Adrenal Fatigue

Adrenal fatigue does not exist: a systematic review.

Cadegiani FA, Kater CE · BMC endocrine disorders · 2016

The term "adrenal fatigue" ("AF") has been used by some doctors, healthcare providers, and the general media to describe an alleged condition caused by chronic exposure to stressful situations. Despite this, "AF" has not been recognized by any Endocrinology society, who claim there is no hard evidence for the existence. The aim of this systematic review is to verify whether there is substantiation for "AF". A systematic search was performed at PUBMED, MEDLINE (Ebsco) and Cochrane databases, from the beginning of the data until April 22nd, 2016. Searched key words were: "adrenal" + "fatigue", "adrenal" + "burnout", "adrenal" + "exhaustion", "hypoadrenia", "burnout" + "cortisol", "fatigue" + "cortisol", "clinical" + "burnout", "cortisol" + "vitalility", "adrenal" + "vitality", and "cortisol" + "exhaustion". Eligibility criteria were: (1) articles written in Engli

Erratum to: Adrenal fatigue does not exist: a systematic review.

Cadegiani FA, Kater CE · BMC endocrine disorders · 2016

Endocrine Society's Position Statement on Adrenal Fatigue

Endocrine Society · Strength: Strong recommendation

The Endocrine Society provides a clear statement regarding the term 'adrenal fatigue,' clarifying that it is not a recognized medical diagnosis and that symptoms often attributed to it are non-specific.

Adrenal Insufficiency

Endocrine Society

While not directly about 'adrenal fatigue,' the Endocrine Society provides comprehensive information on adrenal insufficiency, a medically recognized condition with distinct diagnostic criteria and treatment, which is sometimes confused with 'adrenal fatigue.'

Adrenal Insufficiency (Beyond Addison's Disease): A Comprehensive Review

Endocrine Society

This review from the Endocrine Society discusses various forms of adrenal insufficiency, providing context that is highly relevant for understanding the scientific perspective on 'adrenal fatigue' in relation to established medical diagnoses.

Repeated mixing and isolation: measuring chronic, intermittent stress in Holstein calves.

Wilcox CS, Schutz MM, Rostagno MR, Lay DC Jr, Eicher SD · Journal of dairy science · 2013

Objectives of this study were to determine the physiological effects of psychological stress applied to dairy calves and to test if molasses consumption could be used to validate that a stressed condition was achieved. Twenty male calves (3 wk old) received jugular catheters and were randomly assigned to control (CTR; n = 4 pens of 1 calf per pen) or social stress treatments (STR; n = 4 pens of 4 calves per pen). The STR treatment included 5 cycles of 24-h isolation followed by regrouping with unfamiliar animals for 48 h (over 15 d). An ACTH challenge (0.1 IU/kg of body weight) was used to determine adrenal fatigue. Peak and total cortisol concentrations were greater for STR calves until the ACTH challenge. After the ACTH challenge, CTR calf cortisol increased and STR calf cortisol continued to decrease, suggesting adrenal fatigue. The number of calves that became positive for fecal shedding of Salmonella after the acute stress of being moved and the number of calves that were positive

Beyond adrenal fatigue: reframing the adrenal stress index through neutrophil-mediated glucocorticoid resistance.

Cardillo G · Frontiers in endocrinology · 2026

The Adrenal Stress Index (ASI) is widely used in functional medicine but dismissed by mainstream endocrinology. Traditionally interpreted as a measure of adrenal secretory capacity, it has been criticized for lacking clinical validity. Yet salivary cortisol and dehydroepiandrosterone sulfate (DHEAS) may offer more than redundant hormone monitoring: they may capture the organism's ability to maintain resilience against chronic inflammation. We propose that the ASI should be reframed not as a test of adrenal "fatigue," but as a candidate biomarker of inflammatory adaptation. Cortisol, bound to corticosteroid-binding globulin (CBG), is released at inflamed sites through neutrophil elastase stored in azurophilic granules. Since these granules are formed only at the promyelocyte stage, their depletion under chronic demand leads to neutrophil exhaustion and impaired cortisol delivery. DHEAS, conversely, buffers cortisol's catabolic and immunosuppressive actions and declines with age or pers

Adrenal Asthenia.

Kalra S, Dhingra A, Kapoor N · JPMA. The Journal of the Pakistan Medical Association · 2025

The terms 'adrenal asthenia', 'adrenal fatigue' and 'adrenal burnout', sometimes used in lay language, are not a part of the medical or endocrine lexicon. In this opinion piece, we explore the relevance of adrenal asthenia and describe how it can be used in different clinical situations, with varying connotations. Adrenal asthenia may refer to adrenocortical insufficiency, increased parasympathetic or reduced adrenergic tone, or fatigue due to excessive and continuous exposure to stress. It may be mediated by hypoglycaemia or dyselectrolytaemia. The term adrenal asthenia has important clinical and public health advantages.

Chapter 29: Unproved and controversial methods and theories in allergy-immunology.

Shah R, Greenberger PA · Allergy and asthma proceedings · 2012

Unproved methods and controversial theories in the diagnosis and management of allergy-immunology are those that lack scientific credibility. Some definitions are provided for perspective because in chronic medical conditions, frequently, nonscientifically based treatments are developed that can have a very positive psychological effect on the patients in the absence of objective physical benefit. Standard practice can be described as "the methods of diagnosis and treatment used by reputable physicians in a particular subspecialty or primary care practice" with the understanding that diagnosis and treatment options are consistent with established mechanisms of conditions or diseases.(3) Conventional medicine (Western or allopathic medicine) is that which is practiced by the majority of MDs, DOs, psychologists, RNs, and physical therapists. Complementary medicine uses the practice of conventional medicine with complementary and alternative medicine such as using acupuncture for pain rel

Adrenal Gland Disorders

NIH/MedlinePlus

MedlinePlus, a service of the National Library of Medicine (NIH), offers comprehensive information on various adrenal gland disorders, which provides a medically recognized framework for conditions related to adrenal function.

Addison's disease

NHS

This NHS page describes Addison's disease, a form of adrenal insufficiency that is a recognized medical condition. It details symptoms, diagnosis, and treatment options, providing a contrast to the unproven concept of 'adrenal fatigue'.

Changes in the Hormonal and Inflammatory Profile of Young Sprint- and Endurance-trained Athletes Following a Sports Camp

n=24 · NCT06150105 · COMPLETED · COMPLETED

One essential element of athlete training is conditioning camps, where athletes undergo a rigorous and targeted training schedule to prepare for upcoming sporting events. During sports camps, due to the accumulation of a large number of training units, including high-intensity exercises, athletes react with post-exercise overload, acute fatigue, and overreaching which can become a chronic overtraining syndrome. Overtraining syndrome is a very specific and severe condition where overtraining without adequate rest and recovery leads to performance decrements lasting more than 2-3 months, coupled with a mood disturbance. The exact etiology and pathogenesis are unknown and actively being investigated. During training camps the balance between training volumes and recovery is often a delicate one and, the accumulation of exercise-induced stress may exceed the capacity of both neuroendocrine and immune adaptation leading to an alteration of physiological functions, decreasing adaptation to performance, impairment of psychological processing, immunological dysfunction, and biochemical abnormalities. Moreover, there is currently a lack of biomarkers accessible to assist in diagnosing and, what's even more important - help to prevent the overtraining syndrome, except for the continued presence of unexplained underperformance despite athletes' adequate rest and recovery. Thus, this study aims to explain how long and intensive training for endurance affects the hormonal and immune systems of young athletes. The main questions it aims to answer are: 1. How does intense training influence hormonal and immune responses in young, trained athletes? 2. Does training specialization affect the hormonal and immune response to intense training?

The Etiology and Extent of Impaired Quality of Life, Fatigue and Cognitive, Affective and Emotional Dysfunction in Patients With Cushing's Syndrome - Prospective Studies

n=72 · NCT03211624 · ACTIVE_NOT_RECRUITING · ACTIVE_NOT_RECRUITING

This is a prospective, multi-center, case-control study where neurocognitive function will be evaluated in 36 patients with Cushing syndrome (CS) and 36 controls matched for age, gender and education.

Effect of Modified-release Compared to Conventional Hydrocortisone on Fatigue, Measured by Ecological Momentary Assessments; a Pilot Study.

n=30 · NCT02282150 · UNKNOWN · UNKNOWN

Despite optimized hydrocortisone replacement regimes, many patients with adrenal insufficiency (AI) suffer from impaired quality of life (QoL). Characteristically, patients report high fatigue levels at certain times during the day. A modified-release hydrocortisone has been shown to improve QoL, particularly fatigue, in patients with primary AI. However, it is unknown, if the same effect can be observed in patients with secondary AI. Further, no studies have evaluated the effect, taking into account the diurnal variation of fatigue. A novel survey method termed Ecological Momentary Assessments (EMA) has the potential to provide reliable measurements of diurnal variations in patient-reported outcomes, such as fatigue. We will compare the effect of modified-release compared to conventional hydrocortisone on fatigue in patients with secondary AI due to pituitary disease, and hereby assess the feasibility of EMA as outcome in future large-scale randomised clinical trials (RCTs).

Adrenal Fatigue

TRIP Database

TRIP Database is an evidence-based search engine that allows users to find high-quality research evidence on various medical topics, including searches related to 'Adrenal Fatigue,' often yielding results discussing the lack of scientific support for the diagnosis.