Adrenal Fatigue: Is It Real? Symptoms, Causes, Treatments

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Originally Posted March 2017
Updated October 2019

Our adrenals are integral to the body’s stress response. If they become overworked due to constant activation, or are incapable of producing sufficient hormones to appropriately respond to stress, the result is rippling dysfunction and inflammation throughout the body.

Unfortunately, even though high stress is considered normal in our society, many are unaware of adrenal issues or do not respect the serious impact they have on the body. Often people only act to resolve adrenal fatigue when the situation becomes unbearable. The two extremes of adrenal function are known as Addison’s disease, where the adrenals cannot produce necessary hormones, and Cushing’s disease, understood as excess production of adrenal hormones. Acting only when the condition has reached its upper or lower limit means that the body has been unnecessarily suffering for an extended period. Through early recognition and better understanding of adrenal fatigue we can improve our daily lives and overall health.

Adrenal Basics

The adrenals are located just above the kidneys and are responsible for producing over 150 different hormones. Many of these hormones are used to maintain and regulate different functions in the body including blood sugar levels, anti-inflammatory responses, immune system function, and blood pressure. Other hormones produced by the adrenals that you may recognize are adrenaline, estrogen, and progesterone. Because it plays a role in so many bodily functions it is important that the adrenals are given proper care.

Learn even more about the adrenal glands here.

Perhaps the most prominent function of the adrenals is its influence on stress. Cortisol, sometimes referred to as the “stress hormone” or the “fight or flight” hormone, is the primary anti-stress hormone produced by the adrenals. When we experience stress, real or imagined, cortisol is secreted to trigger our natural stress response. Chronic or continuous stress causes the adrenals to constantly release cortisol, which keeps the body in a state of alertness. Furthermore, persistent stress puts a lot of pressure on the adrenals to continually produce, which ultimately causes fatigue and they become unable to provide the hormones needed for other bodily processes.

Cortisol is also a key component in motivating the body in the morning. As we awaken, the body releases cortisol to activate the body and mind to make us alert and ready to face the day. In the presence of adrenal dysfunction, an individual may lose out on the morning release of cortisol to get them going. Alternatively, the individual may experience a cortisol high in the evening that keeps them from falling asleep. Both scenarios inhibit the body’s ability to achieve quality rest, which negatively impacts the entire body.

Symptoms of Adrenal Fatigue

Identifying adrenal fatigue can be difficult because the symptoms often sneak into our lives and progressively get worse. For example, if you notice that your sleep cycle is slightly off, but rather than investigate you simply ignore it, you will become accustomed to it and begin living with unnecessary hardship. Many of the symptoms of adrenal fatigue begin small but continue to increase in severity when left unanswered.

If you experience multiple of the following symptoms, it is beneficial to investigate the presence of adrenal fatigue.

  • Decreased sex drive
  • Insomnia
  • Poor cognitive function or “brain fog”
  • Irritability
  • Dizziness
  • Reduced ability to handle stress or extreme responses to stress
  • Anxiety
  • Chronic fatigue not resolved by rest
  • Muscle weakness or stiffness
  • Weight loss and/or loss of appetite
  • Depression
  • Recurring infections
  • Difficulty getting up in the morning
  • Shaking and/or trembling
  • Headaches
  • Craving salty foods
  • Needing caffeinated or sugary drinks to stay awake (coffee, energy drinks etc.)

Perhaps the most common identifier of adrenal fatigue is feeling wide awake but physically exhausted. When an individual feels overly tired and goes to bed just to be met with a racing mind and inability to sleep, it is likely due to adrenal fatigue – learn more about being “wired and tired” here. Fatigue-related symptoms, like those listed above, coupled with sleep difficulties is a major signal that the body is experiencing adrenal fatigue. Realizing that you have a dysfunction is only the first step. You must also identify the source of your stressors.

Why Am I Stressed?

Anything that brings undue stress to the adrenals can inhibit its function. Some may be unaware of how much stress their body experiences daily. There are numerous stressors that occur throughout our lives that can induce a temporary spike in adrenal function or cause long-lasting chronic stress. Some of the most common stressors that increase the risk for adrenal failure include:

  • Ongoing illness, such as respiratory, bacterial, or viral infections
  • Chronic insomnia or insufficient sleep
  • Acute life stress, such as death of a loved one, divorce, and job loss
  • Prolonged emotional stress
  • Substance abuse
  • Poor eating habits and nutrient deficiencies
  • Hormone imbalances
  • Surgeries or accidents
  • Chronic fatigue syndrome or fibromyalgia
  • Perimenopause or menopause

Although the source of many of the above stressors are out of your direct control, there are ways to improve the body’s response to them.

Check out our stress-reducing tips here!

Treating and Resolving Adrenal Fatigue

Adrenal fatigue can be difficult to manage because there are numerous possible causes. Speaking with a physician to identify your stressors can help you formulate the proper treatment approach. Their insight into clinical triggers such as chronic infection, mitochondrial dysfunction, abnormal immune responses, and thyroid health, may be instrumental in restoring adrenal function.

Engaging in healthy exercise is essential for adrenal restoration and health. Although, it is important not to overly exhaust the body when being active as that places extra stress on the body. Furthermore, you may not be able to do strenuous exercise if adrenal fatigue has reached severe levels. However, low intensity exercise can be beneficial. In addition to getting the body moving, walking and yoga promote calming sensations and can improve adrenal function.

Finding a Doctor that Treats Your Adrenal Dysfunction

Now that you are acquainted with the symptoms of adrenal fatigue and the stressors that can induce it, you are better equipped to recognize it in yourself and others. When you see signs of adrenal dysfunction don’t be complacent and accept it as a part of your stressful life. Seek out proper treatment and act to resolve adrenal dysfunction to regain your health!

At Holtorf Medical Group, our physicians are trained to provide you with cutting-edge testing and innovative treatments to properly diagnose and treat your adrenal dysfunction, optimize your health and improve your quality of life. If you have symptoms associated with adrenal fatigue, call us at 877-508-1177 to see how we can help you!


1. Kent Holtorf, MD. “Diagnosis and Treatment of Hypothalamic-Pituitary-Adrenal (HPA) Axis Dysfunction in Patients with Chronic Fatigue Syndrome (CFS) and Fibromyalgia (FM).”

2. Kent Holtorf, MD. “Adrenal Fatigue Testing.”
3. Kent Holtorf, MD. “Adrenal Fatigue Treatment Options.”

How HMG Has Helped Others: Patient Testimonial

I came to Dr Bullington very sick and feeling very badly. I didn’t know where to go for help with my hormones, anxiety and depression. She made a diagnosis, put me on biodentical hormones and gave me hope for a complete turnaround. She is an excellent doctor, very kind, caring and very knowledgeable. I am now completely recovered and feeling great! Thank you Dr. Bullington and staff for giving me such outstanding care and helping me in this journey back to health! – K.G.

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About Holtorf Medical Group

The Holtorf Medical Group specializes in optimizing quality of life and being medical detectives to uncover the underlying cause of symptoms, rather than just prescribing medications to cover-up the symptoms. We are experts in natural, prescription bioidentical hormone replacement and optimization, complex endocrine dysfunction, fibromyalgia, chronic fatigue syndrome and Lyme disease.

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