November 14, 2019
Is "Adrenal Fatigue" A Real Condition ?

Is “Adrenal Fatigue” A Real Condition ?

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There has been much debate over the years as to whether “adrenal fatigue” is a real condition or not.

Adrenal fatigue refers to a proposed condition by alternative medicine practitioners in which the adrenal glands become exhausted or dysfunctional, and are unable to produce adequate amounts of hormones such as cortisol due to chronic stress or other factors.

Western medicine and allopathic physicians effectively consider “adrenal fatigue” to be no more than pseudo-science and tend to completely ignore the vital role that the adrenal glands play in many common health problems from asthma to chronic fatigue syndrome.

Most allopathic doctors being of the opinion that the adrenal glands only have two degree’s of function, either working or not working at all in the case of Addison’s disease, which is an auto-immune disease in most cases.

Now we know this notion to be incorrect as varying states of adrenal gland dysfunction have been observed in studies relating to post-traumatic stress disorder, chronic fatigue syndrome, fibromyalgia and other stress-related disorders.

The real terminology for “adrenal fatigue” is hypothalamic-pituitary-adrenal axis dysfunction or dysregulation.  A term most doctors and psychologists should hopefully be aware of, given how clinically significant hpa-axis disorders are.

As we’ll see from the scientific evidence later in this article, hypocortisolism plays a potential role in the pathophysiology of many common health problems such as PTSD and chronic fatigue syndrome.

Now whilst allopathic doctors are completely correct in their claims that “adrenal fatigue” is not a real condition, that doesn’t mean the likes of hypoactive adrenal function, hypothalamic-pituitary-adrenal axis dysfunction and hypocortisolism for example don’t exist.

Whilst it doesn’t appear that the adrenal glands “fatigue” or exhaust as such, scientists continue to speculate that dysregulation at a hypothalamic-pituitary-adrenal level to be a potential cause of hypoactive adrenal function and a lowered state of adrenal hormone output such as low cortisol seen in stress-related disorders.

It is often the chronic over-activation of the sympathetic-adrenal system from stress, drugs and so on, which leads to hypothalamic-pituitary-adrenal axis dysregulation, a phenomenon which has been observed even in healthy individuals.

This is where i find allopathic doctors to be extremely disingenuous, because many physicians are more than aware of the current scientific research documenting the role of hypocortisolism and hypothalamic-pituitary-adrenal axis dysfunction in the pathophysiology of many common health problems such as PTSD, CFS, fibromyalgia, pain disorders and so on.

Yet when these patients present to their doctor complaining of extreme chronic fatigue especially in the morning and other symptoms of low cortisol, they are typically misdiagnosed as “generalized anxiety disorder” or brushed off as being psychosomatic complaints of no known cause.

Anecdotally I have found that many individuals who tend to complain of “adrenal fatigue” type health problems are often individuals who have suffered early childhood trauma/abuse or significant stress in their lives at some point or worse suffer from drug and alcohol addiction/misuse problems, which can most certainly contribute to hypothalamic-pituitary-adrenal axis dysregulation and ANS(autonomic nervous system) dysfunction.

Especially stimulant drugs which are notorious for contributing to autonomic nervous system, hpa-axis and adrenal gland dysfunction.  I find it ironic that Western medicine is keen to dismiss the role of the adrenal glands, yet we have a literal nation of individuals at this point addicted to drinking the likes of coffee, all in order to stimulate their sluggish adrenal glands in the morning and to temporarily boost adrenal hormone output such as cortisol, in order to improve energy levels.

Again we know from the scientific research that dampened cortisol reactivity, hypothalamic-pituitary-adrenal axis dysfunction and low cortisol to be common in individuals exposed to early childhood trauma, which is also a factor why these individuals often turn to stimulating drugs to compensate for the low cortisol levels and to mask the physiological state of stress-response dysfunction.

Yet even when these sort of individuals with PTSD and CFS present their doctors and psychologists with solid proof via private tests such as salivary cortisol indicating low cortisol levels, their doctors still tend to brush it off as nothing more than “generalized anxiety disorder”.

Which again is complete nonsense and not medically accurate, as the scientific literature suggests that individuals with generalized anxiety disorder typically exhibit high cortisol levels, not low cortisol levels as we see more commonly in stress-related disorders such as PTSD and CFS.

The potential role of hypocortisolism in the pathophysiology of stress-related bodily disorders.

The potential role of hypocortisolism in the pathophysiology of stress-related bodily disorders.One review study from 2000 published in the Journal for Psychoneuroendocrinology shared many interesting findings.

Representing a challenge for current concepts of stress research, a number of studies have now provided convincing evidence that the adrenal gland is hypoactive in some stress-related states.

The phenomenon of hypocortisolism has mainly been described for patients, who experienced a traumatic event and subsequently developed post-traumatic stress disorder (PTSD).

However, as presented in this review, hypocortisolism does not merely represent a specific correlate of PTSD, since similar findings have been reported for healthy individuals living under conditions of chronic stress as well as for patients with several bodily disorders.

These include chronic fatigue syndrome, fibromyalgia, other somatoform disorders, rheumatoid arthritis, and asthma, and many of these disorders have been related to stress.

Although hypocortisolism appears to be a frequent and widespread phenomenon, the nature of the underlying mechanisms and the homology of these mechanisms within and across clinical groups remain speculative.

Potential mechanisms include dysregulations on several levels of the hypothalamic-pituitary adrenal axis.

In addition, factors such as genetic vulnerability, previous stress experience, coping and personality styles may determine the manifestation of this neuroendocrine abnormality.

Several authors proposed theoretical concepts on the development or physiological meaning of hypocortisolism.

Based on the reviewed findings, we propose that a persistent lack of cortisol availability in traumatized or chronically stressed individuals may promote an increased vulnerability for the development of stress-related bodily disorders.

This pathophysiological model may have important implications for the prevention, diagnosis and treatment of the classical psychosomatic disorders.


[1] The potential role of hypocortisolism in the pathophysiology of stress-related bodily disorders.

[2] Effect of Childhood Emotional Abuse and Age on Cortisol Responsivity in Adulthood

The information in this article has not been evaluated by the FDA and should not be used to diagnose, cure or treat any disease, implied or otherwise.

2 thoughts on “Is “Adrenal Fatigue” A Real Condition ?

  1. What’s the difference between adrenal fatigue and adrenal insufficiency? While adrenal fatigue is not accepted by most doctors, adrenal insufficiency is a real medical condition that occurs when our adrenal glands cannot produce enough hormones.

    1. Adrenal Insufficiency can be primary or secondary in nature. Primary adrenal insufficiency is most commonly caused by Addison’s disease, which is an auto-immune disease.

      Secondary adrenal insufficiency can be caused due to many reasons such as a lack of ACTH, pituitary adenoma, long-term corticosteroid usage.

      “Adrenal Fatigue” is not an accepted medical term, so it’s probably best to refer to these type of stress-induced issues as hypothalamic-pituitary-adrenal axis dysfunction/dysregulation.

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