Adrenal Insufficiency vs. Adrenal Fatigue

Occasionally, new patients will come into the clinic which a chief complaint of “adrenal fatigue”. When I ask them to explain why they think that they have such a condition and what signs and symptoms led them to that conclusion the justification is often that they were simply told so by another alternative healthcare practitioner. Trying to get to the bottom of what concerns them, I ask that they elaborate on the difficulties they have been having which brought them into the clinic for treatment. Suffering from fatigue, nervous energy, sleep disruption, and anxiety are all common answers given by patients who have been told that they have adrenal fatigue. These are real, valid, and true symptoms that these patients are suffering from. The problem seems to be that they have been assigned a nebulous alternative health diagnosis that is not bio-medically or physiology based in its origin. Further, it attaches a disease name to the patient and asks them to carry it with them as they would a scarlet letter on their chest. It does nothing to help them with their complaints, other than lead them to a vast and costly prescription of supposed adrenal supplements. It really is just translating their worries into a made up disease name so that they have something to call it. While fatigue, poor sleep and anxiety from overwork or stress are very real causes of concern, the syndrome of “Adrenal Fatigue” is not a actual medically recognized condition in the body and thus we should avoid using it as one.

Adrenal Insufficiency(AI) is a genuine medical disease which may have given birth to the alternative medicine concept of adrenal fatigue. According to the National Endocrine and Metabolic Disease Information Service, part of the National Institutes of Health, “Adrenal insufficiency is an endocrine-or hormonal-disorder that occurs when the adrenal glands do not produce enough of certain hormones. The adrenal glands are located just above the kidneys. Adrenal insufficiency can be primary or secondary”. Primary AI is something people can be born with and is called Addison’s Disease. Secondary AI is a conditioner where the Pituitary gland stops producing a hormone, Adrenocorticotropin (ACTH), which causes a diminishing amount of adrenal hormones to be produced and a gradual shrinking of the adrenal glands. This is rather serious because adrenal hormones do a great many things in our bodies including regulating blood pressure, metabolising nutrients, controlling blood sugars, and the managing the immune response.

AI requires medical intervention as imbalances in these body systems can lead to kidney disease and potentially death if left untreated. The severity of the condition is why we should not confuse it with a term like adrenal fatigue which may lead patients to seek primary care from a alternative health practitioner instead of a medical doctor. I do believe Chinese Medicine most definitely would play a valuable role in both the symptoms of fatigue and anxiety associated with the term adrenal fatigue as well as the medically serious condition that is Adrenal Insufficiency. I believe we should continue to respect and work with proven diseases and practice proper referral methods when needed to ensure the health of the patient.