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). His theory was 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 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 claiming to treat it on the internet.

The most common causes of fatigue, listlessness, and malaise are the following:  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 if diagnosed treated appropriately. Unfortunately, when patients present with these symptoms all too often doctors run a few tests and tell them there’s nothing wrong with them, which leads them to seek unproven and sometimes dangerous remedies.

The adrenals are small glands located on top of the kidneys. They secrete several hormones that are essential for health and wellbeing, including the “stress hormones” adrenaline, and cortisone, which increase alertness, blood pressure, and pulse rate. During most of the 20 plus million years of human evolution these ‘flight or fight” stress hormones were necessary to react to immediate danger, such as a predator or enemy.  Chronic elevation of adrenaline and cortisone cause health problems, and we humans did not evolve to have chronic high levels. Unfortunately, for various reasons modern life often involves chronic stress for many people.

Nutrition Action is an evidence-based publication put out by the Center for Science in the Public Interest. A few years ago, an issue included an article about treatments for adrenal fatigue, titled “real remedies…or really good marketing?” The article pointed out that adrenal gland hormone production is regulated by the pituitary 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 adrenal “burn out” occurs, even with chronic stress.

True adrenal insufficiency occurs in Addison’s Disease, which President JFK suffered from. 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; along with supplements which they claim provide “adrenal support.” There is minimal control over all supplements. Although it is illegal for them to contain thyroid or steroid hormones, most supplements promoted for “adrenal fatigue” contain one or both. 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, but 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. If their symptoms persist in spite of improved lifestyle, tests should be done to rule out the conditions mentioned above 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.

Dr. Greg Feinsinger is a retired family physician who started the non-profit Center For Prevention and Treatment of Disease Through Nutrition. For questions or to schedule a free consultation about nutrition or heart attack prevention contact him at gfmd41@gmail.com or 970-379-5718.