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Adrenals Shot? Probably Not.

June 24, 2016 14 Comments by Scott Isaacs, M.D.

Many of my patients have been told that they are gaining weight because their adrenal glands are burned out or they have a condition called adrenal fatigue. You may have heard the terms adrenal fatigue, adrenal burnout, or adrenal exhaustion. Proponents of this condition claim that the condition is caused by the effects of chronic mental, emotional, or physical stress on the adrenal gland.

The Endocrine Society, the professional organization for more than 18,000 physicians and scientists from around the world, states that

“Adrenal fatigue is not a real medical condition.”

Proponents recommend saliva testing for cortisol to diagnose adrenal fatigue; however, the Endocrine Society states,

“There are no tests that can detect adrenal fatigue.”

A 2016 Fox News Report stated,

“There’s still no way to test for the condition. What’s more, researchers have uncovered no concrete evidence that stress actually does drain the adrenal glands.”

Supporters of adrenal fatigue recommend improving lifestyle by quitting smoking and ceasing to drink alcohol, getting more sleep, exercising regularly, and eating healthy foods. These important health behaviors will make you feel better no matter what the diagnosis.

“The symptoms people experience [when they believe they have adrenal fatigue] are very real, and sometimes it’s difficult to have symptoms and not have a diagnosis, so that could be where the persistent myth of ‘adrenal fatigue’ syndrome comes from,” said Dr. Salila Kurra, co-director of the Columbia Adrenal Center and assistant professor of medicine at Columbia University Medical Center in New York City.

“There really is harm in believing that myth and “waiting for the research to catch up,” as some people put it, said Dr. Marilyn Tan, an endocrinologist with Stanford Health Care and clinical assistant professor of medicine at Stanford School of Medicine in California.

A systematic review published in the peer-reviewed journal BMC Endocrine Disorders found that

“Adrenal fatigue does not exist.”

TODAY (4/17, Raymond) reported,

“Adrenal fatigue is one of the latest in a long line of maladies that traditional doctors say is a bunch of hooey.” According to Today, “endocrinologists say there is no science proving the existence of adrenal fatigue.” What’s more, “supplements and herbs used to treat adrenal fatigue can actually screw up your adrenal glands, according to The Hormone Health Network, the public education affiliate of the Endocrine Society.”

Websites about adrenal fatigue have permeated the Internet and promote a variety of unproven herbal supplements, animal glandular extracts, and even cortisol medications to treat the condition. According to the Endocrine Society,

“Supplements and vitamins made to treat adrenal fatigue may not be safe. Taking these supplements when you do not need them can cause your adrenal glands to stop working and may put your life in danger.”

Whatever you want to call it—adrenal fatigue, exhaustion, or burnout—it is not a real hormonal condition. Adrenal fatigue is a fake diagnosis that has no scientific basis. If you have been told you have adrenal fatigue, get a second opinion from a board-certified endocrinologist.

Unlike adrenal fatigue, Addison’s disease is a real medical condition that occurs when the adrenal glands cannot make enough cortisol. People with deficiencies of cortisol lose weight and feel tired all the time. As cortisol levels continue to drop, the body shuts down and goes into shock. The condition is often misdiagnosed as shock from a severe infection. It can sometimes come on very suddenly, especially when a person is exposed to stress. Like President Kennedy did, patients with Addison’s disease must take cortisol medications in order to live. Without treatment the condition is fatal.

Read the Endocrine Society Fact Sheet on Adrenal Fatigue

For more information, please read my book Hormonal Balance: How to Lose Weight by Understanding Your Hormones and Metabolism or visit my Facebook page.

www.YourEndocrinologist.com
www.atlantaendocrine.com

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14 Comments

  1. lionel martin says:
    Tuesday, September 25, 2012 at 8:37am

    so what do you call it when circadian rythms are off.???… cortisol output is low, sodium and chlorine levels are wacked out….and your ability to put out anti inflammatory hormones is reduced????? virtually expressing some kind of adrenal problems…. these endocrinologists also claim weight gain is not a symptom of hypothyroid!

  2. Scott Isaacs, MD says:
    Tuesday, September 25, 2012 at 11:24am

    Lionel, This is simply not true. I am not sure where you get your information, but there is no evidence to support your claim about endocrinologists, weight gain and hypothyroidism. I am not sure what you mean by “anti inflammatory hormones” because this is not a term used by doctors and does not appear in the medical literature. I can certainly understand your frustration finding a diagnosis for your symptoms. I hope you get some answers.

  3. Howard says:
    Tuesday, October 2, 2012 at 4:00pm

    I’m all for open debates on things, but when I read close-minded articles like this I get a little frustrated. I’ve been to numerous ‘board certified’ and ‘by-the-book’ practitioners who either laugh or shrug at me when they can’t figure out what’s wrong. Or try to put me on antidepressants! They balk at the concept of adrenal fatigue, yet can offer no good diagnosis/explanation why I feel so bad. Just with any field there are bad apples out there selling snake oil, but there are also board-certified practitioners out there helping people with adrenal issues. I finally found one myself and let me say: it feels good to not be told I’m crazy or a hypochondriac. And I feel better than I’ve felt in years. In my opinion, it all comes down to semantics. Call it what you will, but there has to be something between Cushing’s and Addison’s, right?

  4. Scott Isaacs, MD says:
    Tuesday, October 2, 2012 at 4:22pm

    Howard, I certainly understand your concerns. I am sorry you feel that my article is closed-minded. I am glad that you are feeling better. The issue is that there is absolutely no research on adrenal fatigue. It is a made up fake diagnosis. And there are no treatments with proven benefit that are any better than a placebo. I have treated hundreds of patients who were misdiagnosed with “adrenal fatigue.” Most of these patients have a treatable medical condition causing their symptoms. For these patients, getting an accurate diagnosis was the first step to feeling better.

  5. Sarah says:
    Friday, March 22, 2013 at 12:07am

    I have the Factor V Leiden Mutation (heterozygous), history of a left renal vein thrombosis as an infant and last year a CT scan showed my right adrenal gland has calcifications that the radiologist said were either from prior infection or hemorrhage.

    I have a history of thyroid cancer and have been well managed on Armour Thyroid for over 5 years with very stable TSH.

    Last March I had routine reconstructive out-patient surgery and 5 days later had a rapid onset of high fever, passed out at home, ended up in the hospital for a week — was dx’d with hypovolemic shock secondary to c.diff colitis – my blood pressure was in the toilet for over 24 hours despite aggressive IV fluids.

    In 2011 I had a similar reaction as far as shock after surgery when I lost blood – again, passed out, hospitalized for several days.

    For the last 6 months I’ve been developing serious issues with not being able to fall asleep, stay asleep, severe fatigue, muscle pain and weakness, nausea at times, irritability and depression, headaches, I get really hot for no reason, I get dizzy sometimes and I’ve been sick 5 times in 4 months (usually get sick once per year).

    No weight loss, actually a 15 lb weight gain, but I have a history of MO, have a lap-band and have maintained a stable weight for about 2 yrs after shedding 80 lbs. I think I’ve gained weight because I just can’t exercise anymore. If I exercise I’m in bed the next day even more exhausted than usual.

    When I read about Addison’s I guess I don’t have all of the classic symptoms — is it possible to have Addison’s without weight loss?

    I had a great endo in FL but I moved last fall and haven’t found one in GA yet. I have an appt with you on 4/10/13. Really looking forward to discussing my concerns.

    Thanks
    Sarah Kopp

  6. a patient says:
    Sunday, October 20, 2013 at 10:57am

    Scott Isaacs, you’ve made a positive assertion “Adrenal fatigue is not a real medical condition.” Now you need to prove it.

    So show us your evidence that adrenal fatigue is not real. Note that evidence does not equal anecdata from your buddies at the endocrine societies, or your opinion, or your proclamations of what establishment medicine thinks.

    A few decades ago, MDs like yourself would cluelessly claim that only 3 types of diabetes exist. Now medicine has caught up with what patients already know, there are multiple types of diabetes.

    Best you keep an open mind if you don’t want to look silly.

  7. the man with a plan says:
    Tuesday, November 26, 2013 at 2:48pm

    Honestly, i think people underestimate the power that placebo really has on the mind.

  8. A.J. Ponder says:
    Tuesday, August 19, 2014 at 7:15am

    An article that talks about adrenal fatigue and Addison’s and does not mention pituitary insufficiencies (isolated ACTH deficiency etc) is not much of an article. If only endocrinologists would stop looking at each other for answers and start actually reading scientific papers, maybe this area of medicine would have the proper medical advice available and desperate people wouldn’t have to look on the internet for dodgy cures.

  9. Scott Isaacs, MD says:
    Tuesday, August 19, 2014 at 7:41am

    Alicia, while I appreciate your comments, I must disagree with your assumptions. Pituitary disease is a well known cause of Addison’s disease. Your comments, while quite critical of the speciality of endocrinology, don’t really reflect the current medical standard of care.

  10. susannah says:
    Monday, August 3, 2015 at 1:41am

    Dr. Isaacs,

    Since you published this statement on your blog three years ago, have you had time to research the literature on PTSD in vets? Have you had time to read up on autonomic dysfunction in vets? The vets are experiencing the same exact physical symptoms as Adrenal fatigue patients. Why?

    The diffuse, seemingly idiopathic symptoms of AF, when one EXPERIENCES them are so clearly related to the master hormone regulator being “out of whack” in some way. When you live saturated in a broken vessel, you know where the illness is, just like one does when the flu is present, or any other medical ailment. This is especially easy for women to figure out because we are used to being “posesed” every once in a while by our hormones. Pregnant people can tell you what that “posession” feels like, and no one doubts when a pregnant woman states she can not control her exhaustion (it is not sleep related) or that she can not control anything going on…

    I am glad you found some patients who did not get a proper diagnosis and were able to help them. But for those of us who have AI and need help you are a danger. Don’t be so quick to speak about something you are ignorant of. Every disease existed before humans gave it a name. What makes you believe you live in a time when ALL the answers are available to you, and that you and your colleagues have them? Or even care to write about them?

    Are you saying you and the other endocronologists have mastered the human hormone system?

    Medical research must be funded, and funding AF research is not a money maker. The endocrine system is still not well understood, especially in women. There are other social reasons AF research is not well funded.

    Many of us are treated very successfully on traditional medications, in use in standardized dosages, for thousands of years and are perfectly happy to heal more slowly, without side effects of big pharma drugs when they are not necessary.

    Big pharma drugs see everything as a nail. Your hammer approach to a disease people in your industry (medicine) refuse to put a name on, is leaving thousands of people watching their lives go by. I don’t know how old you are or where you are from, but I am old enough to remember when we didn’t jump to drugs so quickly and I still live in a place where traditional medicine is respected- because it works – and all MD’s are trained in it’s use.

    Pharmaceuticals are synthetic versions of what already exists in nature, by and large. So mocking the use of botanicals or animal parts is plain silly and every doctor who has taken a chemistry class might do well not to play on the ignorance of non doctors who might not know that, to make a self serving point and only appear more knowledgable.

    Is is doctors like you in the US who nearly cost me my life and sent me on a cycle of years of destructive and harmful medications. All of those were “Top Doctors” who studied under the most famous endo’s – including the one who treated President Kennedy. All arrogant. All convinced they knew all that was to be known..because they WROTE the literature. And I almost died in a hospital until an herbalist found me.

  11. Michelle says:
    Monday, October 12, 2015 at 4:43pm

    Thank you for this article. I have been on the opposite side of watching someone believe they have this fake disease and it’s just awful. People pay their homeopathic “doctors” an arm and a leg for “treatment” aka. supplements that aren’t FDA approved and radically change their diet for nothing. Taking B vitamins and cutting out everything except raw fruits/veggies and some meats is NOT healthy. In fact, most of the people I know who claim to have this are actually struggling from depression and panic attacks, but are not getting treated for that. In most of these cases, getting mental help will actually fix the issue. I’m so over American society saying they are gluten free. Guess what, that’s a marketing scheme to get you to buy more expensive items and the supermarkets making more money. My hope is these people can start seeing a counselor and eating some bread.

  12. Scott Isaacs, MD says:
    Thursday, February 11, 2016 at 5:39pm

    The biggest issue is that when someone is diagnosed with a fake disease, they never find the real solution to their problem. I see some many patients who were given a fake diagnosis of adrenal fatigue and sold expensive supplements which they believe will make them better. By the time I see these patients, the real disease may have gone undiagnosed and untreated for years. It is not about what I believe but about the research and getting people better with evidence-based medicine. I an sorry that you had a bad experience with your physicians. Adrenal insufficiency (AI) also known as Addison’s disease is a real medical condition which is very different than the fake made up condition of Adrenal Fatigue, which was invented by a chiropractor by the name of James Wilson who is in the business of selling untested and unproven supplements.

  13. robert says:
    Sunday, March 27, 2016 at 12:08pm

    ?Dear Dr. Isaacs.
    I am glad to find your article…
    I have a friend that is a follower of James Wilson.. Has the book and I believe she is getting supplements… We are having a difficult time, because she says I cause her stress and aggravate her “adrenal fatigue”. I probably do cause some stress. But because I care, I looked it up. WOW! I am stunned to see such a fraudulent scheme! I don’t know what to think except that she probably is ill in some form, but not from a fake disease. Not helping is the fact that a dentist she started dating is “helping’ her with it. Shouldn’t he know better or, wouldn’t you think he would Google it and see what I see if he didn’t know, and someone with his education level would know better or at least ask one of his physician buddies? She is also getting counseling and the therapists is also helping with adrenal fatigue.
    I don’t know how to broach the subject and I am worried what will happen when she realizes this is a sham.
    Any thoughts and advice for this situation?
    Thanks,
    Robert

  14. Scott Isaacs, M.D. says:
    Wednesday, April 19, 2017 at 3:20pm

    A recent paper on Adrenal Fatigue as a fake diagnosis:

    https://bmcendocrdisord.biomedcentral.com/articles/10.1186/s12902-016-0128-4

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