Doctor’s Tip: There’s no such thing as adrenal fatigue
Is there such a thing as adrenal fatigue? The short answer is no. Chiropractor James Wilson came up with this term in 1998 to explain common patient complaints of fatigue, listlessness and malaise (feeling crummy). The theory is that if we’re under constant stress, as a lot of people are these days, our adrenal glands burn out and don’t produce an adequate supply of stress hormones. Many alternative providers as well as a few misguided or unethical M.D.s (e.g. Dr. Mercola) and D.O.s subscribe to this unproven theory. Treating alleged adrenal fatigue has become a lucrative industry — check out supplements for it on the internet.
The most common causes of fatigue, listlessness and malaise: sleep apnea, anemia, autoimmune diseases, cancer, infections, hormonal imbalance, depression, heart and lung disease, liver and kidney disease, unhealthy diet and sedentary lifestyle. These conditions need to be ruled out in any patient who presents with these symptoms, and treated appropriately if they are diagnosed. Unfortunately, all too often doctors run a few tests and tell patients there’s nothing wrong with them, which leads them to seek unproven and sometimes dangerous remedies for their symptoms.
The adrenals are small glands located on top of the kidneys. They secrete several hormones that are essential for health and well-being, including adrenaline, and the steroids cortisone — the “flight or fight” hormones, which increase alertness, blood pressure and pulse rate. During most of the 20 million years of human evolution these hormones were necessary to react to immediate danger. We did not evolve to have chronic elevation of these flight or fight hormones, but people who are under chronic stress do, which contributes to chronic disease.
Nutrition Action is an evidence-based monthly publication put out by the Center for Science in the Public Interest. The June 2019 issue included an article about treatments for adrenal fatigue, titled “real remedies … or really good marketing?” The article points out that adrenal hormone production is regulated by the pituitary gland in the brain, via a feedback mechanism. Depending on the level of adrenaline hormones in the blood, the pituitary signals the adrenals to produce more hormones or less. There is no scientific evidence that adrenals “burn out,” even with chronic stress.
True adrenal insufficiency occurs in Addison’s disease, which President Kennedy had. It is manifested by fatigue, body aches, unexplained weight loss, low blood pressure, lightheadedness, loss of body hair and hyperpigmentation. Overactive adrenals cause a disease called Cushing’s syndrome. Both conditions are easy to diagnose with appropriate lab tests, and are easy to treat. Patients with alleged “adrenal fatigue” have normal adrenal hormone levels.
The proponents of the unproven adrenal fatigue theory recommend the following to treat it: a diet low in sugar, caffeine and processed (junk) food; plus supplements which claim to provide “adrenal support.” There is minimal control over all supplements, although it is illegal for them to contain thyroid or steroid hormones. According to Nutrition Action, researchers analyzed 12 such supplements and found thyroid hormone in all of them and at least one steroid hormone in seven — and since they’re illegal they weren’t listed on the labels.
The majority of people complaining of fatigue, listlessness and malaise feel much better if they exercise and eat a healthy diet, which includes avoiding sugar, processed food and more than minimal caffeine. It they improve their diet but their symptoms persist, tests should be done to rule out the conditions mentioned in the second paragraph. Don’t fall for unproven fad theories such as adrenal fatigue, and don’t spend your money on potentially dangerous supplements.
Retired physician Greg Feinsinger, M.D., is author of new book “Enjoy Optimal Health, 98 Health Tips From a Family Doctor,” available on Amazon and in local bookstores. Profits go towards an endowment to the University of Colorado School of Medicine to add prevention and nutrition to the curriculum. He is available for free consultations about heart attack prevention, diabetes reversal, nutrition, and other health issues. Call 379-5718 for an appointment. For questions about his column, email firstname.lastname@example.org.
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