Is Adrenal Fatigue Real? Myths vs. Facts
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Is Adrenal Fatigue Real?

Is Adrenal Fatigue Real?
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Published on October 7, 2022
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This article explores the myths around adrenal fatigue, what else can cause similar symptoms, and what to do if you feel your symptoms match those attributed to adrenal fatigue.

Is Adrenal Fatigue a Real Medical Condition?

“Adrenal fatigue” has become a popular term in alternative medicine circles and among online health influencers, stemming from a 2001 book called Adrenal Fatigue: The 21st Century Stress Syndrome.

 Several online sources discuss the steps for diagnosing and treating adrenal fatigue. But the major bodies overseeing medical specialties (including the Endocrine Society, whose members specialize in treating problems with hormone production) state that no reliable evidence supports the existence of adrenal fatigue.


An older review of 58 studies also found no scientific basis for a link between impaired adrenal gland function and fatigue. Testing the saliva for levels of cortisol, a hormone the adrenal glands make in response to stress, is common among practitioners who claim to treat adrenal fatigue. However, in over 61 percent of the studies, researchers found no difference in the cortisol levels of people who reported feeling fatigue and those who didn’t, when checking them four times in 24 hours.

 The review questions whether there are enough criteria, including which cortisol levels should be considered “normal” and which fall outside of that range, to diagnose or even define adrenal fatigue. Newer research has come to similar conclusions.

 No medical test shows adrenal fatigue, and a person who gets a “diagnosis” of the condition will do so based on only a description of their symptoms.

Can Stress Tire Out the Adrenal Glands?

Although other health problems can affect how well the adrenal glands can make cortisol, they don’t simply wear out. Your adrenal glands are vital for how your body works, producing a range of hormones, including cortisol.

Theories behind adrenal fatigue suggest that constant exposure to stress leaves the adrenals drained, leading to a constant state of low cortisol.

 But the adrenal glands have a high capacity to respond to stress. While other conditions can affect how they work, they don’t get tired.

What Symptoms Do People Link to Adrenal Fatigue?

People use the term “adrenal fatigue” to describe several different symptoms, including:

  • Tiredness
  • Weakness
  • Sleep issues
  • Low motivation
  • Low mood
  • Feeling lightheaded
  • Cravings for salty or sugary snacks
However, these symptoms are common and vague. Many conditions — or even a busy or demanding schedule — can lead to them.

What Else Might Be Causing Adrenal Fatigue Symptoms?

The symptoms people associate with adrenal fatigue are nonspecific, meaning they can relate to a wide range of health problems or more than one condition at the same time. This makes getting an accurate diagnosis even more important. Misdiagnosing adrenal fatigue could mean you’re not treating an underlying health issue.

A few examples of health issues that can cause fatigue, low mood, and sleep issues include:

  • Anemia
  • Sleep apnea
  • Autoimmune diseases
  • Infections
  • Other hormonal impairments
  • Mental health issues
  • Heart disease
  • Lung problems
  • Kidney diseases
  • Liver diseases

It’s a good idea to speak to a doctor if these symptoms regularly interfere with your daily life.

Are Adrenal Disorders Real?

Unlike adrenal fatigue, there are some recognized disorders that directly affect the adrenal glands and the amount of cortisol they produce. Adrenal insufficiency, also known as Addison’s disease, is one of them. It can develop when your immune system mistakenly attacks the tissue in your adrenal glands, and it can result from cancer, infections, a hemorrhage, or genetically inherited health problems.

A deficiency of a pituitary hormone called adrenocorticotropic hormone (ACTH), which stimulates the adrenal glands to produce cortisol, can also lead to adrenal insufficiency. This is generally not as severe as Addison’s disease, since the adrenal glands can still produce aldosterone, the hormone that tells the body to hold on to salt and get rid of potassium. Often, this can result from using steroids like prednisone or opiates for a long time, but could also be due to a pituitary tumor.

So, while some serious conditions can affect the adrenal glands, the glands don’t experience tiredness in a way that causes the symptoms people understand as fatigue. However, extreme, ongoing exhaustion can be a symptom of adrenal gland issues like those described above. Other symptoms might include:

  • Appetite loss
  • Unwanted or unexpected weight loss
  • Diarrhea
  • Low blood glucose
  • Low blood pressure

What Treatments Do Adrenal Fatigue Proponents Suggest?

People who claim to diagnose and treat adrenal fatigue often recommend lifestyle changes, including giving up alcohol, smoking, and drugs, as well as moving more, eating healthy foods, and keeping up a regular sleep-wake cycle every day.

Whatever your medical diagnosis, or even if you’re feeling run down from your daily schedule, taking these steps is almost always likely to improve how you feel. Some practitioners also suggest taking certain supplements. However, the U.S. Food and Drug Administration (FDA) hasn’t approved any treatment for adrenal fatigue and doesn’t regulate supplements in the same way that it does medications.

That means you can’t be sure that the recommended supplements contain the ingredients they claim or will be effective for the outcomes they claim on the packaging — and also that insurers are probably not going to pay the costs. Consultants and products that claim to treat adrenal fatigue can therefore be costly, and there is no strong evidence that they will improve how you feel.

Some supplements claiming to treat adrenal fatigue can even be harmful. Glandular adrenal supplements are steroids, so they might feel good at first. However, if you use them for a long time when you don’t actually need them, they can have the opposite effect on your adrenal glands, reducing the amount of cortisol they produce.

What to Do if You Feel Tired All the Time

If you’re dealing with ongoing symptoms that no doctor has been able to explain, seeking explanations from other sources to cope with the frustration is understandable. But people who get supplements and consultations to try to manage a condition that doesn’t show up on currently available tests and isn’t backed by strong evidence could be at risk of missing a serious health problem that affects the body over time.

So, if you’re constantly fatigued, and lifestyle changes like getting more sleep, exercising more, and eating a healthier diet aren’t helping how you feel, speak to a healthcare professional. They can help you get an accurate diagnosis and connect you with the treatment you need.

They can reliably test how well your adrenal glands make cortisol using an hour-long ACTH stimulation test. A clinician might also check for diabetes and thyroid problems or refer you to doctors who specialize in treating health conditions in the heart, lungs, joints, immune system, and urinary system, as well as infectious disease specialists.

Mental health conditions like depression or anxiety can also cause fatigue and low mood, especially if life is hectic, stressful, or full of change. Speaking with a mental health professional might empower you with tools to pinpoint and manage stress and reduce these symptoms.

Find Help Now

If the emotional issues are severe or you’re experiencing the urge to self-harm, you can call the 988 Suicide and Crisis Lifeline, which also has options for Spanish speakers, or the Crisis Text Line (text HELLO to 741741).

Teams from different fields and disciplines may collaborate to help you identify and treat the issue. A key problem with an adrenal fatigue diagnosis is that it can mean you don’t get the treatment you need for a real underlying problem.

Even if your symptoms do directly involve the adrenal glands, connecting with a healthcare professional can help you access the care you need.

Resources We Trust

EDITORIAL SOURCES
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Resources
  1. Wilson JL. Adrenal Fatigue: The 21st Century Stress Syndrome. Doctor Wilson’s Original Formulations. 2001.
  2. Adrenal Fatigue. Endocrine Society. January 25, 2022.
  3. Cadegiani GP et al. Adrenal Fatigue Does Not Exist: A Systematic Review. BMC Endocrine Disorders. August 24, 2016.
  4. Mcdermott M et al. Pseudo-Endocrine Disorders: Recognition, Management, and Action. Journal of the Endocrine Society. December 17, 2024.
  5. Here’s the Truth About ‘Adrenal Fatigue’. Cleveland Clinic. February 14, 2025.
  6. Adrenal Fatigue: What Causes It? Mayo Clinic. April 10, 2024.
  7. Fatigue. Mayo Clinic. February 20, 2026.
  8. Adrenal Insufficiency (Addison’s Disease). Johns Hopkins Medicine.
  9. Mitchell S. Debunking Adrenal Fatigue. Cedars-Sinai. January 16, 2018.
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Anna L. Goldman, MD

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Anna L. Goldman, MD, is a board-certified endocrinologist. She teaches first year medical students at Harvard Medical School and practices general endocrinology in Boston.

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