What Is Adrenal Fatigue and Addison's Disease?

DrSugar Answers: Adrenal Fatigue?

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Dear DrSugar,
I was researching my recent increased PMS symptoms and discovered they are a symptom of something that naturopaths call adrenal fatigue or adrenal exhaustion. Is this condition or something like it acknowledged in the medical community? Could it be a source of my problems?
— Tired and Confused

Well, I must admit this was a very interesting topic to research, as I had never heard of it before since it was not a subject that I learned of in medical school or residency training. So just what is adrenal fatigue? To learn more about it, keep on reading!

Adrenal fatigue or exhaustion is a term used in alternative medicine to describe the belief that the adrenal glands are exhausted and unable to produce adequate quantities of stress or steroid hormones, primarily cortisol. The term "adrenal fatigue" may be applied to a collection of nonspecific, medically unexplained symptoms but is not recognized by mainstream medical institutions.

The nonspecific medical symptoms typically include body aches, fatigue, nervousness/anxiety, sleep disturbances, and digestive problems. I encountered many websites devoted to adrenal fatigue. Other symptoms for adrenal fatigue that were listed on the websites include weight gain, frequent upper respiratory infections, reduced sex drive, poor memory, cravings for fatty, salty or sweet foods, increased PMS symptoms, depression, hair loss, constipation and diarrhea, and improvement of symptoms when stress is relieved.

According to one website, six months to two years may be needed to "reverse" adrenal fatigue and includes the following steps: removal of stressors, sleep, avoiding caffeine, avoiding TV and computers, exercise, nutritional supplementation, adrenal herbal extracts and herbals (which can act as stimulants), diet, and possibly steroid supplementation.

Like I said before, there seem to be endless numbers of websites devoted to this topic, and many of them are promoting supplements, vitamins, or special formulas, and even books/fliers/seminars to help treat adrenal fatigue. Most of them contain your typical vitamin supplements (with some of the vitamins included being at 500-2000 percent of the recommended daily intake); however, some of them contain herbal preparations. Whether or not these supplements and formulas are safe, pure, or of good quality are unknown because they are not required to undergo formal safety testing with the Food and Drug Administration.

The adrenal glands are important because they produce a variety of hormones that are essential to life. The medically accepted diagnosis of adrenal insufficiency, also known as Addison’s disease, refers to inadequate production of one or more of the hormones. Signs and symptoms of adrenal insufficiency include fatigue, body aches, unexplained weight loss, low blood pressure, lightheadedness, and loss of body hair. Adrenal insufficiency can be diagnosed by blood tests and special adrenal stimulation tests that show inadequate levels of adrenal hormones.

Proponents of the adrenal fatigue diagnosis claim that adrenal fatigue is a very mild form of adrenal insufficiency and caused by chronic stress. They believe that because of the chronic stress, the adrenal glands cannot keep up with the demands of the permanent stress, and as a result, the glands cannot produce enough of the hormones you need to feel "good." Proponents also state that because it is such a mild form of adrenal dysfunction, blood tests available today aren’t sensitive enough to pick up such a small decline in adrenal function.

According to an article from a Mayo Clinic endocrinologist, this theory is unproven, and accepting a medically unrecognized diagnosis such as adrenal fatigue could make you worse. This is because one may choose to buy or use the remedies that are being sold for "treatment" of adrenal fatigue, which may or may not be safe. There are many other medically recognized conditions that could mimic the symptoms of "adrenal fatigue," such as depression, fibromyalgia, or possibly real adrenal insufficiency.

The safest bet is to discuss your symptoms with your primary care physician so that a full history and physical examination can be done and appropriate lab work and tests can be done to rule out any medical conditions. I also would not recommend taking any herbal or supplemental remedies without first checking with your physician so that the contents can be reviewed and their safety evaluated given your medical history.

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