No, adrenal fatigue isn’t why you’re always tired

Q: So many people think adrenal fatigue is the reason they feel run down. But is it actually a proven condition?

It’s not surprising to me that women often seek a medical explanation for why they’re feeling tired. In my clinic, women regularly come in asking to have their thyroid checked, convinced it isn’t functioning normally. But very frequently the tests come back normal. Now there is a trend of people looking to the adrenal glands as a possible explanation.

The adrenal glands produce hormones in response to stress. When they don’t work properly, that leads to a potentially very serious, very real condition called adrenal insufficiency, which requires prompt diagnosis and treatment. But adrenal fatigue, as a condition, is not a recognized entity. It amazes me that it’s become an accepted diagnosis in some circles. There is no peer-reviewed medical literature that supports its existence, and no biochemical evidence to back up the notion that your adrenal glands can get “fatigued.” There’s no validated test that can be done, and no treatment that has been properly studied and shown to work.

Related: Why are you so tired?

I think the concept of adrenal fatigue, which is talked about in some complementary alternative medical circles, is gaining traction because it speaks to something that women very commonly experience — the sense of being overstressed and overtired and feeling like their reserves are depleted. That is a real sensation, and it merits attention. I just don’t think it’s caused by so-called “fatigue” of the adrenal glands.

The “adrenal support” supplements recommended by some practitioners can be dangerous: They often contain desiccated adrenal glands from animals and even steroids, which can have potentially serious side effects. These supplements have not been approved by Health Canada. Just because they’re natural doesn’t mean that they’re harmless.

For women who are feeling exhausted, it’s important to identify the cause. Ask some tried-and-true questions of yourself: Are you getting enough good-quality sleep? Are you getting fresh air and moving regularly, or spending all day at a desk? Are you having meaningful interactions with people you love? Addressing these issues can help fill up the tank, so to speak. And if you make some changes and still feel awful, talk to your doctor to figure out, given your story and your circumstances, what might warrant further investigation.

Dr. Danielle Martin is a family physician and vice-president, medical affairs and health system solutions, at Women’s College Hospital in Toronto. 

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