Is Adrenal Fatigue Real?

Dr. Jolene BrightenPublished: Last Reviewed: Sex Hormones Leave a Comment

Hold up! Adrenal fatigue isn't real? Try telling that to my exhausted body! In this article I'm going to explain why adrenal fatigue isn't real and what is going on instead.

Chances are if you've been following my work then you've probably already heard me explain what takes place in “adrenal fatigue” and how it isn't really an issue with the adrenals becoming fatigued. I dedicated an entire section to explaining Adrenal Dysfunction in both of my books, Beyond the Pill and Healing Your Body Naturally After Childbirth, because it is indeed a very real condition.

But what about the concept of Adrenal Fatigue?

Adrenal fatigue is a term that is used to express a collection of symptoms and is really just a term that helps us communicate a bigger concept, making it easier to grasp. And like “leaky gut,” which is really intestinal hyper-permeability, it is an easy way to quickly express to your doctor what you think is happening. And as a doctor, I definitely see no fault in that.

But the problem is that saying adrenal fatigue doesn't always carry over well with a doc who doesn't have a clue about adrenal dysfunction outside of Cushing's (cortisol excess) or Addison's (primary adrenal insufficiency), which are two ends of the spectrum. And sometimes that doc will push back, “Adrenal fatigue isn't real.”

So what's really going on with your adrenal glands and why are you feeling so tired?

The Hypothalamic-Pitutary-Adrenal axis (aka HPA), is the system by which the brain and adrenal glands communicate. The brain signals to the adrenals to secrete hormones and that the brain monitors the amount of hormones in the system. And for our purpose we'll focus on one hormone in particular— cortisol.

Under times of stress the HPA axis is activated and what follows is a symphony of hormones that help your body adapt to the stressor. It begins with the secretion of corticotropin releasing hormone (CRH) from the hypothalamus, which signals the release of adrenocorticotropic hormone (ACTH) from the pituitary. ACTH is the signal that causes the adrenal glands to secrete cortisol, which typically continues until the stress has resolved.

But herein lies the problem— for many of us, the stress is always present, never gone and well, frankly it can be relentless. That cortisol your adrenals are working so hard to produce should signal to the brain to stop the secretion of adrenal signaling hormones (CRH, ACTH) in what is called negative feedback. Instead, chronic stress results in our adrenal glands secreting more and more cortisol. Overtime, your cells become resistant to cortisol and the negative feedback system becomes ineffective. Without intervention, the HPA axis becomes dysregulated and eventually cortisol drops and is too low, leading to the symptoms of adrenal fatigue. This is what is classically called “Adrenal Fatigue Syndrome.”

What are common symptoms of HPA Dysregulation, Adrenal Dysfunction or Adrenal Fatigue Syndrome?

  • Feeling stressed by every little thing
  • Feeling overwhelmed by day-to-day activities
  • Waking feeling tired
  • Difficulty falling asleep or staying asleep
  • Feeling “wired and tired”
  • Low libido
  • Menstrual irregularities
  • PMS
  • Feeling lightheaded when you go from lying down or seated to a standing position
  • Low blood pressure
  • Blood sugar irregularities
  • Anxiety
  • Difficulty concentrating
  • Exercise intolerance or difficulty recovering
  • And so much more…

6 Ways to Prevent Adrenal Dysfunction

As a doctor, I'd much rather help someone prevent a condition opposed to having to treat it because the later means that they've already been experiencing the difficulties of this condition. There's a lot of talk these days about how to treat adrenal fatigue, but what if we could do better? What if we could prevent it?

Here are 5 tips I share with my patients to help them care for their adrenals and prevent adrenal dysfunction (they also work well for treating it too).

Eat Regular Meals.

Skipping meals, grabbing quick energy fixes and forgetting to fuel your body creates stress on an already stressed out system. Your body has no way of knowing if there is a famine versus you just got too busy and forgot to eat. Start your day with protein and aim to include it with each meal to keep you feeling full longer and avoiding peaks & dips in blood sugar.

Build Your Stress Toolbox!

Meditation, deep breathing, yoga, pilates, weight lifting, epsom salt soaks, massage, singing out loud, visualization, time with friends, play, walking, reading… the list just keeps going! Stress is always going to be a part of life. It is how you perceive it and what you do about it that determines how it effects you. Sure, there are going to be major life events that bring unavoidable stress, but the idea is to make sure you have to tools to handle the day-to-day stressors so when the big one hits you've got some reserve to handle it.

Many of my patients are able to master their meditation routine and get amazing results using Muse. Muse is a personal meditation device that gently redirects a wandering mind back into a meditative state.


If my teenage self knew how little sleep my adult self would get, I'm certain I would have slept more then… ok, maybe not. But honestly, sleep is so crucial to our existence, yet so undervalued. And in some circles, it is even viewed as a burden. “I'll sleep when I'm dead.” Ever heard that one? Aim for 7-9 hours per night in a completely dark room (no electronics). It's ideal to avoid electronics 1-2 hours before bed. And if you can get those amazingly cool looking [sarcasm] blue light blocking glasses on a couple hours before bed, even better!

My husband also shared with me F.lux, which he uses on his computer to block blue light.

Avoid refined carbohydrates, sugar..and pretty much all the things you crave when you're tired.

Yes, they will give you a temporary quick fix in energy, but at the expense of your overall well being. Again, we want healthy, happy, stable blood sugar. Read more about the Sugar-Anxiety Connection.

Have Fun, often!

Yes, you read that right. Enjoying life isn't just a bonus— it's a necessary component to having incredible health. And there is a reason why the number one thing I prescribe is play. We forget how nourishing play is. And we forget how necessary play was as a child in helping us understand our world, ourselves and in helping us grow.

Adrenal Supplements

Once you've got a great foundation of diet and lifestyle therapies, consider bringing in supplements to assist you adrenals and the HPA system in healing.

Nutrients like B5, vitamin C, B6, and magnesium are tremendously beneficial for adrenal function.

Adapatogenic herbs support your adrenal glands in producing cortisol levels that benefit the body. Adaptogens help your body modulate healthy function and can take three months or more to notice their effect. 

In my practice, we use the Optimal Adrenal Kit, which contains a blend of adaptogenic herbs, minerals, vitamins and amino acids to provide comprehensive adrenal care.

The typical way my patients use the kit is…
☀️Adrenal Support 2 caps with breakfast 
☀️B Active Plus 1 cap with breakfast  
🌙Adrenal Calm 3 caps after dinner (we call this the “chill pill” in my clinic)

Is Adrenal Fatigue Real?

So is it wrong to say “Adrenal Fatigue?” I would say that technically speaking, the term doesn't explain the physiology correctly. But I would also say that I understand the concept you are trying to convey when you use the term adrenal fatigue. And isn't that the purpose— to communicate a complex concept simply?

And now you have a better understanding regarding why your doctor may tell you adrenal fatigue isn't real. The adrenal glands don't give out (although there are conditions where this can happen) and they aren't just tired, instead there is a disruption in the entire system that must be addressed.

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About The Author

Dr. Jolene Brighten

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Dr. Jolene Brighten, NMD, is a women’s hormone expert and prominent leader in women’s medicine. As a licensed naturopathic physician who is board certified in naturopathic endocrinology, she takes an integrative approach in her clinical practice. A fierce patient advocate and completely dedicated to uncovering the root cause of hormonal imbalances, Dr. Brighten empowers women worldwide to take control of their health and their hormones. She is the best selling author of Beyond the Pill and Healing Your Body Naturally After Childbirth. Dr. Brighten is an international speaker, clinical educator, medical advisor within the tech community, and considered a leading authority on women’s health. She is a member of the MindBodyGreen Collective and a faculty member for the American Academy of Anti Aging Medicine. Her work has been featured in the New York Post, Forbes, Cosmopolitan, Huffington Post, Bustle, The Guardian, Sports Illustrated, Elle, and ABC News. Read more about me here.