What Is Adrenal Fatigue and Why It Matters
Feeling constantly tired, burned out, or unable to recover from stress? These are common experiences, often attributed to a condition called adrenal fatigue. Popular in functional and integrative medicine circles, adrenal fatigue is believed to result from chronic stress that overtaxes the adrenal glands—small glands that produce cortisol and other stress-related hormones.
However, adrenal fatigue remains a controversial diagnosis and is not recognized as a medical condition in conventional medicine. This blog explores what adrenal fatigue means, how it differs from adrenal insufficiency, and what you should know when seeking answers to ongoing fatigue.
What Are the Adrenal Glands?
The adrenal glands are two small, triangular-shaped glands that sit on top of your kidneys. They play a vital role in hormone production, including cortisol, adrenaline, and aldosterone. These hormones help regulate your stress response, blood pressure, metabolism, and immune system.
When your body is under stress, the adrenal glands release cortisol to help you adapt. Over time, some practitioners believe chronic stress can "exhaust" these glands, leading to what's often called adrenal fatigue—though this concept is not recognized in conventional medicine.
Is It the Same as Adrenal Insufficiency?
No—adrenal fatigue and adrenal insufficiency are not the same. Adrenal insufficiency, including Addison’s disease, is a medically recognized condition where the adrenal glands fail to produce adequate levels of cortisol or other essential hormones. This condition is rare but serious and can be diagnosed through blood tests that show hormonal deficiencies.
In contrast, people labeled with adrenal fatigue typically have normal or low-normal lab results, and no structural damage to the adrenal glands. While both share symptoms like fatigue and low energy, adrenal insufficiency often includes more severe signs such as low blood pressure, unexplained weight loss, and electrolyte imbalances—which are not usually present in suspected adrenal fatigue.
Symptoms of Adrenal Fatigue
The symptoms commonly attributed to adrenal fatigue are non-specific and often overlap with other health conditions. These may include:
Persistent fatigue, even after rest
Difficulty falling or staying asleep
Cravings for salt or sugar
Brain fog or poor concentration
Low energy in the morning or mid-afternoon
Increased reliance on caffeine or stimulants
Weight gain, especially around the midsection
Because these symptoms can be caused by a range of issues—like poor sleep, nutrient deficiencies, thyroid disorders, or chronic stress—it’s important to work with a qualified provider to rule out other causes.
What Causes Adrenal Fatigue?
Adrenal fatigue is thought to develop from long-term exposure to physical, emotional, or mental stress. The theory suggests that chronic stress causes the adrenal glands to work overtime, eventually leading to hormone imbalances—especially in cortisol production.
Potential contributing factors may include:
Ongoing psychological stress (work, relationships, trauma)
Chronic infections or illness
Poor sleep and circadian rhythm disruption
Nutritional deficiencies
Overuse of stimulants like caffeine
While this theory is popular in integrative health, it remains scientifically unproven. Most medical professionals emphasize the need to look deeper into lifestyle, mental health, or other underlying conditions that may explain chronic fatigue.
Is There a Test for Adrenal Fatigue?
There is no validated medical test to diagnose adrenal fatigue. Standard blood tests for adrenal function—such as cortisol levels or ACTH stimulation tests—typically return normal results in individuals suspected of having adrenal fatigue.
Some alternative practitioners may use saliva cortisol testing throughout the day to assess patterns of adrenal output. However, these tests are not widely accepted in conventional medicine, as cortisol levels naturally fluctuate and can be influenced by many variables, including sleep, stress, and illness. However, it is reasonable to look at your patterns over time and find problematic functional issues such as low cortisol in the morning and high at night (a reverse rhythm often associated with chronic stress).
If you're experiencing unexplained fatigue, your provider will likely order labs to rule out anemia, thyroid dysfunction, vitamin deficiencies, or other medical conditions first.
How Is Adrenal Fatigue Treated?
Because adrenal fatigue is not a recognized medical diagnosis, there is no standardized treatment protocol. However, many integrative providers focus on supporting overall stress resilience and hormone balance through lifestyle changes.
Common recommendations include:
Improving sleep habits and maintaining a consistent sleep schedule
Reducing stress through mindfulness, therapy, or relaxation techniques
Following a balanced, anti-inflammatory diet rich in whole foods
Limiting caffeine and alcohol, which may further stress the adrenal system
Engaging in light physical activity, like walking or yoga, instead of intense workouts
Targeted supplements (like adaptogens) — though these should only be used under professional guidance
These approaches are generally safe and may help improve energy and wellbeing, even if adrenal fatigue itself cannot be confirmed.
When to See a Doctor
If you're experiencing persistent fatigue, brain fog, or other unexplained symptoms, it's important to consult with a healthcare provider. These symptoms could signal a treatable medical condition such as:
Thyroid dysfunction
Iron deficiency anemia
Sleep disorders
Chronic infections
Depression or anxiety
A licensed provider can perform appropriate evaluations to rule out serious conditions and guide you toward a personalized treatment plan. Even if your labs are normal, addressing sleep, stress, and nutrition can have a profound effect on your overall health.
Conclusion
Adrenal fatigue is a widely discussed concept in integrative health, but it remains unsupported by mainstream medical evidence. While the symptoms are real and often debilitating, they are usually the result of multiple overlapping factors, including chronic stress, poor sleep, and nutritional imbalances—not adrenal failure.
If you're struggling with low energy or burnout, it’s essential to take your symptoms seriously. Partnering with a provider who considers both conventional and lifestyle-based approaches can help uncover the root cause and guide you toward lasting recovery.
References
Huecker MR, Bhutta BS, Dominique E. Adrenal Insufficiency. [Updated 2023 Aug 17]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK441832/
Head, K. A., & Kelly, G. S. (2009). Nutrients and botanicals for treatment of stress: adrenal fatigue, neurotransmitter imbalance, anxiety, and restless sleep. Alternative medicine review : a journal of clinical therapeutic, 14(2), 114–140.
