What are the symptoms of adrenal insufficiency (Adrenal Fatigue)?

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Last updated: May 27, 2025View editorial policy

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From the Guidelines

Adrenal fatigue is not a recognized medical diagnosis, and its symptoms are non-specific and could be caused by many other conditions, including primary adrenal insufficiency (PAI), which can be diagnosed through paired measurement of serum cortisol and plasma ACTH, as recommended by the consensus statement on the diagnosis, treatment, and follow-up of patients with PAI 1. The symptoms commonly attributed to adrenal fatigue include persistent fatigue, body aches, unexplained weight loss, low blood pressure, lightheadedness, loss of body hair, and skin discoloration. People may also experience sleep disturbances, salt and sugar cravings, decreased stress tolerance, and reduced immune function. However, these symptoms are similar to those of PAI, which can be diagnosed and treated with hydrocortisone and fludrocortisone, as outlined in the consensus statement 1.

  • Key symptoms that may indicate PAI, and therefore require medical evaluation, include:
    • Unexplained collapse, hypotension, vomiting, or diarrhea
    • Hyperpigmentation, hyponatremia, hyperkalemia, acidosis, and hypoglycemia
    • Low blood pressure and lightheadedness
  • If you're experiencing these symptoms, it's essential to consult with a healthcare provider who can evaluate for recognized medical conditions like PAI, depression, sleep disorders, or chronic fatigue syndrome.
  • Blood tests for cortisol levels and other hormones can help determine if you have a genuine adrenal disorder that requires medical treatment, as recommended by the consensus statement 1.
  • In the absence of a recognized medical condition like PAI, focus on general health practices like maintaining a balanced diet, getting adequate sleep, managing stress through techniques like meditation or yoga, and regular physical activity, which can help address fatigue regardless of its cause.

From the Research

Symptoms of Adrenal Fatigue

  • Fatigue
  • Insomnia
  • Joint pain
  • Weight gain 2

Proposed Methods to Assess Adrenal Fatigue

  • The methodology for assessing the hypothalamic-pituitary-adrenal (HPA) axis has often been inappropriate 2
  • Only a minority of studies have actually examined the HPA axis 2

Treatment of Adrenal Fatigue

  • Non-pharmaceutical approaches have much to offer such patients 3
  • Nutrients and botanicals to support the adrenals, balance neurotransmitters, treat acute anxiety, and support restful sleep 3
  • Ashwagandha root extract can improve sleep quality and can help in managing insomnia [(4,5)]
  • Ashwagandha can have a positive effect on the functioning of the endocrine system, including improving the secretory function of the thyroid gland, normalizing adrenal activity 6

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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