Adrenal Fatigue: The Naturopathic Boogey Man

I'm seeing this "diagnosis" more and more often. First it started sprouting up on message boards frequented by naturopathic doctors, and somehow it has made its way into the fitness community. Often times athletes complain of symptoms that would normally be dismissed as overtraining, yet, on message boards and forums, naturopaths and nutritionists are telling them they have adrenal fatigue. What's worse is their information is down right incorrect. On one forum, I read that adrenal fatigue makes you retain fat. If they had any understanding of adrenal deficiency they would know that impaired adrenal function causes weight loss. Before I get too far, let's address what adrenal fatigue is. Some of the common symptoms are being tired, having trouble getting up in the morning, caffeine addiction, feeling run down, feeling stressed, craving salty or sweet snacks, struggling to keep up with life's demands, illness, stress, and not having fun anymore. You may have just one symptom or all of them. Some common causes of adrenal fatigue are lack of sleep, eating flour or sugar, not eating enough raw vegetables, using caffeine, eating sweet or salty foods, staying up late, trying to be perfect, no win situations, driving yourself, or too few enjoyable activities. The condition of adrenal fatigue is reached when the amount of stress exceeds the body's ability to cope with with stress.

Considering these symptoms and causes, it's clear that absolutely everyone is at risk of developing adrenal fatigue. For those of you with experience in pathology, you know that this is not possible. Conditions with symptoms that overlap and apply to everyone smack of fear mongering. Adrenal fatigue reminds me of a book I read by Dr. Sarno, The Mindbody Prescription. In it, Dr. Sarno discusses the many psychosomatic "diseases" that have progressed over the years. It used to be that everyone had ulcers, then migraines, all children had ADD, back pain, tension myositis syndrome, chronic fatigue syndrome, autism, and I feel that adrenal fatigue is simply the next ailment that everyone has. Please don't misinterpret what I'm saying here, if you have these symptoms, clearly something is not functioning optimally, but the diagnosis of adrenal fatigue is a blanket diagnosis with no actual medical basis. Further, just because something is psychosomatic doesn't mean you aren't actually experiencing the symptoms, but there must be an underlying condition. I believe in the power of the mind, but I believe that symptoms are the manifestation of underlying physiological disturbances.

Briefly, an opinion on why adrenal fatigue is an unlikely, if not impossible, condition. For thousands and thousands of years of human evolution, humans as a species existed like wild animals fleeing from predators, chasing prey, surviving extremes of cold and heat, fighting with other tribes, and fighting for survival on a daily basis. The idea that adrenal glands incapable of keeping up with daily high stress situations would have survived natural selection is absurd. Surely ancestors who did not have the capacity to produce adequate amounts of cortisol, aldosterone, and adrenaline would have been eliminated by the demands of survival long before civilization began to offer a slightly less dangerous life. Even still, let's imagine that some of those genes survived the paleolithic era, it would be hard to argue that the demands of daily life today are anywhere near the capacity of our adrenals. I would believe that our young men fighting in Iraq and Afghanistan are under a daily level of stress that could exceed their bodies' ability to produce stress hormones, but I do not believe that even the most overtrained athletes are anywhere near that stress level.

So, if it's not adrenal fatigue, what is it? Well, if you are in fact suffering from "adrenal insufficiency," then you likely have something more quantifiable like Addison's disease, Schmidt's syndrome, polyendocrine deficiency syndrome, tuberculosis, or amyloidosis. Most common in 30-50 year olds, it can be a life threatening disease. Inadequate production of the adrenal hormones causes weight loss, fatigue, body aches, low blood pressure, and hair loss. It can be diagnosed through blood tests and treated by taking hormones that mimic the hormones normally produced by the adrenals. Because of this hormonal deficiency, it is necessary for persons suffering from any of these conditions to carry an injectable form of cortisol with them and an identification card to alert emergency personnel to inject cortisol if they are found injured.

If you are not suffering from a chemical deficiency, but you are suffering from the symptoms of "adrenal fatigue," you are likely suffering from what was previously accepted as overtraining. Realize that once you reach a level of overtraining, it is absolutely miserable and can take up to 3 months to recover from. We can only push our bodies so far before we surpass our ability to recover and progress. If we push this threshold for too long, it can take weeks and even months before we return to a level where our capacity for recovery matches our level of training again, but it is necessary that we take this time off if we are to improve and progress as athletes.

As always, if you suspect that you may have some form of adrenal dysfunction or other condition, you should see your health care professional, and don't be afraid to ask for your doctor to order tests. It is your health, a good doctor will respect your concerns.