Is Adrenal Fatigue Real? What Doctors Say

You feel tired and irritable all the time. You’re having difficulty sleeping, you can’t concentrate at work or school, you’re craving junk food, and maybe even coming down with more illnesses than usual. 

After a quick search online or a talk with a friend, you might encounter a condition called adrenal fatigue. It’s becoming more popular as a diagnosis due to the increased awareness we have of the impact of stress on our minds and bodies. There are lots of causes of chronic stress, from work and money to our relationships with partners, family members, and friends, and some people claim that chronic stress can lead to adrenal fatigue.

So, what’s the truth? And, regardless of whether the symptoms you’re experiencing are from adrenal fatigue or simply chronic stress or anxiety, what can you do to help yourself? Let’s take a closer look. 

Understanding Adrenal Fatigue

First off, what are the adrenal glands? You’ll find these triangle-shaped endocrine glands on top of the kidneys. They release hormones that affect a lot of the body’s processes, from regulating metabolism to managing stress to supporting the immune system.  

When the adrenal glands don’t make enough hormones, this is known as adrenal insufficiency—which you might have seen referred to as Addison’s disease. Some people believe adrenal fatigue to be a mild form of adrenal insufficiency. In this condition, the adrenal glands are not able to cope with the fight-or-flight state which can be caused by chronic stress. However, there’s no medical evidence to suggest this.

Naheed Ali, MD, PhD, a health expert, physician, and senior contributor at Vera Clinic, explains, “It’s important not to confuse [adrenal failure] with adrenal insufficiency, which is a serious medical condition … and it can be tested and treated properly. The two aren’t the same, though they sometimes get lumped together.”

Lucy da Silva, MSc MBACP, a psychotherapist and the co-founder of Silva Wellness, describes adrenal fatigue as a term used to describe “chronic exhaustion and other symptoms caused by prolonged stress, where the body’s stress response system becomes overwhelmed.”

She explains that, when stress hormones like cortisol and adrenaline are activated constantly, our bodies stay in a fight-or-flight state, and this can lead to the chronic stress symptoms often attributed to adrenal fatigue. She uses the phrase “the body keeps the score” to highlight how the body stores the effects of stress over time.

Of both recent stressors and long-term exposure to stress factors, as well as the pressure to achieve and perform, she says, “Recognizing these patterns and the cumulative impact of stress is leading more people to seek understanding, healing, and ways to restore balance in their lives.”

The Scientific Perspective

“Adrenal fatigue is a term inappropriately used to explain feeling constantly tired, stressed, or burnt out,” says Raj Dasgupta, MD. “Adrenal fatigue is not a real medical diagnosis and multiple studies have shown that adrenal fatigue is not a medical condition. The adrenal glands don’t ‘wear out’ the way this theory suggests, and there is no scientific evidence to back it up.”

Chronic stress and the effects it can have on the mind and body shouldn’t be taken lightly, and it’s important to take a step back and look at the bigger picture. Rather than adrenal fatigue, could there be other issues along with stress, like an iron deficiency, a thyroid imbalance, or a dietary gap?

Da Silva points out that stress does have an impact on the hypothalamic-pituitary-adrenal (HPA) axis, the system that regulates cortisol levels, and can cause dysregulation. While researchers are still trying to find out more about the origin of this dysregulation, it remains true that HPA axis dysregulation can contribute to many of the symptoms sometimes described as being part of adrenal fatigue.

Medical and Alternative Views

The overwhelming medical view is that adrenal fatigue is not a legitimate diagnosis, and it’s sometimes referred to as a “pseudo-endocrine disorder” as a result. As Dr. Ali says, despite its popularity in alternative medicine, “Mainstream medicine doesn’t support it because the science behind it just isn’t there.”

However, there are people who believe that adrenal fatigue is real—and some have first-hand experience. Joanna Chodorowska, a holistic nutrition coach and the founder of Nutrition In Motion, says that she had adrenal exhaustion in the past and compares it to chronic fatigue. She says, “I was seeing a holistic doctor at the time … he ran an adrenal stress index test and it confirmed I had fried my adrenals.”

Likewise, Cina Hoey, LCSW, a licensed psychotherapist, says, “I believe adrenal fatigue is very real and is a result of unmanaged chronic stress for extended periods of time,” giving root causes including self-abandonment, low self-worth, codependency, and people-pleasing. 

But while the concept of adrenal fatigue is a contentious one, the fact that it is a concept at all is a reflection of the struggles with stress that many of us face, and the very real impact that stress has on our health.

Potential Causes and Symptoms

“If someone believes they have adrenal fatigue, what they’re really noticing is likely a combination of things,” says Dr. Ali. “Poor sleep, lack of proper nutrition, high stress levels, and maybe not enough physical activity—it all adds up. When you address these areas, the symptoms often improve.”

The potential causes of adrenal fatigue are often very similar to the factors that can cause chronic stress. Dr. Dasguspta adds, “People who believe in adrenal fatigue think it’s caused by long-term stress making the adrenal glands unable to produce enough hormones like cortisol,” so, again, stress is the culprit.

Among the most common symptoms attributed to adrenal fatigue include:

• Persistent fatigue and low energy
• Difficulty concentrating and brain fog
• Trouble sleeping
• Mood swings and irritability
• Weakened immune system 
• Craving salty and sugary foods
• Feeling like you need caffeine to function

Addressing Symptoms and Seeking Help

Regardless of whether adrenal fatigue exists or not, as da Silva says, the symptoms “underscore the need to address chronic stress and its effects on both physical and mental health.”

You might find that your doctor suggests another condition. As mentioned, there could be a thyroid issue or an iron deficiency, as well as anything from depression to chronic fatigue syndrome to a sleep disorder like obstructive sleep apnea. If your adrenal glands are involved, Addison’s disease could be a possibility, rather than adrenal fatigue.

Where chronic stress is causing your symptoms, taking steps to improve sleep, practice mindfulness, and eat well can help you. You may also find therapy useful, in exploring unresolved stress and trauma, or try practices like breathwork or movement.

Conclusion

Generally speaking, the science doesn’t support the idea that adrenal fatigue is a legitimate diagnosis. But if you’re struggling, and it sounds like it would explain the symptoms you’re experiencing, there is support out there.

As Dr. Dasgupta says, “If you’re feeling this way, it’s a good idea to check in with a doctor to rule out any underlying health issues and find out what’s really going on. In the meantime, try things like managing stress, getting good sleep, eating well, and staying active—these can make a real difference in your energy levels and how you’re feeling overall.”

Dr. Ali adds, “The bottom line is that while adrenal fatigue as a diagnosis isn’t supported, the symptoms people feel are real and deserve attention. It’s not about dismissing someone’s experience but looking deeper to figure out what’s really going on and how to help.”

Many of us are living with chronic stress and other issues that affect our physical and mental health, so you’re definitely not alone. But speaking to your physician or a mental health professional could go a long way to helping you manage—and work out exactly what’s going on.