Adrenal burnout? – Henri Timmers

Henri J.L.M. Timmers, internist-endocrinologist, RADBOUDUMC, Nijmegen
  • Are you often tired and lifeless without obvious reason?
  • Do you often feel overwhelmed by the hustle and bustle of everyday life?
  • Do you feel an urgent need for salty or sweet snacks?
  • Do you struggle to get out of bed?
  • Can you not make it through the day without coffee?

If you live with an adrenal disorder, chances are you will answer some of these questions positively. But this can certainly apply to people who do NOT have a chronic illness. The complaints mentioned speak to the imagination of many, especially in the context of our modern society that demands a lot of us on many fronts. It also makes sense that people start googling to find out if there is a medical cause for their lack of energy. It is quite possible that they will come across reduced function of the adrenal gland in their search.

The term adrenal exhaustion, also called adrenal fatigue or adrenal burnout, was introduced in 1998 by naturopath and chiropractor James L. Wilson. The “diagnosis” has since spread like wildfire on the Internet and in popular health and lifestyle literature. The cause for chronic exposure to physical, mental or emotional stress has been sought after. The theory is that the adrenal glands can no longer cope with this continuous need of the body for stress hormones and become burned out. Adrenal exhaustion is seen by the people who believe in it as a mild form of adrenal insufficiency.

Complaints attributed to adrenal exhaustion are very diverse. Fatigue, sleep problems, diffuse pain, intestinal complaints or nervousness are propagated as typical. Moreover, factors such as sleep deprivation, poor eating habits, too little or too much physical effort, relationship problems, financial concerns, a negative attitude, smoking, alcohol, sugar and toxic substances are constantly lurking. It is no wonder that many people, after their own research or through alternative healers, come to the conclusion that they have a cortisol deficiency and other adrenal hormones and that doctors and other health care practitioners are increasingly being consulted on the subject.

In conventional medicine, the term adrenal exhaustion is not recognized as a condition. There is no scientific evidence for the concept of adrenal fatigue under the influence of persistent stress stimuli. The Endocrine Society/Hormone Health Network published a “fact sheet1” on the subject.

Although adrenal exhaustion is not recognized as a disorder, the complaints that people experience are obviously real.

The symptoms may be due to other conditions, such as an underactive thyroid gland, sleep apnoea syndrome, inflammatory diseases, depression, etc. An unhealthy lifestyle may also play a role. Of course, there is overlap between this picture and that of adrenal insufficiency. However, for the latter, symptoms such as weight loss, lack of appetite, muscle weakness, nausea, vomiting, diarrhoea, dizziness and low blood pressure are more specific. In addition, adrenal insufficiency is hard to determine with validated diagnostic tests and in adrenal fatigue this is not the case.

In addition to masking a real condition, there are other drawbacks to the pseudo-diagnosis of adrenal exhaustion. In this context there is a lively trade in (expensive) adrenal hormone supplements, vitamins, minerals and liquorice extract. Sometimes these preparations contain impure extracts from bovine adrenal or even steroid hormones. This can damage your health.
Also in this context it is essential that healthcare providers listen carefully to their patients in order to arrive at a correct diagnosis and a sensible policy.

If you recognize yourself in the description of adrenal exhaustion, there is no doubt that your symptoms are real. Discuss them with your doctor. Take good care of yourself in terms of nutrition, exercise and rest.


  2. Adrenal fatigue does not exist: a systematic review. Cadegiani and Kater BMC Endocrine Disorders (2016) 16:48