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Adrenal Fatigue: Real Condition or Something Else

Are you feeling tired, stressed and searching for answers? You might have come across the term adrenal fatigue as an explanation for your symptoms while scrolling Google search results or TikTok videos.  

Adrenal fatigue is embraced by many complementary and alternative medicine practitioners as the cause for these symptoms, but is it a real, legitimate health issue?

Leena Shahla, MD, an endocrinologist with Banner – University Medicine, helps separate fact from fiction, shedding light on whether adrenal fatigue is a concrete diagnosis or a catch-all phrase for more complex health issues.

What is adrenal fatigue?

Adrenal fatigue is a term used to describe when your adrenal glands, which help you deal with stress, might be working less.

As a result, you might always feel tired, have difficulty falling asleep or waking up, want to eat salty or sugary foods and crave caffeine to stay awake during the day. It might also affect your body’s ability to fight off infections.

“The idea behind this theory is that chronic stress overworks your adrenal glands, which causes them to stop producing the hormones you need, like cortisol,” Dr. Shahla said.

The problem? It’s not an officially recognized medical condition. 

“There is no scientific evidence that supports the idea that long-term stress drains the adrenal glands to the point they cannot function,” Dr. Shahla said. 

“In actuality, your glands don’t fatigue,” she added. “They rise to the challenge and put out more cortisol when you are stressed. Many studies have failed to prove that adrenal fatigue is a medical condition.”

What are the adrenal glands and what do they do?

You have two small adrenal glands that sit just above your kidneys. These glands have an important job keeping your body balanced and ready for different situations.

“The adrenal glands make many hormones, including cortisol and adrenaline, that help regulate metabolism, immune system, blood pressure and stress response,” Dr. Shahla said. “These hormones work together to ensure your body can handle stress effectively.”

Cortisol helps your body handle stress, regulates blood pressure and controls how you use energy. 

Adrenaline is like a quick energy booster. When you’re scared or in danger, it gives you a burst of energy to help you react fast — the fight or flight response. 

What are the dangers of an adrenal fatigue diagnosis?

There are no specific tests or treatments for adrenal fatigue. However, some alternative medicine providers will start “treating” with vitamins and supplements. 

The risk is that taking these products without an underlying medical condition can be dangerous. Because the U.S. Food and Drug Administration (FDA) does not regulate the safety and effectiveness of dietary supplements, they may contain hidden ingredients and have side effects.

“While many of the supplements used to treat ‘adrenal fatigue’ claim to be safe and hormone-free, many contain unknown amounts of active hormones,” Dr. Shahla said. “These hormonal supplements may make you feel good at first, but over time they can damage the adrenal glands. 

Some supplements may contain thyroid hormones that you don’t even need, testosterone which can be harmful (especially for women) and steroids that will suppress the pituitary-adrenal axis. “These hormones may not be even listed on the label,” Dr. Shahla said.

The other real danger is that taking these supplements may delay the diagnosis and treatment of medical issues. 

How does adrenal fatigue differ from adrenal insufficiency?

“In simple terms, adrenal insufficiency is a real medical issue while adrenal fatigue is a term that some people use to explain feeling tired,” Dr. Shahla said.

Unlike adrenal fatigue, adrenal insufficiency is a disorder where the adrenal glands don’t produce enough hormones. It can be caused by autoimmune diseases like Addison’s disease, infections, medications or pituitary disease. 

In addition to fatigue, this condition may cause weight loss, nausea, vomiting, low blood pressure and low blood sugar.

Your provider can determine whether or not you have adrenal insufficiency with blood testing. If the condition is confirmed, your provider may prescribe medication to replace the hormones your adrenal glands would typically make.

If it’s not adrenal fatigue, then what else could be causing your symptoms?

Many symptoms of “adrenal fatigue” may overlap with other medical conditions. Potential causes for your symptoms may include:

  • Mental health: Mood changes and irritability might stem from stress, anxiety, depression or other mental health conditions.
  • Medical conditions: Underlying medical conditions (such as anemia, thyroid disorders, diabetes and adrenal insufficiency) can have fatigue as a symptom.
  • Stress and lifestyle: High-stress levels, poor diet, lack of exercise and poor sleep can contribute to symptoms like fatigue, mood swings and food cravings.
  • Sleep quality: Conditions like sleep apnea, insomnia or restless leg syndrome can lead to fatigue and difficulty waking up refreshed.

Your provider can perform tests to determine the underlying cause of your symptoms and provide appropriate treatment and support.

Manage stress and optimize your adrenal health

While adrenal fatigue is not a medical diagnosis, you can take steps to manage and support your overall health. Here are some general tips:

  • Manage stress: Practice stress relieving techniques like deep breathing, meditation and yoga to manage stress levels.
  • Eat healthily: Eat a balanced diet with plenty of fruits, vegetables, whole grains, lean meats and healthy fats. Avoid excessive caffeine and sugar intake.
  • Get regular exercise and enough sleep: Engage in regular physical activity to help reduce stress and improve overall well-being. Aim for 7-9 hours of quality sleep.
  • Strive for balance: Manage stress through routines and coping strategies. Try not to overcommit and overextend yourself at home and work.
  • Seek professional help: If you’re struggling with stress, talk to your health care provider or a licensed behavioral health specialist who can provide guidance and support.


While the term “adrenal fatigue” is commonly used to describe feelings of extreme tiredness during periods of stress, it’s not a recognized medical condition.

If you’re tired all the time or have other troubling symptoms, it’s important to talk to your health care provider or find a Banner Health specialist near you. They can help determine the underlying cause of your symptoms and provide guidance and treatment.

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