If you or a loved one has ever felt “burned out,” you may have researched “adrenal fatigue.” While the existence of this condition is highly controversial, especially if you ask a medical doctor, the symptoms are real. Adrenal fatigue doesn’t have an official International Code of Diagnosis (ICD10) number to classify it as a disease and line it up with a medication. It doesn’t work that way. However, something in the body is interfering with its ability to adapt to stress.
What is Adrenal Fatigue?
“Adrenal fatigue” refers to reduced functioning of the adrenal glands, leading to inconsistent cortisol levels in the bloodstream. The concept was introduced to the natural medicine community in 1998 by naturopathic doctor James L. Wilson in his book Adrenal Fatigue: The 21st Century Stress Syndrome.
Situated atop the kidneys, the adrenal glands form a vital part of the endocrine system, working closely with the hypothalamus and pituitary glands in the brain. Together, these glands make up the hypothalamic-pituitary-adrenal axis, which regulates the “fight-or-flight” stress response.
Within the adrenal glands, the inner region (medulla) secretes adrenaline and noradrenaline. The outer region (cortex) produces three types of hormones: glucocorticoids (such as cortisol), mineralocorticoids (such as aldosterone), and androgens/male sex hormones (such as DHEA).
Now, “adrenal fatigue” is not recognized in scientific literature. However, you’ll find “HPA axis” and “HPA dysregulation” come up thousands of times in a search on PubMed and the National Library of Medicine. 
A study published in 2005 found that children and teens diagnosed with chronic fatigue syndrome had “alterations in adrenal function,” showing their adrenal glands weren’t functioning optimally. This study was published in the Journal of Pediatric Endocrinology & Metabolism, a respected, peer-reviewed medical journal. 
An HPA dysfunction mainly affects cortisol (the “stress hormone”) and aldosterone. These hormones play crucial roles in the stress response, blood sugar regulation, metabolism, fluid retention, maintenance of electrolyte balance, blood pressure, and inflammation.
Symptoms of Adrenal Fatigue
Adrenal fatigue has many of the same symptoms as Addison’s disease but without the autoimmune aspect:
- Tiredness that persists despite getting enough sleep
- Muscle weakness
- Low blood pressure
- Dizziness upon standing
- Changes in skin color (hyperpigmentation)
- Hair loss
- Lack of appetite
- Weight loss/Weight gain
- Poor stress tolerance
- Sleep disturbances
- An overall feeling of being unwell
- Brain fog
- Muscle and joint pain
- Cravings for salt, sugar, caffeine, and other stimulants
Many seek help from healthcare professionals for these symptoms, only to receive prescriptions for depression or anxiety. Although these approaches can give some relief, the symptoms of adrenal fatigue may persist for months or even years until the underlying causes are appropriately addressed.
How is Adrenal Fatigue Diagnosed?
Again, the medical field does not recognize adrenal fatigue as a medical condition. However, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDKD), these are standard tests for assessing adrenal function. Endocrinologists will usually order these tests if Addison’s disease or Cushing’s disease is suspected: 
- Adrenocorticotropic Hormone (ACTH) Stimulation Test: The ACTH stimulation test is a blood test used for diagnosing Addison’s disease. Synthetic ACTH is injected into the bloodstream, and the healthcare professional watches for a rise in cortisol levels. If the adrenal glands are damaged, the response will be limited or nonexistent.
- Corticotropin-Releasing Hormone (CRH) Stimulation Test: This test is used when there are abnormal results from the ACTH test. It looks for secondary adrenal insufficiency, often caused by poor pituitary function. It’s like the ACTH test in that CRH is injected into the bloodstream, and the medical professional watches for the response. If the adrenal glands cannot produce much cortisol in response, they may not be functioning well.
- Insulin-Induced Hypoglycemia Test: This test helps differentiate between problems with the pituitary gland and issues with the adrenal glands. Again, it looks for secondary adrenal insufficiency caused by poor pituitary function. To do so, healthcare professionals measure blood sugar before and after an insulin injection to see whether it leads to a drop in blood sugar and a rise in cortisol.
- Computer Tomography (CT scan): A CT scan uses imaging to show abnormal physical changes in the adrenal glands and/or the pituitary gland.
While these tests can certainly assess the adrenal glands, medical doctors aren’t likely to run them. If they don’t suspect Addison’s disease, they won’t believe these tests are worth running.
The Fireman vs. The Carpenter in Healthcare
At The Wellness Way, we talk about the mainstream perspective on healthcare versus our perspective and methods as the “fireman approach” or the “carpenter approach.”
Mainstream “fireman” doctors have two tools (treatment options) for caring for people: an axe and a hose. The axe represents cutting things out in a surgical procedure. The hose represents using medications to extinguish inflammation, pain, and other symptoms.
The Wellness Way doctors are more like carpenters. They assess the current state of the body with testing and then create a personalized plan to rebuild using nutrients from foods and supplements. Sunshine, rest, and positive relationships are other natural therapies that help with healing.
While these things are considered “complementary medicine” or even “alternative medicine,” scientific research backs up their effectiveness in healing.
Mainstream Medicine’s Approach to Adrenal Fatigue
Again, conventional medicine doesn’t recognize adrenal fatigue as a condition. They might even believe the patient suffers from depression or anxiety and prescribe medications accordingly. However, they do recognize low adrenal function, which they call adrenal insufficiency. If they test and find low cortisol levels, they may prescribe an oral dose of hydrocortisone at 20 mg. 
What Causes Adrenal Fatigue? Trauma, Toxins, and Thoughts
At The Wellness Way, we always go back to the “three Ts” (traumas, toxins, and thoughts) as the triggers that stress the nervous system. Trauma, exposure to toxins, or severe mental stress set off the HPA axis, leading to symptoms of adrenal fatigue.
Traumas (Physical Stressors)
Traumas or physical stressors can be acute or chronic. Chronic subluxations in the spine can inhibit nerve and blood flow to the small intestine, triggering an inflammatory response. Other forms of physical stress may include:
- Car accidents/Whiplash
- A fall
- Physical abuse
Physical trauma may lead to biochemical stressors, like an infection following surgery or medication following an injury. That’s literally adding insult to injury and multiplying stressors.
Toxins (Biochemical Stressors)
Toxins are biochemical stressors that may be either natural or synthetic. Toxins associated with poor adrenal function include the following:
- Lack of sleep – Sleep is needed for the brain to clean itself out each night via the glymphatic system. Without adequate sleep, toxins build up in the brain, which may trigger the stress response. 
- Processed food-based diet – A processed Western-style diet is linked to an increased stress response in animal studies.  A high-carb diet is also known to aggravate the adrenal glands. 
- Food allergies – Eating foods you’re allergic to triggers the immune system and the stress response in the body, further contributing to adrenal fatigue.
- Nutrient deficiencies, such as low magnesium, may also increase the risk of low adrenal function. 
- Exposure to environmental toxins and pollution – Endocrine-disrupting chemicals are especially harmful to adrenal function. 
Traumas and toxins are made worse by negative thought patterns and emotional stress.
Thoughts (Emotional Stressors)
Emotional stress can significantly contribute to feelings of adrenal fatigue, and staying in a stressed state can make it difficult to overcome it. Here are some potential emotional contributors to chronic stress, inflammation, and adrenal fatigue.
- Negative thinking
- Watching or reading the news (fear/worry)
- Emotional stress from marriage, financial, career, or other issues
- A state of overwhelm by major life changes, such as marriage, a new baby, graduation, divorce, or even moving to a new city.
- Grief/feelings of loss
- Pent up anger
- A toxic workplace
- Skipping vacations
Thoughts are powerful! They can lead to a cycle of stress, insomnia, and burnout.
The Wellness Way Approach to Adrenal Fatigue
At The Wellness Way, we dig deeper to solve the health challenges others can’t. We start with testing to see where there may be imbalances and then develop a personalized nutrition and supplement plan to help your body heal itself.
Important Tests for Assessing Your Gut and Brain Health
Here are some commonly recommended tests at The Wellness Way — especially when a patient is feeling severely burned out:
- DUTCH Hormone Test: DUTCH Complete Hormone Panel
- Food Allergy Test: Immuno Food Allergy Test
- Hormone Panel: Male Hormone Panel or Female Hormone Panel
- Gut Health Test: Genova GI Effects with Parasitology
Testing depends on which ones your Wellness Way practitioner considers most important based on your symptoms and health history.
Dietary Changes for Those with Adrenal Fatigue
- No sugar or processed foods – Both increase inflammation.
- Adequate salt (Salty foods may improve levels of cortisol in the body)
- Overall low carbohydrate, non-inflammatory diet of organic whole foods.
- Personalized nutrition based on your food allergy test results.
- Specific nutrient-dense foods: Liver/organ meats, sauerkraut, and micro greens for added nutrition.
Supplements For Those with Adrenal Fatigue
- Adrenal Glandular – Taking desiccated adrenal glands as a supplement can supply missing nutrients needed for healing.
- B Complex Vitamins — B complex vitamins, like in Wellness B Complex, help improve adrenal function, especially under stress. 
- Rehmannia – Rehmannia stimulates the adrenals to supply needed reinforcement for the stress response. 
- Bacopa – Bacopa was shown to protect the adrenal glands against acute and chronic stress. 
- Licorice – Licorice root (Glycyrrhiza glabra) may increase the absorption of cortisol into the tissues, especially when combined with grapefruit juice. 
- Ashwagandha – Ashwagandha (Withania somnifera) is an adaptogenic herb that can help increase energy levels. 
- Schisandra – Schisandra fruit helps the body adapt to stress by toning down an overactive hypothalamic-pituitary-adrenal (HPA) axis. 
- Mushroom Immune – Adaptogenic mushrooms like cordyceps can also support adrenal function. 
- DHEA – DHEA stands for dehydroepiandrosterone. It’s a potent steroid hormone naturally produced in the adrenal cortex. If the adrenal glands aren’t adequately producing DHEA, supplementing it may help.  **Be sure to get tested before adding DHEA to your regimen.**
Herbal supplements and other dietary supplements can be incredibly supportive in restoring adrenal function.
Educational Resources for Adrenal Fatigue
To start educating yourself on adrenal fatigue, here are some recommended video trainings and articles:
Videos & Webinars Related to Adrenal Fatigue
- Sleep | A Different Perspective | Episode 126
- Salt: The Refined Truth and Why We Need It | A Different Perspective | Episode 32
Articles to Support Those with Adrenal Fatigue
- Fatigue Factor: Why am I so Tired?
- Addison’s Disease: Adrenal Fatigue *NOT* on Steroids
- It’s Good to Be Salty!
- The Scoop on Salt
- Thyroid Conditions: How Do You know if You’re Low or High, and What Can You Do?
- Hashimoto’s Thyroiditis: The Destructive Thyroid Disease That Slows You Down
Connect With Us!
We invite you to connect with us! Find an event at a clinic near you! Follow us on social media. Tune in to A Different Perspective each Saturday morning LIVE to get cutting-edge training directly from Dr. Patrick Flynn. Please set up a no-obligation health consult with one of our doctors today. The best is yet to come! Think differently – and THRIVE. Reach out to a Wellness Way clinic today to get thorough testing and start on your health journey. We are here to help!
- Adrenal fatigue does not exist: a systematic review: PubMed
- Disturbed adrenal function in adolescents with chronic fatigue syndrome: PubMed
- Diagnosis of Adrenal Insufficiency & Addison’s Disease: National Institute of Diabetes and Digestive and Kidney Diseases
- Plasma, salivary and urinary cortisol levels following physiological and stress doses of hydrocortisone in normal volunteers: PubMed
- Brain may flush out toxins during sleep: NIH
- Exaggerated response to mild stress in rats fed high-fat diet: PubMed
- A Short Study Exploring the Effect of the Glycaemic Index of the Diet on Energy intake and Salivary Steroid Hormones: PubMed
- Adrenal gland factors in magnesium-deficient rats: PubMed
- Effects of endocrine-disrupting chemicals on adrenal function: PubMed
- Nutritional and botanical interventions to assist with the adaptation to stress: PubMed
- Metabolomics Profiling Reveals Rehmanniae Radix Preparata Extract Protects against Glucocorticoid-Induced Osteoporosis Mainly via Intervening Steroid Hormone Biosynthesis: PubMed
- Adaptogenic effect of Bacopa monniera (Brahmi): PubMed
- Grapefruit juice and licorice increase cortisol availability in patients with Addison’s disease: PubMed
- Adaptogens exert a stress-protective effect by modulation of expression of molecular chaperones: PubMed
- Pharmacological studies on the anxiolytic effect of standardized Schisandra lignans extract on restraint-stressed mice: PubMed
- Antifatigue and antistress effect of the hot-water fraction from mycelia of Cordyceps sinensis: PubMed
- Improvement in mood and fatigue after dehydroepiandrosterone replacement in Addison’s disease in a randomized, double blind trial: PubMed