Is adrenal fatigue for real? Breaking down this appealing explanation for exhaustion.

On Nutrition

Have your energy levels hit rock bottom? When someone asks, “How are you?” is your automatic response, “exhausted”? There are many reasons why someone might feel fatigued or burned out, including physical- and mental-health conditions such as anemia, depression, anxiety, fibromyalgia, obstructive sleep apnea and chronic fatigue syndrome. But adrenal fatigue has emerged as an appealing explanation, especially in the absence of a clear-cut diagnosis. That could be a problem.

Adrenal fatigue, a term coined in the 1990s by a chiropractor, is generally defined as a group of nonspecific symptoms caused by chronic mental, emotional or physical stress. The adrenals are two small glands that sit on top of your kidneys and produce several hormones, including cortisol. When you experience stress, your adrenal glands secrete cortisol — which is why it is known as the “stress hormone” — but you also experience a natural rise in cortisol in the morning, with a dip in the middle of the night.

The claim is that chronic stress exhausts our adrenal glands to the point that they can’t produce enough cortisol, resulting in symptoms such as tiredness, trouble falling asleep at night or waking in the morning, salt and sugar cravings, and reliance on caffeine to make it through the day. It’s often blamed for “burnout,” the mental fatigue and exhaustion that can develop after experiencing severe, chronic stress. Feelings of burnout are real and shouldn’t be ignored, but feeling burned out doesn’t mean your adrenal glands are burned out.

The fact is that adrenal fatigue is an unproven theory, mostly because there isn’t strong scientific evidence to support it. A systematic review in 2016 concluded there is no consistent evidence supporting the idea that adrenal fatigue is an actual medical condition, and that the blood or saliva tests that supposedly diagnose adrenal fatigue are not reliable. However, there are a number of actual medical conditions that do involve the adrenal glands, including adrenal insufficiency, caused by damage to the adrenal glands or a problem with the pituitary gland. Symptoms can include fatigue, weight loss, joint pain, low blood pressure, nausea and vomiting, dry skin and dizziness.

Adrenal fatigue may not be real, but that doesn’t mean the symptoms ascribed to it aren’t. If you’re feeling tired and burned out, of course you want to know why — that’s why it’s important to get a real diagnosis. Talk to your doctor, who may recommend testing by an endocrinologist. If you simply assume you have adrenal fatigue, the real cause of your symptoms may remain undiscovered and continue to get worse. According to the Endocrine Society’s Hormone Health Network, taking “adrenal hormone supplements” when you don’t need them can damage your adrenal glands and can even be life-threatening.

However, if your symptoms are more vague, or medical testing doesn’t yield a firm diagnosis, diet and lifestyle improvements can still help. While there’s no specific diet to follow, a nutritious, balanced eating plan can support both body and mind. Avoiding tobacco, limiting alcohol and including enjoyable forms of physical activity are important, too. Yoga, tai chi and meditation can help you feel better in the moment, while also changing the structure of the brain to help you be more resilient in the long term. Working on setting boundaries around negative people and situations is another tool worth honing. Finally, there is some evidence to support use of adaptogens, herbs and roots that may help the body resist stress of all kinds.