Adrenal fatigue is not a real medical diagnosis. There are no scientific studies that show it exists. A review of 58 studies concluded that there is no evidence to support the existence of this condition and that the theory behind it is too simplistic to explain the complex reality of human physiology (2). So, why do so many people believe they have it? It is because they are experiencing fatigue, headaches, weight gain, difficulty sleeping, and cravings for salt or sugar, among all the other symptoms. Alternative health practitioners (naturopaths, chiropractors, and functional medicine doctors) have attributed these symptoms to adrenal fatigue. However, here’s the truth to this bold claim. The vast majority of people experiencing these symptoms do not have adrenal fatigue. In most cases, they are suffering from other conditions like anxiety, depression, or thyroid problems. Let’s dive into what adrenal fatigue is, how it’s diagnosed (or not), and what might actually be going on if you’re feeling fatigued.
What Is Adrenal Fatigue?
The adrenal glands are a pair of small glands that sit on top of your kidneys. They produce hormones like adrenaline and cortisol, which help regulate your body’s stress response (16).
Adrenal fatigue is a condition that is said to occur when your adrenal glands are “exhausted” by chronic stress and can no longer produce these hormones effectively.
This can lead to a host of symptoms like (3):
- Brain fog
- Weight gain
How Is Adrenal Fatigue Diagnosed?
There is no definitive test to diagnose adrenal fatigue. However, your doctor may suspect adrenal fatigue if you have several of the symptoms listed above and if you have a history of chronic stress.
To confirm the diagnosis, your doctor may order one or more of the following tests:
- Blood Tests: These can measure the levels of hormones produced by the adrenal glands, including cortisol. However, blood tests aren’t always accurate, as cortisol levels can fluctuate throughout the day.
- Saliva Tests: These may be used to measure the level of cortisol in your body for a day.
- Urine Tests: These can measure the level of cortisol and other hormones in your body.
A review of 58 studies noted that there was no difference in cortisol levels between fatigued and healthy patients in 61.5% of the studies. The disparity is attributed to the unreliable and inconsistent methods used to measure cortisol levels (2).
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Can Low Cortisol Cause You To Gain Weight?
One of the purported symptoms of adrenal fatigue is weight gain. This makes sense as to why this would be the case, as cortisol is a hormone that helps regulate metabolism (17).
However, the relationship between cortisol and weight gain is apparent when there are high levels of the hormone, not low levels.
Here’s how it works:
Cortisol is a stress hormone that is released in response to physical or psychological stress. In small amounts, it is beneficial as it can help increase energy and stamina. However, when levels of cortisol become chronically elevated, it can lead to weight gain (22).
This is because:
- Cortisol helps control how your body uses fats, carbohydrates, and proteins for energy.
- Cortisol raises blood sugar by releasing stored glucose. Having chronically high cortisol levels can lead to persistent high blood sugar (hyperglycemia). This can cause weight gain and insulin resistance (5).
- High levels of the stress hormone also stimulate your appetite and increase your cravings for high-sugar and high-fat foods (18).
So, while it is true that cortisol can cause weight gain, this is only the case when levels of the hormone are high. Low levels of cortisol are associated with weight loss.
Conditions that affect the adrenal glands like Addison’s disease, pituitary tumors, and Cushing’s syndrome are associated with weight loss, not weight gain (1) (6).
What Might Be Going On If You Have Symptoms Of Adrenal Fatigue?
It’s frustrating to go to the doctor with a set of symptoms and be told that there’s nothing biologically wrong with you.
Below are some medical conditions that could cause similar symptoms, and may be worth looking into:
Anemia is a condition where you don’t have enough healthy red blood cells to carry oxygen throughout your body. This can cause fatigue, weakness, and brain fog (4).
Conditions like lupus, rheumatoid arthritis, and celiac disease are all associated with fatigue. This is because when your body is fighting off an infection or inflammation, it takes a lot of energy (8).
Thyroid disorders and menopause are both associated with fatigue. This is because they can cause imbalances in the hormones that regulate energy levels (9) (21).
Infections like Epstein-Barr virus (EBV), Lyme disease, and hepatitis C can all cause fatigue (15). This is because your body is using a lot of energy to fight off the infection. Even more common infections like the flu can leave you feeling exhausted.
Heart And Lung Problems
Conditions like congestive heart failure and COPD can cause fatigue (14). This is because they make it harder for your body to get the oxygen it needs to function properly.
Kidney And Liver Diseases
Kidney and liver diseases can both cause fatigue. This is because these organs are responsible for filtering toxins out of your body, and when they’re not working properly, you can feel very tired (12) (13).
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Sleep Apnea And Other Sleep Disorders
Conditions like sleep apnea, insomnia, and restless leg syndrome can all lead to fatigue (10). This is because they disrupt the quality of your sleep, leaving you feeling tired during the day.
Depression And Other Mental Health Conditions
Depression is a common mental health condition that can cause fatigue, insomnia, and weight gain (11). Other mental health conditions like anxiety and stress can also lead to these symptoms.
What Can You Do About Symptoms Of Adrenal Fatigue?
If your lab tests come back negative and your doctor can’t find a medical reason for your fatigue, there are still things you can do to feel better.
First, ask yourself, why would your body be experiencing these symptoms? You’re likely under a lot of stress. This could be physical stress, like training for a marathon, or emotional stress, like caring for a sick family member.
A recent life event, like a divorce or the death of a loved one, can also be very stressful. Even when you’ve not experienced a big life event, the day-to-day stress of work, family, and life can be enough to stress your body and mind.
Here are a few things you can do to reduce stress and feel better:
The hectic pace of modern life can be consuming. You’re juggling work, family, social obligations, and more. It’s important to take some time for yourself every day, even if it’s just a few minutes.
Turn off your phone, computer, and TV. Take a few deep breaths and just relax. Every few weeks, take a day or two off from work and social obligations. This will give you time to recharge and refocus.
Fuel Your Body Correctly
Eating anything and everything in sight is not going to make you feel better. It’s likely to make you feel worse. When you’re under stress, your body needs nourishing, whole foods to function properly (7).
Eat plenty of fruits, vegetables, lean protein, and healthy fats. Avoid processed foods, sugary drinks, and excessive alcohol.
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Moderate exercise is a great way to reduce stress and improve your overall health. It can also help you sleep better. Avoid excessive exercise, as this can increase your stress levels (20).
Ideally, you should aim for 30 minutes of moderate exercise, 5 days a week. However, even 10 minutes a day can make a difference. Incorporating movement into your day even when you’re busy, like taking a brisk walk during your lunch break, can also help.
If you work a physically demanding job, gentler forms of exercise like yoga or Tai Chi may be more beneficial.
Get Enough Sleep
Sleep is crucial for your body to recover from stress (19). When you’re under stress, you need more sleep than usual. Aim for 7 to 8 hours a night. If you can’t get this much, even a few extra hours can make a difference.
Here are some sleep hygiene tips to help you get a good night’s sleep:
- Keep a regular sleep schedule. Go to bed and wake up at the same time every day, even on weekends.
- Create a bedtime routine. A relaxing routine can help you wind down and prepare for sleep. This could include taking a warm bath, reading, or listening to calming music.
- Create a calm and inviting space for sleep. Make sure your bedroom is dark, quiet, and cool. Reserve your bed for sleep and intimate moments to create positive associations.
- Avoid caffeine, alcohol, and nicotine before bed as these can all disrupt sleep.
If you can’t fall asleep after 20 minutes, get up and do something calming until you feel sleepy again.
Talk To Your Doctor
If you’re still feeling fatigued and stressed, talk to your doctor. They may be able to recommend other treatments, like therapy or medication.
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The Bottom Line
Adrenal fatigue isn’t a real medical condition. If you’re experiencing symptoms of adrenal fatigue, it’s likely due to stress or a medical issue. Good thing is that there are things you can do to feel better.
Reducing stress, eating a healthy diet, and getting enough sleep are all important. However, if you’re still feeling fatigued, talk to your doctor. They can help you figure out what’s going on and can recommend treatment options fitted for you.
This article is intended for general informational purposes only and does not address individual circumstances. It is not a substitute for professional advice or help and should not be relied on to make decisions of any kind. Any action you take upon the information presented in this article is strictly at your own risk and responsibility!
- Addison Disease (2022, ncbi.nlm.nih.gov)
- Adrenal fatigue does not exist: a systematic review (2016, biomedcentral.com)
- Adrenal Insufficiency (2022, ncbi.nlm.nih.gov)
- Anemia (2022, ncbi.nlm.nih.gov)
- Association between Higher Serum Cortisol Levels and Decreased Insulin Secretion in a General Population (2017, journals.plos.org)
- Cushing’s Syndrome (2021, ncbi.nlm.nih.gov)
- Eat to Beat Stress (2020, journals.sagepub.com)
- Fatigue, Sleep, and Autoimmune and Related Disorders (2019, frontiersin.org)
- Fatigue and fatigue-related symptoms in patients treated for different causes of hypothyroidism (2012, pubmed.ncbi.nlm.nih.gov)
- Fatigue and sleep disorders (1997, sciencedirect.com)
- Fatigue as a Residual Symptom of Depression (2011, ncbi.nlm.nih.gov)
- Fatigue in advanced kidney disease (2014, sciencedirect.com)
- Fatigue in liver disease: Pathophysiology and clinical management (2006, ncbi.nlm.nih.gov)
- Fatigue in patients with chronic obstructive pulmonary disease: protocol of the Dutch multicentre, longitudinal, observational FAntasTIGUE study (2018, ncbi.nlm.nih.gov)
- Findings that shed new light on the possible pathogenesis of a disease or an adverse effect: Chronic fatigue syndrome and complement activation (2009, ncbi.nlm.nih.gov)
- Physiology, Adrenal Gland (2022, ncbi.nlm.nih.gov)
- Physiology, Cortisol (2021, ncbi.nlm.nih.gov)
- Stress, cortisol, and other appetite‐related hormones: Prospective prediction of 6‐month changes in food cravings and weight (2017, onlinelibrary.wiley.com)
- Stress and sleep (2013, apa.org)
- STRESS RELIEF: The Role of Exercise in Stress Management (2013, journals.lww.com)
- The Dynamics of Stress and Fatigue across Menopause: Attractors, Coupling and Resilience (2019, ncbi.nlm.nih.gov)
- The Role of Cortisol in the Pathogenesis of the Metabolic Syndrome (2012, ncbi.nlm.nih.gov)