How Adrenal Fatigue is Linked to Chronic Conditions

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Many chronic conditions such as chronic fatigue syndrome and fibromyalgia are caused by dysfunction within the hypothalamus-pituitary-adrenal axis. The adrenals are a primary component of this system. Therefore, adrenal disruption, especially in the form of adrenal fatigue, plays an important role in the occurrence of chronic disorders.

Learning about adrenal fatigue and understanding how it influences the development of other conditions is an important step towards greater treatment and prevention of chronic disorders.

What is Adrenal Fatigue

Adrenal fatigue occurs when the adrenal glands have been overworked and are unable to keep up with demand for various hormones, specifically cortisol. Typically, adrenal fatigue develops when a person experiences extended periods of mental or physical stress. When the body experiences stress, even if it is caused by imagined or perceived issues, the adrenals respond by releasing cortisol, which triggers a stress response. This is beneficial in that it improves awareness, reflex, and physical responsiveness. However, chronic stress can keep the body in this heightened state and eventually exhaust the body’s stores of cortisol and adrenal hormones.

Once the adrenals reach this drained state, they cannot produce the hormones necessary to maintain healthy bodily function. This causes individuals to experience mental and physical exhaustion that is not resolved through sleep and may continue for months or even years.

There are many other symptoms associated with adrenal fatigue including:

  • Brain fog
  • Craving salt or sugar
  • Dizziness caused by low blood pressure
  • Easily fatigued after physical activity
  • Fatigue that is not resolved by sleep
  • Food sensitivities
  • Insomnia
  • Irritability
  • Lack of appetite
  • Muscle weakness
  • Poor stress response
  • Recurrent infections
  • Reduced libido
  • Swelling in the ankles

It is easy to see that adrenal fatigue has a broad impact on bodily function. Many of these symptoms are also shared with chronic conditions such as chronic fatigue syndrome (CFS) and fibromyalgia. This makes sense because adrenal dysfunction, particularly adrenal fatigue, plays a role in the development and perpetuation of these and other chronic conditions.

The Adrenal Connection to Chronic Conditions

Anybody who has experienced a chronic condition such as CFS or fibromyalgia knows that these disorders can be debilitating, frustrating, and often cause severe long-lasting dysfunction. Two of the most common chronic conditions are fibromyalgia and Chronic Fatigue Syndrome. Each are associated with extreme fatigue that is not resolved through rest, difficulty thinking clearly, and physical discomfort or pain.

When discussing chronic conditions, it is important to recognize that there are many different factors involved. Typically, chronic conditions are caused by multiple dysfunctions that have developed throughout the body. One such factor is adrenal fatigue. Although adrenal fatigue is a different condition than CFS and fibromyalgia, it may have a significant degree of involvement with both conditions.

Data from over 50 studies showed that adrenal function among CFS and fibromyalgia patients was caused by abnormal hypothalamic-pituitary activity. This reinforces the fact that each part of the HPA axis influences the functionality of the other. Therefore, the impact of adrenal dysfunction on the HPA axis, and subsequently chronic conditions, should not be overlooked.

The Adrenals and CFS

CFS is caused by pituitary malfunction. This gland regulates hormone production and activity of many hormones including those produced in the adrenals. As the pituitary begins to malfunction, so too does adrenal activity. This contributes significantly to sensations of lethargy, fatigue, and inhibited mental clarity, which are symptoms frequently seen in CFS. It is believed that these symptoms are closely tied cortisol levels and therefore the adrenals. The adrenals are the primary producer of cortisol and if they become overworked, the body is likely to suffer a cortisol deficiency. As adrenal function declines and adrenal fatigue sets in, symptoms of CFS typically increase. Without resolving the many factors associated with CFS, including adrenal fatigue, there is little hope of fully resolving this debilitating condition.

Fibromyalgia and Adrenal Failings

Fibromyalgia is a chronic condition impacting between 2 and 4 percent of the population. It is often described as a stress-related disorder. Stress is a major factor in fibromyalgia and often exacerbates symptoms. Like CFS, it is believed that disruption of the HPA axis may be the cause of fibromyalgia. Therefore, adrenal fatigue likely plays a prominent role in the its development.

The main source of dysfunction regarding fibromyalgia is the hypothalamus. This system is located in the brain and regulates hormone activity there and elsewhere. The hypothalamus plays an essential part in the production and regulation of cortisol and thyroid hormone. When working correctly, the hypothalamus prompts the production of cortisol which triggers the adrenals. However, if the adrenals have become stressed or are already fatigued, they will not be able to respond appropriately. This results in hormonal imbalances and malfunctions that increase the risk of developing chronic conditions.

Addressing Adrenal Dysfunction

A lack of adrenal hormones including cortisol, DHEA, aldosterone, pregnenolone, estradiol, progesterone, testosterone, and growth hormones can be caused by adrenal dysfunction and contribute further to the development and perpetuation of CFS and fibromyalgia. Hormone deficiency may also increase symptom intensity and duration.

Unfortunately, adrenal-related indicators of malfunction are frequently overlooked because standard blood tests do not gauge adrenal hormone activity. Assessing hormone function, and not just hormone prevalence, can aid in the diagnosis of adrenal fatigue CFS, and fibromyalgia.

Resolving adrenal and pituitary issues often require a multifaceted approach that includes therapies with multiple hormones in order to restore functionality to various systems throughout the body such as the HPA axis. Without resolving each of the contributing factors of CFS and fibromyalgia, there is little hope of improving these conditions. It is important to consider all the possible causes, including adrenal fatigue and dysfunction, when pursuing treatment.

Knowing the powerful impact of the adrenals and their connection to chronic disease may lead to greater treatment and easier resolution of debilitating disorders such as CFS and fibromyalgia.


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

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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