"Adrenal Fatigue" & "Adrenal Support" Claims

Real adrenal disease first. Long-lasting tiredness, weakness, weight loss, poor appetite, belly pain, or dizziness or fainting when standing up can come from adrenal insufficiency, a recognized and treatable condition. [1] If this sounds like you, ask a health professional to test for real causes rather than trying a supplement first. Adrenal insufficiency can become an emergency ("adrenal crisis"): sudden severe pain in the lower back, belly or legs, vomiting and diarrhea, weakness, confusion or loss of consciousness need emergency medical treatment, which in the US means calling 911. [2] If low mood or hopelessness is part of how you feel, you can also call or text 988 in the US.

The claim as it is marketed

"Adrenal fatigue" and "adrenal support" appear on supplement labels, test kits and websites, often beside adaptogens. The claim is usually that long-term stress wears out the adrenal glands, so that they cannot make enough cortisol, and that a supplement can restore them. The Endocrine Society describes the same theory: supporters believe long-term stress means the adrenal glands cannot keep up with the body's need for hormones such as cortisol. [3]

What the evidence is

A PubMed search is not proof that no study exists anywhere, and we say only what we found.

Why a wrong label matters

The Endocrine Society says doctors are concerned that, if you are told you have this condition, the real cause of your symptoms may not be found and treated correctly. [3] Tiredness, trouble sleeping, salt or sugar cravings and needing caffeine are common and non-specific, meaning they occur in many diseases and in normal busy lives. [3] The same source lists adrenal insufficiency, depression and obstructive sleep apnea among possible real causes. [3]

Real adrenal conditions, briefly

• Adrenal insufficiency (including Addison's disease). NIDDK lists long-lasting fatigue, muscle weakness, loss of appetite, weight loss and abdominal pain as the most common symptoms. [1] Addison's disease is usually caused by autoimmune disease, and the most common cause of adrenal insufficiency overall is suddenly stopping corticosteroid medicine after taking it for a long time. [1] If you take corticosteroids, ask the prescriber or pharmacist before changing anything.
• Cushing's syndrome. This is the opposite problem: the body makes too much cortisol over a long period, and NIDDK notes that symptoms such as fatigue and weight gain can have many causes, so it can be hard to diagnose. [5]

What a reader can safely do

• Tell a clinician about the symptoms, how long they have lasted and every supplement and medicine you take.
• Ask whether sleep problems, depression, sleep apnea, thyroid or other conditions could explain them.
• Check supplement interactions with a pharmacist: how medicine interactions work.
• For everyday habits that the Endocrine Society says will almost always make you feel better, such as exercise, healthy food and a regular sleep routine, see cortisol and adrenal fatigue in Wellness Goals and how to relieve stress. [3]