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Adrienne Dellwo

Adrenal Fatigue in Fibromyalgia & Chronic Fatigue Syndrome: Is It Real?

By November 13, 2010

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Many people with fibromyalgia and chronic fatigue syndrome are also diagnosed with, or come to believe they have, adrenal fatigue. Recently, information put out by The Hormone Foundation (which is part of the Endocrine Society) created a lot of stir by stating that adrenal fatigue is not a valid diagnosis. The case against adrenal fatigue appears in a PDF titled "Myth vs. Fact: Adrenal Fatigue."

The fact sheet states:

"The term 'adrenal fatigue' has been used to explain
a group of symptoms that are said to occur in people
who are under long-term mental, emotional, or physical
stress. Supporters of adrenal fatigue say that you may be
more likely to develop this condition if, for example, you
have a stressful job; are a shift worker, working student,
or single parent; or if you abuse alcohol or drugs."

"'Adrenal fatigue' is not a real medical condition.
There are no scientific facts to support the theory
that long-term mental, emotional, or physical stress
drains the adrenal glands and causes many common

Symptoms that are generally attributed to adrenal fatigue are nearly identical to those of fibromyalgia and chronic fatigue syndrome. You can find a list here: Adrenal Fatigue.

The fact sheet says that tests for adrenal fatigue are not proven to work, and that special supplements marketed for adrenal fatigue are also unproven and could be dangerous.

It then goes on to talk about adrenal insufficiency, which it says is a real condition diagnosable by proven blood tests. Symptoms of adrenal insufficiency include:

  • Dehydration
  • Confusion
  • Unintentional weight loss
  • Feeling weak
  • Dizziness
  • Low blood pressure

The sheet urges anyone with a diagnosis of adrenal fatigue to pursue other avenues, including adrenal insufficiency, depression, or obstructive sleep apnea. You can read the entire fact sheet here:

However, some people in the medical community contend that adrenal fatigue is a very valid diagnosis and a very real problem. Here's an interview with one of them from About.com Thyroid Guide Mary Shomon:

If you've been diagnosed with adrenal fatigue and haven't been evaluated for adrenal insufficiency, depression, sleep apnea, or other possible causes, you probably should be. That's just good health care. However, whether you believe it's a valid diagnosis is purely up to you. Treatment decisions are yours to make as well. If you want to take certain supplements, you should talk to your doctor about potential dangers and any testing that may need to be done to safeguard your health -- but the decision is up to you, whether or not your doctor agrees. The important thing is that you make an informed decision.

Have you been diagnosed with adrenal fatigue, or do you believe you have it? Do you think adrenal fatigue is an invalid diagnosis? Has treatment for adrenal fatigue helped you? Harmed you? Leave your comments below!

Learn more or join the conversation!


Photo Jason Reed/Getty Images

November 15, 2010 at 8:12 pm
(1) Taliba says:

I’ll jump in and say thanks Adrienne for discussing this topic and linking back to what Mary Shomon’s been writing about this controversy.

In the summer of this year, I bit the bullet and got a 4 point saliva test to test my adrenals because the a symptoms list that I read rang true for me. The results showed deficiencies in my cortisol and DHEA. Since starting supplements both both, I am feeling 100% more like my real self, and it keeps improving day by day.

The main differences are improvements in my energy level, reduced feelings of anxiety, better mood, and improvements cognitive side effects (like I can catch subtleties in both verbal and non-verbal communication). I’ve also found that I can eat small amounts of sugar without being exhausted (apparently cortisol is related to digesting sugar).

After such a dramatic improvement after nearly two decades of illness, I am at a loss to understand why the American Endocrinology Association would deny this as a “real” condition, since I know all too well the ‘real’ effects of not treating it!

November 19, 2010 at 7:01 pm
(2) Donna says:

what would one take to increase cortisol levels?

November 20, 2010 at 9:18 am
(3) pattie says:

I was sent to an endocrinologist for adrenal fatigue. He told me that my body did not produce any and he prescribed a very high quality DHEA. I took it at the prescribed dose of 25mg and could not tolerate it. I felt speeded up, but jittery and was really hungry. My ME dr. said to open the capsule and dump most of it out. Then put the capsule back together and swallow. She said even a very small amount can help. I have since found that you can buy 5mg capsules. I believe it does help with energy and mood. I wouldn’t take anything unless I was first tested to see if I actually needed it. I understand that DHEA can make you thick in the middle, grow hair in place you don’t want, lose hair from your head, etc. Body builders take it to build muscles, so I would be very careful with it.

November 20, 2010 at 12:04 pm
(4) Kim says:

I believe that adrenal fatigue is a valid diagnosis, yet it might be more complicated than that. Several years ago when my CFS was particularly bad, my chiropractor gave me an adrenal glandular which I began taking. I had such a remarkable reaction to the glandular, it was as if it had jump-started my system. For a whole week I felt fantastic, for the first time in eighteen years. Then I relapsed again into my chronic fatigue. What I think is complicated is that probably the hypothalamus is also probably also diseased.
The adrenal glands produce cortisol, and cortisol raises blood pressure and blood sugar, and it helps with immune function. So if you have low blood pressure, low blood sugar and frequent infections, you might well have adrenal problems. I have these symptoms and believe I have adrenal problems, because all other kinds of treatments for CFS have left me with unresolved symptoms.

November 21, 2010 at 5:22 pm
(5) Richard says:

I refuse to deny anyones pain as I was diagnosed with CFIDS in 1985 (back when it was Chronic Epstein-Barr) and when it was all too frequently just “in your head”. But moving beyond that thinking in the medical and general community will not happen without testing and proving.

I see no reason why Adrenal Fatigue shouldn’t be put to the same rigorous study and testing that FM and CFIDS have been. The results of that rigor have been the two have moved from real but unproven to medical, insurance and increasing public acceptance.

The theory behind these symptoms may indicate a subset within the broader disorders or may be a separate disorder.

If you have been diagnosed with the problem it behooves you to test for adrenal insufficiency and/or the other problems as well as the treatments often prescribed for Adrenal Fatigue are indeed potentially hazardous.

I come from a family in which 4 of 7 have adrenal insufficiency, levoxythrine raises my levels but with both FM and CFIDS it’s a little hard to jump for joy with the minor improvements but then again minor is nothing to sneeze at but that’s another column, eh?

Gabh an latha,

December 1, 2010 at 3:53 am
(6) sabrina says:

I too had the saliva tests for adrenal fatigue and found my body was not producing any adrenal secretions at all. After taking the supplements and adjusting my progesterone levels my health has improved dramatically. The same doctors telling us Fibro is just in our heads are now telling us that adrenal stimulants will not help us. In addition these supplements have helped my pals with Colitis and others who are going through menapause. I do not know anyone who has taken these stimulatns that has not show an improvement in their health. Just be sure to take regular saliva tests to make sure you are not overdosing on hormones or adrenal supplements. Good luck and feel better

April 12, 2011 at 10:41 pm
(7) Heather says:

I was dx-ed by a Rheumy at UNC a couple of years ago with FM. However, due to the lack of other tests done (like one for MS) because I cannot have MRI’s I wanted a second opinion, even though all my symptoms follow FM. I then went to a new Rheumy at Alamance Regional and was dx-ed with Hypermobility Syndrome, Carpal Tunnel, and bursitis. None of which explain the pain in my ribs when touched, or on my leg (where no bursa sac exists) and when I explained this to the new doctor he said that he could prescribe me an antidepressant and that was all he could do for me. I was told by my physical therapist that this particular doc. doesn’t believe in FM. I find that strange since he is a Rheumatologist.

My therapist told me about Adrenal Fatigue and suggested I seek a doctor to have it checked out. From what I understand, the book referenced above seems to say that Adrenal Fatigue is in part responsible for FM. Perhaps the 2 dx’s overlap?

I just want to be able to play with my kids. I do have carpal tunnel and I do have the hypermobility. I’ve known that for years. I also have a degenerative disc as well as Atrial Fibrillation (I wondered if that (AFib) was in part due to Adrenal Fatigue). I’m only 36 years old and I have a been blessed with a 3 year old and a 3 month old – both boys. They need their momma well again. I’ve also been sick with asthmatic bronchitis for 6 months. (again I wonder if due to the Adrenal Fatigue).

October 21, 2011 at 1:03 am
(8) Ian Cameron says:

For everyone above, it may be worth doing an iodine test (a urine test). CFS, FM, anxiety and depression, aches and pains in the joints, problems sleeping have also been linked to lack of iodine. Google Dr. Browstein for more info.

October 21, 2011 at 4:54 am
(9) Kay says:

I totally believe in Adrenal Fatigue (AF), as well as the notion that there are other disorders where people fall into a “low” level test result, which is deemed “normal” by medical standards, but indicates the body is not producing enough of some chemical (neurotransmitter, hormone, etc.). This includes Hypothyroidism, which I’ve read can be a result of AF and Estrogen Dominance (not enough progrsterone), which can also be caused by AF (apparently, blood tests can still read Normal though the blood is low on thyroid hormones due to low progesterone’s effects on the liver).

For me, AF made the only sense because I had ALL the symptoms and my saliva results mirrored my low afternoon energy and insomnia. I wasn’t producing enough progesterone, which is caused from too much cortisol production (i.e., stress). I tested normal but low for thyroid, but exhibited mild hypothyroidism, symptoms that weren’t corrected by progesterone (progesterone relieved my severe fatigue, depression, but mild symptoms remained). The thyroid relieved the remaining mild depression and fatigue. My weight finally stabilized. My acne cleared up. My hair stopped falling out.

An Endocrinologist tested me for Adrenal Insufficiency and decided all ny tests were Normal, but he never questioned why i was Low in so many areas? Honestly, I don’t understand how the medical community can deny that so many actually have a veritable medical condition when there are so many concurring symptoms! I guess if they don’t have a drug for that, they want to convince you that it’s in your head so they can make money off the antidepressant instead!

I say: The research, results are out there. You have to do your own research, listen to your body, and treat yourself (tell doctors what you want).

September 9, 2012 at 12:30 am
(10) Courtney says:

I have been deeply fatigued and unwell for the past year, progressivelyl. One abnormal I had was an elevated DHEA, though none of my doctors think that means anything. Recently started on thyroid med for low tsh (slight. Also T4 and TSH were normal).
Went to chiropractor for neck and told him how ill I had been feeling. He did an exam and concluded my adrenals are shot and started me on a supplement twice a day.
Why doesn’t medicine/ MD’s take us more seriously, refer you to specialist, acknowledge Adrenal Fatique/ Exhaustion? I don’t think they’d like to suffer as I have. I hope to fight and make a full recovery, my health and my children are worth it!

March 9, 2014 at 7:32 am
(11) Forrest says:

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