The Truth About ‘Adrenal Fatigue’

Learn how an accurate diagnosis leads to symptom relief

Excessive fatigue, sleeping problems and trouble concentrating — especially after having an infection or being overwhelmed by stress?

Advertising Policy

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy

Many patients with these complaints have been told by a doctor or healthcare professional that the cause is adrenal fatigue. And they struggle to get relief.

But the problem with the term ‘adrenal fatigue’ (not an officially recognized diagnosis) is that it has been used to describe a group of symptoms when nothing else can be used to explain it.

Endocrinologist Betul Hatipoglu, MD, discusses the truth about adrenal fatigue and how a proper diagnosis and multidisciplinary care lead to symptom relief.

Q: Is it possible for your adrenal glands to be truly fatigued?

A: The adrenal glands are responsible for producing and regulating specific hormones in the body. Your adrenal glands are working constantly and have a huge functional capacity — just like your heart or lungs. Just because your heart is pumping all the time doesn’t mean it’s fatigued. The same is true of your adrenals.

Q: Why is an accurate diagnosis so important?

A: Unfortunately, adrenal fatigue doesn’t truly explain what’s going on in the patient’s body. And it can lead to mistreatment and unpleasant side effects. Many patients come to me after being told that the symptoms they’re experiencing are all in their head, which can be very distressing.

Advertising Policy

Sometimes, patients who have been misdiagnosed with adrenal fatigue are prescribed prednisone (a type of steroid) or advised to purchase expensive adrenal supplements but experience no benefits from doing so. In fact, taking prednisone can result in several bad side effects.

Quite often, patients misdiagnosed with adrenal fatigue actually have postural orthostatic tachycardia syndrome (POTS), a surprisingly common condition that’s still relatively unknown in the medical community. Patients may also have an underlying autoimmune disease such as lupus.

That’s why it’s so important that doctors spend enough time gathering patient history details and performing tests before diagnosing the problem and beginning treatment. Sometimes, we can start to help a patient immediately by making modifications to his or her diet, prescribing an exercise regimen and/or recommending specific supplements.

Q: What is true adrenal insufficiency?

A: Real adrenal insufficiency describes adrenal glands that are sick and unable to function properly. Adrenal insufficiency can be caused by Addison’s disease, a pituitary disorder or another disorder. Symptoms of this life-threatening dysfunction include extreme exhaustion, lack of appetite (leading to weight loss), diarrhea, nausea and low blood pressure.

Patients with adrenal insufficiency often feel like they’re wearing a metal jacket. While POTS and adrenal insufficiency can sometimes mimic each other, adrenal insufficiency usually makes the patient feel much worse than a patient with POTS.

Advertising Policy

Q: What is the best approach for managing a suspected adrenal problem?

A: If you’re just beginning your quest for answers or have already been diagnosed with adrenal fatigue, consult your family doctor for a referral to an endocrinologist. If you have suspicions of adrenal insufficiency, it’s important to figure out what’s really causing the underlying issues to help you manage them properly.

To assess adrenal function, we conduct a one-hour ACTH stimulation test, which is very safe and reliable. We also look for thyroid issues and diabetes. After checking for a variety of endocrine disorders using testing and symptom assessment, we start working with a multidisciplinary team of doctors to figure out the root cause of the patient’s problem.

Q: Why is a multidisciplinary approach so important?

A: After ruling out possible endocrine disorders, your endocrinologist can refer you to other specialists, including urologists, cardiologists, rheumatologists, allergists/immunologists and infectious disease physicians. If you’re diagnosed with POTS or another disorder, these specialists will work together to manage your health and develop a targeted treatment plan — putting you on the path to symptom relief.

Advertising Policy