic anxiety and stress, leading to underproduction of cortisol and other stress hormones along with the symptoms of adrenal fatigue. For these reasons, some naturopaths suggest that adrenal fatigue should instead be called “HPA axis dysfunction”.

Regardless of the name used, symptoms of this condition include[iv]:

. decreased energy and stamina—feeling exhausted and run-down most of the day

. reduced resilience

. decreased productivity

. feeling overwhelmed

. lack of a refreshed feeling even after eight hours of sleep

. hypoglycaemia

. mild depression

. concentration problems

. craving sugar and salt

. digestive problems

. trouble in waking up and getting to sleep

. tiredness

. light-headedness when standing up quickly

. inability to really wake until after 10 a.m., afternoon low between 3 and 4 p.m., and then feeling better after 6 p.m.

. increased effort to do everyday tasks

In addition to symptoms, a naturopathic diagnosis of adrenal fatigue is also based on a cortisol profile blood test. Naturopathic treatment usually includes lifestyle modifications that address stress factors and triggers, nutrition recommendations such as eating fewer processed foods and more whole foods. In addition, herbal and other supplements will likely be prescribed.

So what are the takeaways?

First, it’s unlikely you will be diagnosed with adrenal fatigue by a conventional medical provider.

Second, you might notice that the list of symptoms of adrenal fatigue is lengthy and many are somewhat vague. This is why you should not diagnose yourself. If other explanations of your fatigue have been ruled out and you suspect you might be suffering from adrenal fatigue, you should see a naturopath.

Third, there are a lot of products advertised-- some that are quite expensive-- that claim to resolve adrenal fatigue. It is not a good idea to purchase these without the recommendation of a naturopath.

A homeopathic perspective

If you are interested in exploring other approaches to resolving your adrenal fatigue, homeopathic care employs the same approach as that used for other health issues: we begin with a conversation to explore the history of the fatigue, the daily or seasonal pattern, as well as the “modalities”, or things in the environment or that you can do that seem to make it worse or better. All of these factors point to a homeopathic medicines to start with that match the specific pattern of your fatigue.

As we monitor your response to the remedy, others might be added that target specific systems such as the neurological, endocrine or immune system; or specific organs such as the liver, kidney or spleen.

If you are interested in investigating homeopathic care for your adrenal fatigue symptoms, call me for a free 15-minute consultation or schedule one on the online scheduler.

[i] Cadegiani FA, C Kater C (2016) “Adrenal fatigue does not exist: a systematic review”. BMC Endocr Disord. 16(1):48 https://bmcendocrdisord.biomedcentral.com/articles/10.1186/s12902-016-0128-4

[ii] McCall, B (March 5, 2024) “Is adrenal fatigue a real condition?” Medscape Medical Newshttps://www.medscape.com/viewarticle/adrenal-fatigue-real-condition-2024a100047a?form=fpf

[iii] Kearns, A (April 19, 2022) “Is there such a thing as adrenal fatigue?” Mayo Clinic: https://www.mayoclinic.org/diseases-conditions/addisons-disease/expert-answers/adrenal-fatigue/faq-20057906

[iv] Khodarami, F (January 29, 2021) “Adrenal fatigue” Naturopathic Currents: https://naturopathiccurrents.com/ca/articles/adrenal-fatigue-2