I recently posted a Reel on Instagram and mentioned adrenal fatigue in it. I ended up getting a lot of viewers asking me about this condition and telling me that they’d been diagnosed with it by an alternative health practitioner.
Another person commented, saying (paraphrased), ‘isn’t adrenal fatigue when we don’t sleep enough, drink too much caffeine, we’re too stressed, and we’re eating foods that aren’t nutrient-dense enough?’
Those are all behaviours that we’re told lead to adrenal fatigue, but are their symptoms – primarily exhaustion – the adrenals rebelling, or are they a natural result of not resting and feeding ourselves properly?
The term ‘adrenal fatigue’ is used by alternative medical practitioners and some (albeit questionable) doctors to describe a nonspecific group of symptoms that a lot of people happen to have. Not because we have adrenal fatigue, but because…well, we’re all tired and stressed.
These practitioners insist that these symptoms are caused by burnt-out adrenals and mixed up hormones.
They love to point fingers at obscure glands and hormones as the culprits to all sorts of stuff, because these things sound scary and confusing and mysterious to the layperson.
When you frighten people about their own bodies, they’re more likely to believe what you’re telling them, and buy what you’re selling them. Adrenal fatigue is a well-known ‘diagnosis’ in the very profitable wellness industry. Fear sells.
I found the excerpts below in a post on a chiropractor’s website, talking all about the ‘four stages of adrenal fatigue’.
(Here’s the URL for the above post, which I have to post but don’t recommend you visit…http://www.a-familychiropractic.com/blog/the-four-stages-of-adrenal-fatigue/)
WHAT? My adrenals are ‘dismayed’? That sounds sad.
AND NOW, FOR THE SCARIEST STAGE YET;
‘Most never reach this phase.’ That’s right, because if your adrenals have stopped functioning, you’re probably having an Addisonian crisis, and you’ll be diagnosed with Addison’s Disease – not a made-up condition – by a real endocrinologist.
If there’s one thing I hate, it’s people being disingenuous by creating fear and distrust of their bodies, just to line their own pockets. As a dietitian who operates from a place of science and evidence, it’s hard to see people being taken advantage of in this way.
Also, fear spikes cortisol. I guess it doesn’t matter that much if it means a bigger payout for some people.
I’m more than happy to work peacefully and collaboratively with alternative practitioners and dietitians out there, but when some of them use mythical non-scientific woowoo garbage to scare people, I think it’s unethical. That makes me all sorts of angry.
What is ‘adrenal fatigue’?
As you know from the images above, adrenal fatigue supporters say that our adrenal glands, in response to constant stress and too many late nights drinking margaritas, get really tired and messed up. They become exhausted by our lifestyle and crash, causing them to secrete less of the hormones we need to be healthy.
The result? Someone tells you that you have adrenal fatigue, and tries to sell you cortisol-lowering supplements.
Let’s back up for a second and go over the background info you need.
What are the adrenal glands?
Your adrenals are two little triangular endocrine (meaning, they make hormones) glands that sit on top of your kidneys. These guys secrete hormones like cortisol, aldosterone, and adrenaline to name a few.
Let’s take a look at each one of these hormones because they’re the ones that most closely relate to adrenal fatigue.
Cortisol: Cortisol is a steroid hormone that’s released in response to low blood sugar and stress. It increases blood sugar, suppresses the immune system, and helps us metabolize carbohydrates, fat, and protein.
When you drink coffee, this can increase your cortisol levels (only transiently, mind you, and only in the caffeine-naive).
I did a Reel a while back about this local nutritionist warning us that coffee on an empty stomach can spike cortisol. You’ll see a lot of people recommending the same thing, but unless you’re consuming 18 cups of coffee a day and have never had caffeine before in your life, it’s not really something to worry about.
When you’re not sleeping, or your boss yells at you, or you haven’t eaten all day, these things can increase your cortisol levels too. Ever use hydrocortisone for a poison ivy rash? That’s another form of cortisol.
Cortisol has a role in our sleep, our mood, and even our memory, among plenty of other things.
Aldosterone: Aldosterone is a steroid hormone that, in short, regulates how much you pee and how much sodium and potassium your body retains. It helps keep our blood pressure stable.
Adrenaline, or epinephrine, is a hormone that is released in response to stress. Ever hear of the ‘fight or flight’ response? That’s adrenaline that causes it. Adrenaline increases blood flow to the muscles, increases blood sugar, and makes your heart pump harder. Exercise increases your body’s epinephrine secretion.
The adrenal glands are part of the HPA (hypothalamic/pituitary/adrenal) Axis, which is a pathway that responds to stress. It then adjusts the secretion of adrenal hormones accordingly.
All of this supposedly plays into ‘adrenal fatigue’, because ‘adrenal fatigue’ apparently happens when there’s dysregulation of the HPA Axis. I’m not saying that the HPA Axis can’t be abnormal at times because of any number of things, but does this tire out your glands?
That’s the question.
No one said the adrenals weren’t complicated business, but our main question is that of adrenal fatigue, so I will spare you the deep dive into physiology. The hormones above have other jobs, and there are other neurotransmitters that play into things as well.
As you can see, nothing about what I wrote is crazy or mysterious. Our bodies have to have a mechanism to control and respond to stress, and our adrenals are equipped to do just that, so it’s all good.
Adrenal fatigue symptoms:
The term ‘adrenal fatigue’ was invented by a chiropractor in 1998, so it’s relatively new. Its taken off in a big way, though.
If you look up adrenal fatigue online, you’ll see it allegedly has the following symptoms:
Difficulty getting out of bed
Higher energy levels in the evenings from a disturbed circadian rhythm
An inability to handle stress
Lines in your fingertips (what? Like fingerprints?)
Dark circle under your eyes
And many, many more.
All of these symptoms are conveniently vague, and can really be attributed to anything. That’s a gift to anyone who wants to convince you that you’re suffering from some unrecognized condition…and sell you things to ‘cure’ it.
Here’s more craziness from some ‘adrenal fatigue expert’:
Eventually, the adrenals will become totally exhausted. Patients at this stage will have a high chance of cardiovascular collapse and death.
If you find yourself suddenly craving salty snacks, you could be suffering from Adrenal Fatigue. (or maybe you just really want some chips?)
Patients with Adrenal Fatigue often report a lack of enthusiasm, feelings of apathy or disinterest, irritability and anxiety. (these things can also result from many other things in your life, and some of them seriously require treatment…from an actual doctor.)
Oh my god! Better buy his book to find out how to heal your glands!! **eye roll**
The fact that this sort of fearmongering is out there, and is actually convincing people to spend their money on unvalidated adrenal testing and expensive, unnecessary supplements, is extremely frustrating.
Adrenal fatigue testing.
You can bet that there a lotttt of people who will sell you tests in order to ‘diagnose’ you with adrenal fatigue. Don’t fall for it.
The tests for ‘adrenal fatigue’ include salivary cortisol, blood hormone levels including DHEA levels, and numerous questionnaires that you can find on the internet.
The problem with adrenal fatigue testing (besides the fact that it’s looking for a condition that doesn’t exist), is that it’s not accurate. Blood hormone levels fluctuate and because adrenal fatigue is subclinical (according to supporters), you can’t really detect small shifts in the hormones that would be necessarily to diagnose it.
Salivary cortisol can be affected by other numerous things and can’t be trusted. And questionnaires? Those are a huge red flag. They’re used to suck people in to what is most of the time, a trashy diet program.
If the symptoms of adrenal fatigue are so random and non-specific, and the tests that are done to diagnose it aren’t accurate, how do you know if you have it? And, how do you know if, after a few rounds of supplements you bought off the internet, you’re ‘cured’?
You don’t, because there’s no tests for that. Hm.
There’s a simple response to ‘does adrenal fatigue exist?’
The truth is, your adrenal glands don’t get tired. They don’t suffer from an inability to keep pace with your busy lifestyle and crazy stress levels. What if someone told you, ‘Your heart never stops beating, at some point it’s gonna need a rest! You have cardiac fatigue!’
You’d think they were nuts.
Adrenal insufficiency, secondary adrenal insufficiency, and Addison’s disease ARE real things, and can be very serious. Adrenal insufficiency is sometimes (not always) the same as Addison’s Disease.
Adrenal insufficiency is most often caused by medication, and Addison’s can be caused by an autoimmune condition called autoimmune polyendocrine syndrome, infections, or damage to the adrenals by something like cancer.
Neither are caused by excessive stress, but symptoms may be exacerbated by stress.
As well, symptoms of Addison’s Disease and other legitimate conditions overlap with many of the purported adrenal fatigue symptoms. It’s not that stress causes adrenal issues; it can bring them to the surface.
If you suspect something is wrong with you, please see a doctor. An actual doctor. The tests for ‘adrenal fatigue’ include salivary cortisol, blood hormone levels, and numerous questionnaires that you can find on the internet.
People who push this diagnosis are essentially inventing a sub-clinical form of adrenal insufficiency, and presumably using it to further their agenda: whether it’s selling a book, supplements, or their own credibility.
It’s unfortunate that so many people are duped into buying – literally and figuratively – what these people are selling. The supplements for adrenal fatigue may actually be harmful. Don’t buy them, please.
It’s alway interesting to me how many people choose alternative therapies because they have a conspiracy theory about ‘big pharma’ only wanting to make money. But think about this: do you think that many of the people promoting ‘adrenal fatigue’ aren’t looking to cash in on your fear? Come on, people.
So what if you’re experiencing adrenal fatigue symptoms?
Organs and glands don’t get tired. They’re made to work until you drop. Literally. But, if your life is stressful, it’s time to make some changes.
It is safe to say that chronic high levels of stress can leave that ‘fight or flight’ impulse turned on in your body, and this may cause all sorts of issues like anxiety, lack of sleep, weight gain, digestion issues, and mood disorders among other things.
And the remedy to your chronic stress may be simple: more sleep, a healthier diet, and better management of, well, whatever is stressing you out.
Most of us get too little sleep, we eat meals in our cars while running from one place to the other, and we rarely get the chance to fully disconnect and just BE.
If this sounds like you, it’s probably not your adrenal glands as much as it’s your lifestyle. No supplements, books, or crazy woo woo practitioners testing your saliva for cortisol are going to have a magical effect on this.
And if you’re really not feeling well, get yourself checked out. Blaming symptoms on adrenal fatigue when they could actually be something worse can be dangerous.
Do you really need a multivitamin? Read my post here.