Does Adrenal Fatigue Actually Exist?

The term adrenal fatigue was first used by chiropractor James Wilson in 1998, and it became popular with a book he published in 2001. I’ve written before about some of the quacky dabbling of chiropractors outside the neck and back pain issues we commonly associate them with. You can probably guess from that alone where I’m going with this post.

What is adrenal fatigue?

The adrenal glands, which sit on top of the kidneys, produce the hormone cortisol when they receive signals from the brain via the hypothalamic-pituitary-adrenal (HPA) axis. The idea of adrenal fatigue is that stress or chronic infections wear out the adrenal glands so that they can’t produce enough cortisol. The problem is, that there’s been nothing measured that indicates that this actually happens. Chronic adrenal insufficiency is a legitimate disease that can be diagnosed using a lab test, but that’s an entirely different can of tuna.

Proponents of adrenal fatigue claim that it can cause a variety of non-specific symptoms, including:

• fatigue
• having a hard time getting up in the morning, with higher energy levels in the evening
• difficulty handling stress
• consuming a lot of caffeine
• craving salty or sweet foods
• a weak immune system

All of that is vague enough that there could be a whole boatload of potential causes.

Diagnosis

I found multiple sites that talked about a supposed iris contraction test to diagnose adrenal fatigue. That sounded rather dubious, so I plugged “iris contraction test” and “adrenal fatigue” into the great BS detector that is Google Scholar, which yielded a whopping 2 results. That would be a definite fail on the BS test and a checkmark on the quackery test.

Feel like self-“diagnosing” another way? James Wilson has a website, where you can fill out a questionnaire (or a shorter quiz if the questionnaire is too fatiguing). Chances are, if you’re human, you’ll discover that you do indeed have supposed adrenal fatigue. *Update: These resources no longer exist on the site.

A systematic review delightfully titled “Adrenal Fatigue Does Not Exist” concluded that “there is no substantiation that ‘adrenal fatigue’ is an actual medical condition. Therefore, adrenal fatigue is still a myth.” The authors added that none of the studies that they reviewed actually used the methods that would be most appropriate in evaluating the functioning of the HPA axis.

Recommended treatments for adrenal fatigue

This supposed condition can be big business for the supplement-making folks. The website adrenalfatiguesolution.com recommends quite a few of them, and starts with this message that is just silliness:

“Your blood tests might show that you are within range for many of these nutrients, but fatigue and low energy levels often suggest otherwise. Just like hormone levels, you should be aiming for the optimal levels of these vitamins and minerals, not just the minimum levels.”

Who cares if you’re within normal range? Normal, shmormal. Go spend some money anyway!

Supplements

Speaking of spending money, the recommended supplements include:

• vitamins B5, B6, B12, and C
• magnesium
• probiotics
• ashwagandha
• Siberian ginseng
• Rhodiola rosea
• maca root
• omega-3s
• acetyl-L-carnitine
• co-Q10
• D-ribose

That all adds up pretty quickly, which I’m sure makes the supplements industry very happy.

Dried animal adrenal glands

There are also adrenal supplements available that consist of dried-out animal adrenal glands. Just to amp up the quackery a bit more, these aren’t standardized, so you never actually know how much you’re getting.

It’s sort of like drying out some pig thyroid, crushing it up, and then swallowing a handful. Might as well chase it with a shooter of pig urine while you’re at it. All in the name of “natural”, right?

A dash of strychnine

Have you ever heard of the poison strychnine? It’s the basis of one of the homeopathic remedies that’s sometimes used for adrenal fatigue. Don’t worry too much, though; as I’ve written about before, homeopathic remedies are so diluted that there’s unlikely to be a single strychnine molecule left in the end product.

So, we’ve got a made-up illness that is generating a lot of money for alternative health practitioners and supplement makers. All the while, I wouldn’t be surprised if these are the same folks that are militantly anti-Pharma. Funny how these things go.

References

• Cadegiani, F. A., & Kater, C. E. (2016). Adrenal fatigue does not exist: a systematic review. BMC Endocrine Disorders, 16(1), 48.
• Cedars-Sinai. (2018). Debunking adrenal fatigue.
• Wikipedia: Adrenal fatigue