Adrenal Fatigue: Is It a Real Thing?

Have you ever been to the doctor to ask about the health symptoms you're experiencing – like fatigue, anxiety, weight gain, cravings, hair loss, hormonal imbalances, thyroid symptoms – only to be told: “You're fine, there's nothing wrong with you?”

Or have you gone to the doctor and said: “I think I have adrenal fatigue. Can you check me out,” and gotten an eye roll? Worse, you might have even been asked if you got your MD from Google University. I know that sounds terrible, but I've actually had patients have things like that said to them (read more in my post “How to Talk to Your Doctor and Get the Health Care You Need” here).

So why is the medical establishment dismissing a whole host of symptoms that are not only very real, but can be harbingers of down-the-road medical problems including obesity, high blood pressure, chronic fatigue, diabetes, insulin resistance, high cholesterol, or thyroid problems like Hashimoto's?

Is adrenal fatigue a real thing?

You're probably not going to expect me to tell you this, but here it is: there is no such thing as adrenal fatigue. That's the truth. But hold on – I will explain why and what actually is happening in your body and brain that's causing your symptoms.

There are two reasons that adrenal fatigue gets dismissed by doctors. First, there is no recognized medical condition called adrenal fatigue. Adrenal fatigue is a made-up alternative medicine term, and – second, and it's a big thing  – the adrenal glands  don’t actually get fatigued. So unless you have Addison's disease which is a medical condition where the adrenals stop producing cortisol, or one of the other true adrenal diseases, then you can't be classified as having a medical condition of your adrenals. In conventional medicine, you're either healthy or you're sick. There's no gray area. If you don't meet the medical criteria for a disease diagnosis, you're basically told that you're fine, go home, and deal with it, or you may be prescribed an antidepressant or medication for anxiety. The symptoms you're experiencing exist in that medical gray zone! 


Also, and this goes even deeper into problems with the well-documented problem of medical bias against women – many of the symptoms that accompany what we call adrenal fatigue are the very same symptoms that are most likely to be brushed off as “in our heads,’ ‘just stress,” anxiety, or depression.

But hold on – that doesn’t mean something very real isn’t happening to you. It undoubtedly is.

New conditions, medicine lags behind (or if they can’t measure it, they don’t believe it)

Twenty-five years ago, a new set of symptoms cropped up, largely, though not exclusively, in women. It was commonly called Chronic Fatigue Syndrome. As with adrenal fatigue, women were similarly dismissed by the medical community who thought they were hypochondriacs or had mental health problems. Since there were no lab findings to ‘prove’ that they were having these symptoms or that anything ‘real’ was going on, they were told they were fine. Or depressed. Or anxious. Because in medicine, if you can’t measure it, it isn’t happening.

We now know that this Chronic Fatigue Syndrome is very real and has a solid medical explanation. It’s now called ME (Myalgic encephalomyelitis) and is due to a complex array of inflammatory responses. It’s recognized as a formal medical diagnosis – though in reality, the problem of women with it getting dismissed still persists – about 30% of doctors still don’t know it’s a real thing,  and only 70% even learn about it in medical school!.

The same exact thing happened with what we now know to be a legitimate medical diagnosis of fibromyalgia. Women who came into their doctor's office twenty, and even ten years ago, saying that they thought they might have something wrong, or perhaps even called it fibromyalgia, were typically given the eye roll. Most of this was before Dr. Google, so they couldn't be told to stay off the internet, but they were dismissed and often given antidepressants, anti-anxiety medications, pain medications, and a referral for psychotherapy, psychoanalysis, or a psychiatrist visit.

So what is going on?

The symptoms that bring women to a doctor's office wondering whether she has adrenal fatigue, or that land her this ‘alternative diagnosis’ include:

  • Fatigue
  • Sleep problems
  • Irritability,, anxiety, feeling blue
  • Sugar/carbs, fat, caffeine, or salt cravings
  • Tiredness around 3-4 most afternoons,
  • Weight gain, especially around your middle.
  • Getting sick more often than you used to.
  • Hormonal problems,
  • Brain fog, forgetfulness
  • Digestive problems
  • Hashimoto's symptoms or another autoimmune condition

In general, “adrenal fatigue” symptoms include a range of feeling tired, overwhelmed, and stressed, all the way to feeling really fried, burnt out, into deeply exhausted. Sound familiar? You're not alone. There are millions of women going to the doctor's office every day with symptoms that they can't explain. I'm seeing women in their 30s and 40s in my own medical practice with prediabetes, insulin resistance, high blood pressure, sleep problems, hormone problems, fertility problems, polycystic ovarian syndrome (PCOS), chronic aches and pains, and autoimmune diseases – which are significantly on the rise, and one of the top eight killers of women. These women are being told: “You're fine. Your labs are normal. Go home.” It's not okay. It's not just that women are uncomfortable and suffering, which is bad enough, but women's lives are at stake.

I’m here to tell you: Your symptoms are not only in your head. You're not crazy. And something very real – and new that doctors don’t yet recognize – is going on. Which brings us back to this thing called “adrenal fatigue.”

Allostatic load

What we erroneously call  “adrenal fatigue” is a phenomenon properly called allostatic load.  Allostasis means that humans have an incredible ability to adapt to our environments and stay well. However, when the environment we live in starts to exceed our capacity to keep up – as is happening with the major stress we’re all under, the load of environmental toxins on our systems, the electronic overstimulation that keeps up from getting enough sleep at night, the impact of modern diets and childhood and adult exposure to antibiotics on our microbiome, our diets causing chronic inflammation – a few things start to happen. Allostatic load is the wear and tear on your body that happens when you're chronically exposed to an activated stress response.

Most notably, our stress response system – which does include the adrenal glands – initially gets kicked into high gear and sometimes overdrive. Our adrenals start pumping out a hormone called cortisol and a chemical called adrenaline, and we end up in chronic ‘fight or flight’ – anxiety, agitation, and insomnia are hallmarks of this. But for some people, it shows up in other ways. Chronic cortisol exposure causes us to pack weight around our waist, can make our brains feel foggy, makes us crave sugar, salt, or fatty foods, and can make us have a lot of negative stressed out thoughts. It jacks up our blood sugar and messes with our insulin. It can wreak havoc on our hormone balance, tank our sex drive, and suppress our thyroid function.

That weight around our middle – called visceral abdominal fat – is also inflammatory. It's a communication signaling center to your brain that tells you to enjoy sugar and carbs more. It tricks your body into thinking you need to eat more, and more, and more. Why? Because eating those things temporarily quiets down that stress reaction. Then, it just pops its head back up again.

Your immune system gets activated to fight an infection. All these things that are meant to protect us start to backfire. It also affects your reproductive hormones because it's diverting hormones away from making estrogen, progesterone, and testosterone into making more cortisol. What happens is, at first, when you're under this chronic influence, you often feel really amped up

Adrenaline causes our blood vessels to constrict, makes us feel chronically anxious, and affects our digestion. You can get chronic gas, bloating, digestive discomfort, and irritable bowel syndrome. You can get problems in your gut lining that lead to inflammation and leaky gut. You can get problems with your microbiome.

But your body can only sustain these changes for so long before real problems start to happen, so your brain eventually tells your adrenals that enough is enough and in turn, your adrenals dial back on the cortisol and adrenaline production.

Under the influence for too long

Allostatic load is the wear and tear on your body that happens when you're chronically exposed to this activated stress response. In an effort to protect you from this wear and tear, your dialed back adrenals now produce lower levels of cortisol and adrenaline.

When your body dials it down, you're not fighting inflammation quite as well anymore and you may feel more aches and pains. Sleep may still be hard to come by, and now, with low cortisol which is supposed to help us feel awake and refreshed in the morning, you feel, no matter how many hours of sleep you’ve gotten, that you just can’t wake up in the morning. Or you’re crashing mid-afternoon. Or all day long. You may find that you have worsening digestive problems, worsening stress and anxiety overall. Again, it's not your adrenals that are exhausted. YOU'RE exhausted, and your adrenals are responding to that chronic state of stress.

When you're in this long enough, you can develop conditions like diabetes, high blood pressure, and high cholesterol. It can be impossible to take that weight off your middle no matter how much you diet or exercise. You might develop Hashimoto’s or other autoimmune conditions associated with allostatic load. Your periods, fertility, or sex drive might be gone. You can go into early menopause, or if you’re in menopause, your symptoms might be worse. And depression, anxiety, or low motivation can derail your happiness and success.  

As a doctor, I'm seeing women in their 30s, 40s, and 50s already on several medications for symptoms and conditions that are a result of allostatic load. I don't want that to happen to you. Furthermore, most of these are reversible, especially if you catch them on time!


It would be my joy to work myself out of a medical job because every woman in this country knows how to take care of her own health.

Final thoughts on adrenal fatigue, or overcoming allostatic load

So where do you go from here? Most of us can benefit from a conscious, daily commitment to supporting their health by bringing more self-care into their lives. But often, the triggers of allostatic load are more than the kind of stress we all recognize. It goes deeper into the connections between diet, environmental toxins, our gut health, and inflammation and our stress response physiology. Also, you want to make sure a look-alike condition isn't going on. For example, Hashimoto's and iron deficiency anemia can also cause some of these symptoms. It's too easy to lump things into adrenal issues when other things are going on.

If you're pretty sure what I described in the article is what's going on for you, my book The Adrenal Thyroid Revolution is probably your next best step. In it, I outline my entire protocol for healing from what you now know is really allostatic load – or what in this book I call SOS, as you’ll learn. I guide you through a complete natural approach that I have clinically proven to be successful with thousands of women, like you, and which I use every day in my medical practice, to take back your health from allostatic load, and with it, get to your healthiest, trimmest, fittest, happiest you. Get your copy here. Let's get you feeing better, together!

The Adrenal Thyroid Revolution

Best Selling Thyroid Book!

Want to learn how to support your own natural detoxification systems? Get Your Copy of My New Book to Learn How!


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Read or leave comments 16 Comment

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I would like to order this book but not through Amazon. Is it available to purchase via another option? Thanks in advance!

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    Tracy Romm

    You can get it at bookstores, but also through Barnes & Noble or Books A Million. I'm sure there are other places, too.

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DarleeAnn Thompson

Thank you for this article! It describes me to a tee. And it all started with my adrenals 4 years ago and cascaded from there right into my Hashimotos diagnosis. 1.5 years later and with my naturopath, the journey to stabilize is on going. The most debilitating symptom I am dealing with is my brain fog which I have had for 16 months. The emotional disconnect is beyond frustrating. Being in a gorgeous destination or a significant Family event, only to feel completely void of feeling or uphoria. Have had 6 IV doses of glutathione with vitamin C. No changes yet but crossing my fingers!

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I live in Mexico and a non-specific blood test has shown hemoglobin to be low for close to 2 years. I am taking 18 mg of iron and it is not improving during that time. Could I get iron & ferritin tested Male doctor could care less. Not sure a female would do better, either.

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    Aviva Romm

    Hi Mary, Some poeple have low hemoglobin due to inherited factor; but if it's always been normal and now low just for 2 years, there are a number of reasons this can happen from intestinal parasites (not in the woo woo alternative way, I mean real ones like hookwork that cause anemia), low iron in the diet, celiac disease, and more. Having your ferritin checked is worthwhile, but it's also important to get a complete workup to find out why your hemoglobin is low.

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Melissa Sharman

This book has been a God-send for me - truly! I discovered it by accident soon after I suffered a nervous breakdown last year (or so I called it at the time). To hear my symptoms so clearly and compassionately described was an immense relief. And, to be given the tools to heal myself through this book was so empowering. I am now quite well, though it is a continual journey to learn self care. Certainly, my whole life has changed for the better through this journey. I love your work Aviva, thank you for sharing your knowledge with us in such an accessible and empowering way.

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I've just been reading Lesson 3 in Herbal Medicine for Women today, and I listened to the webinar as well. So it's exciting to see the same information pop up in a different format - in my email this evening! Thank you for your work.

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Sharon Scelza

I have your book and love it. Your advice is wonderful. I've learned so much. It's so informative and easy to follow. Thank you.

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Thank you for such helpful information

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Bernie Das

I have been using ashwhaganda for adrenal support but now am sensitive to do you know of another safe alternative for adrenal strength?

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    Aviva Romm

    Reishi mushroom is a fabulous alternative.

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Susan Arnott

Aviva is a true expert in her field. I have her book and finally, all of my questions have been answered and the solutions are right there. Up until 2000, I was a personal trainer/medical exercise specialist for over 25 years....AND an education junkie. I attended every lecture I could on preventative health but could never find the answers I needed on this topic. Thank goodness I was fit and only consumed a home made healthy diet. Thank you Aviva. Amazing work.

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This article (and not this article in terms of its particular contents, but “this article” as in the “last straw”) has helped me decide what I’m going to do: study Traditional Chinese Medicine, and its systematic knowledge, which already goes back millennia, and learn what the body actually is and how the body actually works, and also checking in with Taoist practitioners, who personally helped over the centuries to contribute their own direct experiences in order to build upon and create this empirical knowledge base.

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All me ✅✅✅ Lifelong issues with thyroid and then diagnosed with early menopause mid last year and then working a stressful job in healthcare. I live in Australia and I’ve just purchased your book and am loving it. Thank you Your information is invaluable and looking forward to improving wellness and health.