Adrenal fatigue is a controversial topic. Both in the conventional and alternative medicine communities. Medical doctors don’t acknowledge its existence. Alternative and natural practitioners diagnose everyone with it. Somewhere between the two extremes lies the truth behind adrenal fatigue.
In this post, we’ll expose the common myths surrounding adrenal fatigue.
Myth #1: Adrenal fatigue is a disease
Adrenal fatigue is a syndrome, not a disease. Syndromes are different from diseases. Syndromes are a collection of symptoms. Think of irritable bowel syndrome (IBS). The symptoms of irritable bowel syndrome include abdominal pain and alterations in the frequency or consistency of the stool. When these symptoms occur together, they make up the syndrome that is known as irritable bowel. In a syndrome, the cause of the symptoms is often unknown.
A disease is an entirely different entity. With diseases, there is a known cause. Knowing the cause leads to knowing the pathology, or how the disease will progress. Think of chickenpox. Chickenpox is caused by the varicella-zoster virus. Since we know the cause of chickenpox, it is classified as a disease.
Adrenal fatigue is similar to irritable bowel syndrome in that it is a collection of signs and symptoms. The common symptoms of adrenal fatigue include fatigue, depression, decreased appetite, etc. The collection of symptoms makes up adrenal fatigue syndrome. Adrenal fatigue is a syndrome. Not a disease.
Myth #2: The adrenal glands are the root cause of adrenal fatigue
This is a big misconception. It’s also why your doctor doesn’t believe you when you tell her that you have adrenal fatigue.
The fatiguing adrenal theory started back when stress research was in its infancy. At this time, Dr. Hans Selye coined the term “general adaptation syndrome”. Dr. Selye believed that when placed under stress, an organism would respond in a repeatable manner. Time after time. It should be noted that Dr. Selye’s research was done solely on rats, never on humans. If you want to learn more about where adrenal fatigue came from, check out this post.
Fast forward to present day and you’ll see Dr. Selye’s “General Adaptation Syndrome” alive and well within the adrenal fatigue community. We have Dr. Selye to thank for the 3-stage adrenal fatigue model:
- Alarm/reaction phase
- Resistance phase
- Exhaustion phase
In the 3-stage adrenal fatigue model, it is thought that the adrenal glands first become activated by a stress. Should this stress continue, the adrenal glands continue to excrete cortisol. If the stress continues for a long enough duration or is very intense the adrenal glands “fatigue”, drastically decreasing the amount of cortisol they produce.
We know now that adrenal glands don’t fatigue. They are not the cause of low cortisol levels. The adrenal fatigue model is an over-simplified method of describing stress’s effect on the body. We know now that the interaction between stress and our body is much more complicated than originally thought.
For a more thorough run-down of why adrenal fatigue doesn’t exist, please see this post.
Myth #3: Lowering stress cures adrenal fatigue
This is a great recommendation. Unfortunately, the stresses that cause adrenal fatigue are often not the typical stressors you’re familiar with. When you think of stress, what comes to mind?
- Time constraints?
When we think of stress, this is generally what comes to mind. These stressors are generally cyclical. Meaning that there are times or periods of our life where they are prominent and we feel stressed. This is often followed by times when we’re not worried or stressed about the same event. But if any of the above stressors persist for a long period of time, they can cause adrenal fatigue.
Our body is well adapted to deal with cyclical, short-term stresses. If you think back to our paleolithic ancestors, the stresses that often threatened their survival was short in duration. Think, saber-tooth tiger encounters. Or, seasonal food shortages. This is how our stress system evolved.
Fast forward to modern day and you’ll notice that a lot of the stresses we encounter never end. It is these never-ending stresses that cause adrenal fatigue. Often, these stressors are hiding in plain sight. Some of the main causes of adrenal fatigue include:
- Blood sugar imbalance;
- Chronic inflammation;
- Circadian disruption.
I go into each of these topics in great detail in the following posts:
- How blood sugar imbalance causes adrenal fatigue
- How chronic inflammation causes adrenal fatigue
- How sleep disruption causes adrenal fatigue
Lowering stress will definitely improve adrenal fatigue symptoms. Though what’s most important is determining where the stress is coming from.
Myth #4: Vitamin and nutritional supplements can cure adrenal fatigue
Supplement companies would love if you believed this. You’d probably like it to be true too. Who wouldn’t want to cure something simply by swallowing a pill? Much like many chronic health issues, adrenal fatigue is one that you can’t supplement or medicate yourself out of.
Adrenal fatigue is your body’s response to a stressful stimulus. No amount of supplementation is going to remove the stress. And in order to beat adrenal fatigue, you need to remove the stress. Think of it this way, you have a rock in your shoe that is causing pain in your foot. You could:
a) Take Advil to alleviate the pain
b) Remove the rock
Both will alleviate your pain. But choice A leaves you dependent on the medication without ever addressing the cause. Treating adrenal fatigue works in a similar manner. You can take a lot of supplements that will improve your capacity to handle stress. Eventually, the stress will catch up to you. Adrenal fatigue is not a condition you can supplement yourself out of.
In order to properly treat adrenal fatigue, the underlying or hidden stress needs to be identified and removed. To help uncover your hidden stress, start with this post.
Myth #5: Adrenal fatigue is not a real condition
Your doctor would like you to believe adrenal fatigue is not real. And she’s right. Adrenal fatigue is not a real condition. As described in myth #2, your adrenal glands do not “fatigue” under stress.
However, low cortisol (hypocortisolism) is a very real condition. Hypothalamic-pituitary-adrenal axis dysfunction is also a very real condition. Both of these conditions describe a state where the body struggles to adapt to a long-term stress. These are the medically-acceptable terms that adrenal fatigue should be known as. But adrenal fatigue is just so much easier to write than hypothalamic-pituitary-adrenal axis dysfunction.
I’m confident that both you and your medical doctor can agree that stress has an influence on your health. In the face of long-term stress, the body can falter. This creates a condition that is colloquially known as adrenal fatigue. But if you want to get your doctor on your side, you’ll have to do away with the convenient adrenal fatigue nomenclature and use terms like hypocortisolism or hypothalamic-pituitary-adrenal axis dysfunction.
For more information on what adrenal fatigue is/isn’t and how to best talk to your doctor about it, check out this post.
Myth #6: There are 3 (or 4) stages of adrenal fatigue
This is generally how adrenal fatigue is described:
- Step one: You’re stressed for a long time.
- Step two: The stress doesn’t get any better. You move from stage one adrenal fatigue to stage two adrenal fatigue.
- Step three: Eventually, your adrenals can’t cope. They fatigue and stop producing cortisol. You’re now in stage 3 adrenal fatigue.
- Step four: Should stage three adrenal fatigue continue for a long period of time and you still don’t change your habits, then you fall into stage 4 adrenal fatigue. This is known as adrenal exhaustion.
This three or four stage model is helpful in explaining adrenal fatigue. It’s not useful for much else. Our bodies are a dynamic and complex interworking network of cells. Linear disease progressions like the 3-stage adrenal fatigue model are an oversimplification of a complex process.
If you’re interested in studying or learning about adrenal fatigue, the three-stage model can help give you context. But when it comes to treating the illness itself, it tends to highly variable. People can fluctuate from high cortisol levels (stage 2) to low cortisol levels (stage 4) in a very short period of time. Others can have low cortisol levels for years(stage 4) that then suddenly increase (stage 2). Some patients may have cortisol levels aligned with stage 2 but have all the symptoms of stage 4.
The three (or four) stage model should just be used to better understand the condition. It is not useful in treating or diagnosing adrenal fatigue. In all likelihood, there are far more than four stages. As research progresses, we’re likely to learn more.
Myth #7: Adrenal fatigue is why I feel tired all the time
Adrenal fatigue could be the cause of your low energy. But that’s not a guarantee. Even if all your symptoms fit perfectly with the descriptions on websites that doesn’t mean you have adrenal fatigue. All of the symptoms of adrenal fatigue are non-specific. Meaning that they could be occurring as a result of many different causes.
I strongly recommend getting conventional testing done by your medical doctor before jumping on the adrenal fatigue bandwagon. Fatigue can be brought about by a myriad of different conditions. Some of the more common causes of fatigue include:
- Iron Deficiency
- Gilbert’s syndrome
- Autoimmune disease
After ruling out the above conditions (and many other conventional causes of fatigue) I recommend working with a knowledgeable functional medicine practitioner. Adrenal fatigue is not a condition that can be diagnosed by symptoms alone. Running a lab like the DUTCH test can provide objective data to determine your exact levels of cortisol.
Adrenal fatigue describes a condition of low cortisol. But high levels of cortisol can produce the exact same symptoms. Treatment for high or low levels of cortisol is very different. This is why testing is so important. I go into more detail about the different types of adrenal fatigue in this post.
Ok, now you know the truth behind the most common adrenal fatigue myths.
Now, I want to hear from you!
What adrenal fatigue myths do you still believe to be true?
Want to know more about treating adrenal fatigue naturally? Click here.
Also published on Medium.