By Emma Stessman
You’re tired, you’re burnt out, and you think it’s possible you haven’t gotten a night of quality sleep since last year. Maybe you chalk it up to the inevitable consequences of living an always-on-the-go life, but some experts say if you’ve been living in that state for a while, those symptoms could add up to a more serious condition.
Yes, we’re talking about adrenal fatigue.
Adrenal fatigue is a controversial diagnosis that has been on the tip of every functional medicine doctor’s tongue for years now. These doctors say that the glands involved in our stress response just can’t handle our non-stop, high-pressure lifestyles. This leads to all-too-common symptoms like anxiety, chronic fatigue, and insomnia.
In conventional medicine, however, most physicians and scientists don’t agree. They say that adrenal fatigue is not an accepted medical diagnosis and that there’s not enough science to support the fact that it even exists.
With that in mind, we talked to experts on both sides of the debate to learn about the disputable diagnosis—and what all of it might mean for you.
Adrenal Fatigue 101
First, a little intro to your adrenals. The small glands are responsible for making a handful of important hormones involved in your body’s stress response, like cortisol, adrenaline, and aldosterone, explains Brooke Kalanick, ND, MS, a naturopathic doctor and author of Hangry: 5 Simple Steps to Balance Your Hormones and Restore Your Joy. Cortisol is the hormone that gets thrown around a lot when we talk about chronic stress, but it’s not always the bad guy we make it out to be. When it’s released acutely (meaning, with occasional stress) it can help us burn fat during exercise and lower inflammation, Kalanick says.
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Unfortunately, most of us are living in a constant state of stress, thanks to high-pressure jobs and packed daily schedules. This is where adrenal fatigue comes in, or as many functional medicine doctors call it, HPA Axis Dysfunction. Yes, that’s a crazy science term, but bear with us for a minute.
The HPA axis, or the hypothalamic-pituitary-adrenal axis describes the hormonal communication between these three regions. When the hypothalamus sends a hormonal alert to the pituitary, that gland will signal the adrenals to release cortisol. (It’s like a game of hormonal telephone.) Usually, this release is timed so cortisol is lowest in the evening and highest in the morning. “But when there’s a constant demand on the brain to send the signal to release cortisol due to harried lifestyle, inflammation, emotional stress, and lack of sleep, these signals and the entire axis gets mixed up and we get a less even, less reliable release of cortisol,” says Dr. Kalanick. Hence, adrenal fatigue.
The symptoms of adrenal fatigue can vary from person-to-person, explains Steven Zodkoy, DC, author of Misdiagnosed: The Adrenal Fatigue Link. Generally, people with adrenal fatigue tend to complain of chronic fatigue, insomnia, anxiety, depression, weight gain, and feeling generally “burnt out.”
So Is It Real?
Intuitively, it makes sense, right? If our adrenals are constantly “on” and hormones are out of whack, you’d expect mixed signals and a struggle to keep up (like when the message at the end of that game of telephone is totally garbled).
Science, however, says that so far, there is no research to support that adrenal fatigue is a medical diagnosis with real symptoms. In fact, there’s a 2016 meta-analysis reviewing research on the topic entitled “Adrenal fatigue does not exist: a systematic review.”
“Adrenal fatigue is not a true disease,” says Rocio Salas-Whalen, MD, an endocrinologist at New York Endocrinology. “There is no test that can detect adrenal fatigue, and many times, a person will be told he or she has adrenal fatigue based on symptoms alone.”
The symptoms of adrenal fatigue, like insomnia and weight gain, tend to be pretty general and could be caused by other factors, Dr. Salas-Whalen explains. Obesity, improper diet, sleep apnea, hypothyroidism, and adrenal insufficiency (like Addison’s disease) can all cause the same symptoms as adrenal fatigue. “Getting the proper diagnosis, if any, is a must,” she says.
The Bottom Line
Here’s the thing, though: Maybe whether or not adrenal fatigue “exists” doesn’t really matter, at all.
At the end of the day, the doctors agree that if you’re experiencing issues like anxiety or chronic fatigue, those shouldn’t be brushed off. “It is important to rule out more serious medical conditions before deciding that the adrenals are the culprit, so a trained professional is helpful,” says Dr. Zodkoy.
If you don’t have another medical issue, the plan of action for adrenal fatigue treatment usually emphasizes an anti-inflammatory diet, de-stressing, and getting quality sleep, Dr. Kalanick says. And whether or not your adrenals are at fault, a healthier diet, meditation, and extra ZZZs will definitely do you some good.