Adrenal Fatigue: Fact or Fiction?
I performed a research review to identify whether the term and diagnosis of ‘Adrenal Fatigue’ is valid or credible. 

Why is this study interesting?

Adrenal Fatigue is a common diagnosis in the ‘natural’ and alternative health fields. But the condition lacks clear diagnostic criteria, results that do exist from scientific studies show that there commonly is not a reduction in cortisol levels in those who are fatigued, and the diagnosis of adrenal fatigue may cause practitioners to ‘miss’ other more serious health conditions. 

What are the study highlights?

Most people are diagnosed by questionnaire. This is likely to result in high rates of diagnosis of adrenal fatigue

Most of these patients are unlikely to have adrenal fatigue (hypoadrenia – or low levels of adrenal hormones, especially cortisol)

There are significant variations in individual characteristics of fatigue. 

While there may be some hypothalamo-pituitary axis and biochemical dysfunction present, overall baseline and total cortisol levels do not appear to be significantly different between those with fatigue and controls. 

What are some of the challenges within this research?

There is limited research on the complex known as ‘adrenal fatigue’. This review therefore looked at a wider scope of fatigue, mostly Chronic Fatigue Syndrome. There may still be some types of HPTA axis problems presenting in patients 

How can I apply this?

The lack of research showing any validity or credibility for adrenal fatigue testing casts doubt on the diagnosis and treatment for this (supposed) condition. 

Testing, diagnosis and treatment of adrenal fatigue may provide for harm if someone ‘misses’ a condition causing these symptoms or takes a treatment that is actually inappropriate. The testing and treatment of adrenal fatigue is often very expensive too. 

Until there can be proper reliability and validity testing of adrenal fatigue questionnaires, and validated diagnostic protocols for the condition, the diagnosis of ‘adrenal fatigue’ should be avoided. Practitioners specialising in adrenal fatigue are often also under- or unqualified and not registered.