What are the symptoms of adrenal fatigue?

"Adrenal Fatigue" Is Not a Recognized Medical Condition

"Adrenal fatigue" is not a recognized medical diagnosis by any endocrinology society, and systematic reviews have found no scientific evidence supporting its existence as a medical condition. 1

What Is Claimed About "Adrenal Fatigue"

Proponents of "adrenal fatigue" claim it involves symptoms such as:

• Fatigue and exhaustion
• Difficulty waking up in the morning
• Craving for salty foods
• Poor stress response
• Decreased immunity
• Reliance on stimulants like caffeine
• Difficulty concentrating
• Insomnia
• Weight gain
• Joint pain

However, these nonspecific symptoms can be attributed to many other conditions that have scientific validity.

What The Scientific Evidence Shows

A comprehensive systematic review published in BMC Endocrine Disorders examined 3,470 articles and found:

• No substantiation that "adrenal fatigue" is an actual medical condition 1
• Conflicting results from various testing methodologies
• Poor quality assessment of fatigue in most studies
• Use of unsubstantiated methodology for cortisol assessment 1

Another study directly states that "current evidence does not support the existence of adrenal fatigue or the usefulness of supplements to support adrenal function" 2.

Real Adrenal Conditions That Should Not Be Confused With "Adrenal Fatigue"

Adrenal Insufficiency

Adrenal insufficiency is a legitimate medical condition that occurs in three forms:

1. Primary adrenal insufficiency: Caused by autoimmune destruction, congenital adrenal hyperplasia, infections, or surgical removal of adrenal tissue 3
2. Secondary adrenal insufficiency: Caused by disorders affecting the pituitary gland 3
3. Glucocorticoid-induced adrenal insufficiency: Caused by administration of supraphysiological doses of glucocorticoids 3

Symptoms of True Adrenal Insufficiency

True adrenal insufficiency presents with specific symptoms:

• Fatigue (50%-95% of patients)
• Nausea and vomiting (20%-62%)
• Anorexia and weight loss (43%-73%) 3
• Hyperpigmentation (in primary adrenal insufficiency)
• Electrolyte abnormalities (low sodium, high potassium in primary adrenal insufficiency) 4

Diagnosis of True Adrenal Insufficiency

Proper diagnosis involves:

• Early-morning (8 am) measurements of serum cortisol, corticotropin, and DHEAS 3
• Corticotropin stimulation testing for intermediate cortisol levels 3
• Laboratory findings that distinguish between primary and secondary adrenal insufficiency:

Type	ACTH Level	Cortisol Level	Electrolytes	Hyperpigmentation
Primary	High	Low	↓Na, ↑K	Present
Secondary	Low	Low	Usually normal	Absent
[4]

Why "Adrenal Fatigue" Persists as a Concept

Despite lack of scientific evidence, the concept of "adrenal fatigue" persists because:

1. The symptoms attributed to it are common and nonspecific
2. Patients with unexplained fatigue seek explanations and solutions
3. The concept has been promoted in the lay press and by some alternative medicine practitioners
4. Supplements marketed for "adrenal support" create financial incentives to perpetuate the concept

What To Do If You Have Symptoms Attributed to "Adrenal Fatigue"

If you're experiencing persistent fatigue and other symptoms:

1. Consult with a board-certified physician for proper evaluation
2. Consider legitimate causes of fatigue, including:
   • Sleep disorders
   • Depression and anxiety
   • Thyroid dysfunction
   • True adrenal insufficiency (rare but serious)
   • Chronic fatigue syndrome
   • Nutritional deficiencies
   • Anemia
   • Chronic infections

Conclusion

The medical community, including all major endocrinology societies, does not recognize "adrenal fatigue" as a valid medical diagnosis. If you're experiencing persistent fatigue, seek proper medical evaluation rather than pursuing unproven treatments for a condition that lacks scientific validation.