I know, I know, you’re not just tired, you’re wiped!  It’s a frequent complaint.  See THIS previous article on the major causes of fatigue.

The newest complaint we are hearing in the medical community is  ADRENAL FATIGUE.  Let’s be clear, there is no adrenal fatigue.  There is Addison’s Disease which is also known as Adrenal insufficiency and IS NOT adrenal fatigue.  In this case, fatigue is the least of your worries.  Let’s first have a look at the Adrenal gland and its function (in simple terms)

The Adrenal gland is chilling out on top of the kidneys (both of them), therefore we have two.  There are two major areas of the Adrenal Gland, the cortex and the medulla, which are made up of 4 zones, see figure 1:

Image result for Layers of adrenal gland

Now for their functions (figure 2): 

Image result for Layers of adrenal gland

As you can see, it’s a complex little organ (figure 2).   Aldosterone from the Zona Glomerulosa is responsible for Salt balance in the kidney as well blood pressure.  Cortisol from the Zona Fasciculata is a corticosteroid/stress hormone responsible for blood pressure control, stress responses and internal management of low blood sugar by inducing gluconeogenesis (a biochemical pathway for increasing blood sugars).  When used in medicine, it is a good anti-inflammatory and called Hydrocortisone (not to be confused with Cortisone which is a different corticosteroid).  Also, let’s not confuse this cortico-STEROID with illegal ANABOLIC steroids used for building muscle. Lastly, the zona reticularis produces dihydroepiandrosterone (DHEA) which is a precursor for Testosterone and masculinization.  See Figure 3 below for the biochemistry.  Since DHEA is essentially under the control from the pituitary, any extra we take in in the form of pills or injections (anabolic steroids or too much DHEA) can risk shutting the pituitary down and down-regulating its production (See Hypothalamic-Pituitary-Adrenal – Axis or HPA axis – Figure 4)

Image result for dehydroepiandrosterone
Image result for HPA axis

In the Medulla, the last part, is where catecholamines are produced (norepinephrine and epinephrine) – the major chemicals in the autonomic nervous system responsible our fight or flight response among many others- Refer back to figure 2.   

Some doctors believe this is a real diagnosis.  It’s no wonder that there isn’t a diagnostic code for it.  There are codes for burn due to water-skis on fire, initial encounter (V91.07XA) and being pecked by chicken (W6133XA), but not adrenal fatigue.  In medicine, people with true adrenal fatigue are called tired, or people that need to change their eating habits/lifestyle or people that require more sleep or need to take care of their mental health.  Adrenal fatigue is a hogwash diagnosis to scare and manipulate people into seeing a “specialist” or alternative medicine practitioner to sell their services, herbs or sham pills.  See OTHER SHAMS.

This should not be confused with ADDISON’S DISEASE / ADRENAL INSUFFICIENCY which is a serious and sometimes deadly diagnosis.

If you want to treat your Adrenal fatigue, check in with yourself, your food, your mental health and your eating habits.  Also, please see a doctor who can help tease out the real issue, starting with ruling out simple things like infection, anemia and thyroid issues.  

The public education arm of the Endocrine Society, representing 14,000 endocrinologists, recently issued the following advisory:

“Adrenal fatigue” is not a real medical condition. There are no scientific facts to support the theory that long-term mental, emotional, or physical stress drains the adrenal glands and causes many common symptoms.


These symptoms are real…THEY ARE VERY REAL!  They just aren’t caused by ADRENAL FATIGUE!




Dr. Mike









About the author

I am a Board Certified Family Practice Physician (MD) that has a passion for the proper treatment of patients. We are more than just our physical beings. We are complex and the current medical climate is failing both patients and physicians. As a new author, I feel passionately about letting everyone know how the system is failing us, moreover, how to overcome these barriers!

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Michael Lewis, MD
I am board certified in family medicine and passionate about caring for the whole patient: mind, body, spirit. I am married to a wonderful woman Jenniffer, who is a clinical psychologist and works right here in Willow Medical Center. I have a 7-year-old daughter, Bailey who is the light of my life. I am a soul searcher for myself and others. I also love to help men reach their potential as a conscious male. I am also a musician/guitarist. I have found that nurturing this part of my brain helps me think out of the proverbial box and provide better medicine.