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A quick Google search of “adrenal fatigue” brings up symptoms as long as your arm, many of which are extremely common. But can it be considered a real condition? We asked the experts to explain.

Anxiety, low mood, exhaustion, brain fog and food cravings might sound like a pretty standard rundown of niggly issues we often attribute to hormones. But collectively and over a long period of time, these symptoms might be signs of something a little more concerning. Google them, and you might also find yourself staring at a medically divisive diagnosis.

Adrenal fatigue, while not medically recognised, can be debilitating for those who believe they’re living with it. It’s really hard to get a diagnosis, primarily because not all medical professionals believe it to be ‘a thing’. And that means people have to wait for months or years to receive any help for their very real symptoms. So what’s going on? 

Adrenal fatigue is all to do with our adrenal glands

The adrenal glands are two small glands that sit on top of the kidneys. They are responsible for producing two essential hormones: cortisol and aldosterone. Cortisol is responsible for regulating blood pressure and the immune system. It’s also responsible for getting us out of bed in the morning. Aldosterone, on the other hand, regulates salts in the blood and contributes to regulating blood pressure.

Together, the adrenal glands are crucial to the body’s management of physical and emotional stress. “Cortisol is our major stress hormone,” explains mental health nutritionist and stress management expert Uta Boellinger. “The theory behind adrenal fatigue is that prolonged exposure to stress leads to the body being unable to produce adequate amounts of cortisol, which affects our body’s ability to cope with stress, and is also needed to get us up in the morning and help us feel awake.”

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What are the symptoms of adrenal fatigue?

Sufferers report a range of symptoms that include sleep disturbance, weight gain and low libido.

“I felt exhausted. I just had no energy at all, and I struggled to get out of bed in the morning more than usual,” says HR administrator Lindy Lashbrook, who believes she suffers from adrenal fatigue. “During the day, I felt sluggish and light-headed, with brain fog and headaches most days.”

Success coach Marilyn Devonish recalls feeling similar: “Even though I was suffering with ongoing long-term fatigue, I still found it difficult to get restful sleep, and no matter what I ate, I was constantly bloated and uncomfortable. I went from being someone who was rarely ill, to catching everything going.”

Both Lashbrook and Devonish believe that their symptoms were triggered by stressful and emotional life events. And according to Boellinger, the term adrenal fatigue “is widely used in complementary medicine to describe the progression of adrenal exhaustion caused by long-term/chronic stress”. 

Adrenal fatigue can be debilitating. But medical opinion is divided.

What do the medical experts say?

“Our endocrine system (the part of our body concerned with hormones) is poorly understood mainly because it is so difficult to monitor in people,” explains Dr Gareth Nye, specialist in endocrinology and senior lecturer at Chester Medical School. “Hormones do not work in isolation and are part of a huge network. Often when one aspect isn’t quite right, we feel symptoms that aren’t necessarily associated at first glance. The term itself came about in the 1990s, coined by chiropractor James Wilson, and has since been loosely defined as a ‘weakening or burnout’ of the adrenal glands in response to chronic stress.

Dr Nye continues: “The large burden of evidence suggests adrenal fatigue is not a factual condition, however the symptoms may indicate underlying issues which do need checking by medical professionals.”

“Adrenal fatigue is often the subject of debate and people remain divided,” agrees surgeon Dr Furqan Raja. “Despite not being recognised as a medical condition in its own right, it is a term that is often used when your adrenal glands struggle to work normally under stress. Although adrenal fatigue does not appear in the International Classification of Diseases, the symptoms many patients experience are very real and can include body aches, fatigue and also hair loss often comes as part of this.”

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Can it be treated?

Since the condition isn’t recognised by conventional medicine, it can be difficult to get a diagnosis, and both Lashbrook and Devonish went down the complementary route.

Boellinger maintains that there are many ways to successfully treat and manage the symptoms of adrenal fatigue, while Lashbrook is evangelical about the difference overhauling her lifestyle has made. She tells Stylist, “I’ve reduced my sugar and alcohol consumption, and make sure to have a mix of carbs and protein at every meal. I snack regularly to avoid spikes in my blood sugar and the difference is huge. I now sleep better, am more alert when I wake up and I can exercise again – something that was out of the question before.”

Boellinger’s advises a whole-body, holistic approach to treating symptoms, as follows. 

Manage cortisol levels

“The first and most important step in recovery is stress management. Ideally, we would want to eliminate the root cause of chronic stress, which of course is not always possible. So we’d look at building stress resilience and techniques to help us deal with stress, such as breathing exercises, meditation or spending time in nature. All of these will help to actively lower cortisol, helping to return it to more normal levels.”

Some experts believe that supplements such as magnesium and potassium can help with adrenal fatigue symptoms such as fatigue and insomnia

Consider supplements

You might want to think about upping your magnesium and potassium intake (ideally via your diet but using supplements if that’s not possible). “Magnesium helps us relax and wind down – it has a calming effect on our nervous system,” says Boellinger. “Not having enough magnesium has been linked to low energy, and studies have also found that those who are chronically stressed are more likely to be lacking magnesium.”

One of the key dietary recommendations to support the adrenal glands is to ensure adequate potassium levels within the body, and Boellinger recommends consuming foods rich in potassium and avoiding foods high in sodium.

Magnesium-rich foods include dark chocolate, avocados, fatty fish (like mackerel) and tofu. For potassium, load up on bananas, potatoes, butternut squash, lentils and raisins.

Get enough sleep

“Sleep is absolutely crucial to allow your body to recover,” stresses Boellinger, “so if this is an issue for you, it needs to be resolved.”

That might be easier said than done, but it’s worth giving yourself the best possible chance at getting some decent rest. Assess your sleep environment to see how relaxing it is, give yourself a tech detox before you plan to sleep, and try to create a non-negotiable bedtime routine to help you wind down.

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Do some moderate exercise

“In terms of exercise, we would recommend low intensity exercise,” says Boellinger. “While all movement is good for you, high intensity exercise can actually be counterproductive here as it causes the release of adrenaline in the body, leading the body to feel more stressed.”

So take it easy. Go for yin yoga after work, morning walks or strength-building pilates, rather than HIIT or intense cardio. 

Regulate blood sugar

“Cortisol and blood sugar levels have an intimate relationship,” explains Boellinger. “Don’t skip meals as this will cause further cortisol release. Reduce foods which have high levels of sugar and processed carbs and switch instead to foods which are high in complex carbohydrates such as brown rice, and switch to brown pasta and bread. 

“And always eat carbohydrate-rich foods in combination with protein. Protein slows down digestion and absorption of glucose into your blood stream, so you’ll get less of a spike in blood sugar.”

Why are experts still divided about adrenal fatigue?

Not all experts are convinced about adrenal fatigue, and that’s because many believe the symptoms can be attributed to other medical issues, as Dr Nye explains. “Classically, the term ‘adrenal fatigue’ has been applied to a collection of symptoms, such as body aches, fatigue, nervousness, sleep disturbances and digestive problems. Many of these can be attributed to a number of lifestyle factors such as work patterns, eating times and increased screen time.”

But that’s not necessarily too helpful for those actually living with these issues. Lashbrook recalls a sense of frustration, telling Stylist: “I knew there was something wrong, but no one could tell me what it was. I felt like they didn’t believe me but deep down, I knew I wasn’t myself and I just didn’t know how to feel better. I felt frustrated and helpless.”

Boellinger shares these feelings, stressing that “while it’s not a recognised medical condition, it doesn’t mean that it’s not happening in the body. It just means that studies haven’t found any concrete evidence of it, which can be due to lack of funding or other issues.”

Boellinger says that in her work as a nutritionist, she’s had great success at improving clients’ symptoms by tackling what are seen as the root causes of adrenal fatigue – and implementing the kinds of recommendations mentioned above.

We still don’t know enough about the condition to say for sure if it’s a disease, syndrome or coincidence, but anecdotally at least, it does sound like there’s a light at the end of the tunnel for anyone who believes they’ve got it. Dr Nye cautions, “Whenever you experience a change in your personal medical circumstances, it is advisable to seek medical advice to rule out either conditions that can be easily fixed, or conditions that need further exploration.”

Lowering stress, catching up on sleep and nourishing our bodies are ‘no harm’ interventions – meaning that they can only have a positive effect. Ultimately, maybe it doesn’t matter if not everyone believes in adrenal fatigue – the recommendations are still valid.

Images: Getty

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