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Dr. Allan Kurtz

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Adrenal Fatigue

By: California Center of Longevity & Functional Medicine on February 21, 2014

Adrenal fatigue refers to a collection of symptoms and signs, called a syndrome, which is the result of adrenal glands functioning at lower than optimal levels. Although adrenal fatigue is most often thought to be brought about by chronic or intense lasting stress; adrenal fatigue has also been diagnosed as the result of chronic, lasting infections including bronchitis, influenza or pneumonia.

Adrenal fatigue does not mean that your adrenal glands aren't functioning, but instead refers to their inability to maintain optimal homeostasis due to diminished output of regulatory hormones, brought on by over stimulation.

Adrenal fatigue results when your adrenal glands cannot properly meet the demands of stress/stimulation. The adrenal glands are designed to mobilize your body's responses through the production and release of hormones responsible for regulating energy production and storage, maintaining immune function, heart rate, muscle tone, and other processes which allow you to cope with stress/stimulation. When your adrenal glands fail to respond to the stress in order to maintain homeostasis, you are likely to experience adrenal fatigue.


Adrenal fatigue is not a symptomatic disease with noticeable signs such as one would see with the chicken pox, shingles, or measles. Instead, adrenal fatigue is identified by its primary symptom of fatigue. However, because adrenal fatigue cannot be treated with sleep or medication, many physicians believe there to be a psychological component to the low functionality of the adrenal glands.

Those suffering from adrenal fatigue may appear and behave absolutely normally, though many patients who are diagnosed with adrenal fatigue will report living with a sense of being unwell, and chronically tired. Many who have undiagnosed adrenal fatigue choose to treat their symptoms of exhaustion or malaise with highly caffeinated beverages and stimulants in order to feel "normal."

History of Adrenal Fatigue

Adrenal fatigue as a syndrome dates back at least one hundred years, and has gone in the past by names such as such as neurasthenia, non-Addison's hypoadrenia, sub-clinical hypoadrenia, and adrenal apathy. It is believed to affect millions of people across the globe, yet it is not recognized by Western Medicine as a distinct medical syndrome.

In 1969, Dr. John Tinterra, a medical doctor who specialized in low adrenal function, estimated that approximately 16% of the public could be classified as having severe adrenal fatigue, but when indications of low cortisol were included, the percentage would be more like 66%.

Symptoms/Diagnosis of Adrenal Fatigue

Adrenal fatigue may affect anyone, at any time during their life. However, it seems to be brought about frequently in response to illness, crisis, or a continuing difficult situation. It is believed that specific lifestyle habits including poor diet, substance abuse, or poor sleeping habits and stress may make one more susceptible to symptoms of adrenal fatigue. Likewise, prolonged infections and illnesses seem to correlate to the onset of adrenal fatigue. Symptoms of adrenal fatigue often include one or more of the following:
  • Feeling tired for no reason
  • Difficulty rising from sleep in the morning
  • Difficulty recovering from illness or stress
  • Craving sweet and/or salty snacks
  • Your energy levels are at their highest in the evening.
Adrenal insufficiency may be diagnosed through blood tests and special stimulation tests.


Adrenal fatigue is caused by a lack of normal hormones produced by the adrenal glands, meaning it can be successfully treated by replacing those hormones. This can be done with oral tablets or pills.
  • Adrenal Fatigue: The 21st Century Stress Syndrome by Dr. James L. Wilson
  • Nieman LK. Diagnosis of adrenal insufficiency in adults. Accessed Feb. 4, 2014.
  • Addison's disease (primary or chronic adrenocortical insufficiency). The Merck Manuals: The Merck Manual for Health Care Professionals. Accessed Feb. 4, 2014.
  • Nippoldt TB (expert opinion). Mayo Clinic, Rochester, Minn. Feb. 8, 2014.
  • Head KA, et al. Nutrients and botanicals for treatment of stress: Adrenal fatigue, neurotransmitter imbalance, anxiety, and restless sleep. Alternative Medicine Review. 2009;14:114.
  • Adrenal insufficiency and Addison's disease. National Endocrine and Metabolic Diseases Information Service. http://www.endocrine.niddk Accessed Feb. 5, 2014.
  • Freeman J. Adrenal fatigue — An interview with Todd Nippoldt. Mayo Clinic Women's HealthSource. 2010;14:6.