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The Adrenal Conundrum 

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Adrenal function often gets blamed for low energy levels. If you start investigating causes for fatigue, it won’t be long before you’ll come across “adrenal fatigue.” Google that term and you’ll get 2.5 million results, many of them links to websites urging consultations, diet modifi cations and a slew of supplements. So what are the adrenals and can they really get tired?

The adrenals are a pair of organs located on top of the kidneys that secrete cortisol and several other hormones in response to stress. A condition called adrenal insufficiency, or Addison’s disease, does exist, but it “should be diagnosed with a specialized stimulation test in a medical office,” says Dr. Lynn Kohlmeier, a Spokane endocrinologist. “Because only a rare number of people truly have adrenal dysfunction, it is important to confi rm the diagnosis before starting treatment. Adrenal insufficiency should not cause fatigue, however, once treated.”

So why does the term “adrenal fatigue” appear so frequently? The symptoms of “adrenal fatigue” are vague enough to make anyone think they may have the disorder on some days — from mood swings and tiredness to trouble sleeping and cravings for sugar, salt or caffeine. But according to the Hormone Foundation and Endocrine Society, “No scientific proof exists to support adrenal fatigue as a true medical condition.” The Society even went so far as to publish a “Myth vs. Fact” paper on the topic.

Kohlmeier and other providers are concerned that people who attempt treatment for adrenal fatigue may in fact miss the real cause of their symptoms and not get effective therapy. In addition, supplements designed to treat “adrenal fatigue” are, for the most part, unregulated by the FDA and may contain “extracts of human adrenal, hypothalamus and pituitary glands that could be harmful,” according to the Endocrine Society. Taking these supplements when you don’t need them may actually cause the adrenal glands to stop working; even after the supplements are discontinued, the adrenal glands may not rebound, potentially leading to a life-threatening condition called adrenal crisis.

Instead of turning to supplements to deal with fatigue, Kohlmeier stresses, “Try to sleep better, eat well and exercise more. And, of course, recheck your thyroid hormone levels with your next blood test.”

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