Eric Bakker N.D.May 15, 2022

These are the most commonly asked questions about adrenal fatigue.


Most Frequently Asked Adrenal Fatigue Questions

Here is a list of the most commonly asked questions about adrenal fatigue. I have tried to answer them all on one page. Please contact me if you have a question and it is not on this page, I’ll gladly answer your question, Eric.

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What is Adrenal Fatigue?

Adrenal Fatigue is a syndrome (a related group of sings and symptoms) that results when the adrenal glands function below the necessary level, usually because of intense, prolonged or repeated stress.  As its name suggests, the chief symptom is fatigue unrelieved by sleep.  However, Adrenal Fatigue is not a readily identifiable entity like measles or allergies.  Its severity can range from a general sense of tiredness, without obvious signs of physical illness, to difficulty getting out of bed for more than a few hours a day.  With each increment of reduction in adrenal function, every organ and system in the body is more profoundly affected.  Changes occur in carbohydrate, protein and fat metabolism; fluid and electrolyte balance; immune, cardiovascular and nervous system function; and even in libido.  Numerous other alterations take place at the biochemical and cellular levels.  This syndrome has been known by many other names throughout the past century, such as non-Addison’s hypo-adrenia, a sub-clinical hypo-adrenia, neurasthenia, adrenal neurasthenia, adrenal apathy and adrenal fatigue.  Although it affects millions of people in New Zealand, Australia and around the world, conventional medicine does not yet recognise it as a distinct, treatable syndrome.

Who gets Adrenal Fatigue?

Anyone from birth to old age and from any race or culture can suffer from Adrenal Fatigue.  People vary greatly in their ability to respond and withstand stress.  An illness, a life crisis or a continuing difficult situation can drain the adrenal resources of even the healthiest person.  However there are certain factors that increase susceptibility to Adrenal Fatigue.  These include poor diet; substance abuse; too little sleep and rest; too many social, emotional or physical pressures; serious or repeated injury; chronic illness;  repeated infections such as bronchitis or pneumonia; allergies; exposure to a toxic environment; and a mother with Adrenal Fatigue during gestation and birth.  Unfortunately many of these factors are common in modern life.

What causes Adrenal Fatigue?

The adrenal glands mobilise the body’s response to every kind of physical, emotional and psychological stress through hormones that regulate energy production and storage, heart rate, muscle tone, immune function and other processes that deal with stress.  Adrenal Fatigue is produced when the output of regulatory adrenal  hormones is diminished through over-stimulation of the adrenals by severe, chronic or repeated stress, or because of adrenals weakened by poor nutrition, congenital factors or other causes.  In Adrenal Fatigue the adrenal glands function, but not well enough to adequately meet the demands of stress and maintain normal, healthy homeostasis.  The causes of Adrenal Fatigue usually stem from one of four common sources that overwhelm the glands:

1)    Disease states such as severe or recurrent pneumonia, bronchitis or flu, cancer, AIDS, auto-immune and other illnesses.

2)    Physical stress such as surgery, poor nutrition, addiction, injury, and exhaustion.

3)    Emotional/psychological stress from relationships, work or other unavoidable life situations

4)    Continual and/or severe environmental stress from toxic chemicals and pollutants in the air, water, clothing or food.

What are the symptoms of Adrenal Fatigue?

Some of the most common symptoms of Adrenal Fatigue are regular experience of:

1)    Early morning fatigue & difficulty getting up in the morning, even after a full night’s sleep

2)    Tiredness, especially in the early morning and mid afternoon.

3)    Symptoms of hypoglycemia

4)    Feeling rundown or overwhelmed

5)    Difficulty bouncing back from stress or illness

6)    Cravings for salty and/or sweet snacks

7)    Feeling best after 6 PM

Is Adrenal Fatigue common?

Yes, Adrenal Fatigue is a very common disorder, estimated to affect many millions of people worldwide at some point in their lives. The problem is that it is not recognised as a syndrome (just like chronic fatigue has been for many years, with many doctors still being skeptical of its existence) in its own right, leaving the patient wandering from doctor to doctor only receiving symptomatic treatment for insomnia, depression, anxiety and a host of other complaints.

Where are the adrenal glands?

The adrenal glands are two small glands, about the size of large grapes, which sit over the kidneys.  They are located towards the back of the body, near the bottom of the ribs on each side of the spine.

How do doctors diagnose Adrenal Fatigue?

Most medical doctors are not aware of Adrenal Fatigue.  They only recognise Addison’s disease, which is the most extreme end of low adrenal function.  Astute doctors who are familiar with the varying degrees of decreased adrenal function usually test the adrenal hormone levels in the saliva. This is an accurate and useful indicator of Adrenal Fatigue. There are other common lab tests that can be used more indirectly to detect Adrenal Fatigue, but the majority of medical doctors do not know how to interpret these tests for indications of Adrenal Fatigue.

Are there laboratory tests that detect Adrenal Fatigue?

Yes. The most accurate and valuable test for detecting Adrenal Fatigue is a saliva adrenal hormone test for cortisol.  This is a simple and relatively inexpensive test that has recently become available from a few labs in the United States, England, Australia and New Zealand. .  A kit can be obtained from your health care practitioner and the test completed at home by simply producing saliva and spitting into the test tubes 4 times throughout a 24 hour day.  There are some other lab tests but they need special interpretation by practitioners to recognise and treat Adrenal Fatigue.

Can people recover from Adrenal Fatigue?

Although Adrenal Fatigue may only last a short while, especially if it was caused by one transient stressful event, it can debilitating and last for many years – even a lifetime – without proper treatment. However, with proper treatment, most people can fully recover from Adrenal Fatigue.

Can children have Adrenal Fatigue?

Yes, children are susceptible to the same causative factors for Adrenal Fatigue as adults.  Children whose mothers had Adrenal Fatigue during their gestation and/or birth are especially vulnerable to lowered adrenal function.  These children are often more sickly, have less ability to handle stressful situations, and take longer to recover from illnesses.  However, they too can greatly benefit from proper adrenal support and healthy lifestyle choices. I have often see adolescents and young adults in the clinic with post-viral fatigue syndromes along with Adrenal Fatigue.

Is age a factor in Adrenal Fatigue?

People can suffer from Adrenal Fatigue at any age but both the very young and the very old are more vulnerable to stress and therefore Adrenal Fatigue.

How often do bouts of Adrenal Fatigue occur?

Frequency of occurrence varies with each person.  Some people have only 1 episode of Adrenal Fatigue during their lifetime, some have several, and others experience chronic Adrenal Fatigue from which they never recover.  Whether the Adrenal Fatigue is infrequent, or chronic, proper adrenal support will make all the difference.

Can Adrenal Fatigue become chronic?

Yes, in some people the adrenal glands do not return to normal levels of function without help, either because the stress was too great or too prolonged, or because their general health is poor.  However, when Adrenal Fatigue becomes chronic, it is almost always because of factors that can be changed through modifications in lifestyle and proper adrenal support.

How likely it is that Adrenal Fatigue will get worse or result in Addison’s disease?

Proper adrenal support using special adrenal dietary supplements is very effective and greatly decreases the likelihood that Adrenal Fatigue will worsen or progress to the extreme of Addison’s.  Approximately 70% of Addison’s disease cases are actually an auto-immune disease.  The rest (about 30%) are called idiopathic (no known cause) but can be precipitated by events in people’s lives that severely impair adrenal function.  Within this 30%, each factor that protects the adrenals, healthy lifestyle, food choices, exercises, attitudes, stress management and supplemental adrenal support has a tremendous impact on whether Adrenal Fatigue progresses to recovery or collapse.

What keeps the adrenal glands healthy?

The guidelines for keeping the adrenal glands healthy are very similar to the overall principles of good health.  A moderate lifestyle with good quality food, regular exercise and adequate rest, combined with a healthy mental attitude to the stresses of life goes a long way towards keeping the adrenal glands strong and resilient.  However, because modern life is so stressful, certain nutritional supplements specially designed for adrenal support are also important to both maintaining healthy adrenal glands and helping depleted adrenal glands to recover.

What can someone do to prevent Adrenal Fatigue?

During any illness dramatically increase intake of Vitamin C, bioflavonoids, magnesium and pantothenic acid or, better yet, use dietary supplements designed for adrenal support.  After an illness, do not try to hit the floor running.  Instead take an extra day off work in order to rejuvenate.  If there is lingering tiredness after an illness, emotional shock or other event that produces Adrenal Fatigue, sleep in late, be especially conscious of eating high quality foods, and avoid caffeine and alcohol.  In addition, saunas can be great for detoxifying and unwinding, thus lessening the stress load on the adrenals.

Is there a genetic predisposition towards Adrenal Fatigue?

It is not known if there is an actual genetic predisposition for Adrenal Fatigue.  However, if one or both parents suffer from Adrenal Fatigue, either chronically or during the time of conception, and if the mother has Adrenal Fatigue during gestation, there is a grater than 50% chance that their children will also suffer from Adrenal Fatigue.  This may be seen as a child with a weak constitution, early allergies, a propensity towards lung infections, a decreased ability to handle stress and longer recovery times after illnesses.  Although these children will never have exceptionally strong adrenal glands, much can be done to help them recover by the use of proper adrenal support and healthy lifestyle choices.

Is Adrenal Fatigue related to other health conditions?

The processes that take place in any chronic disease, from arthritis to cancer, places demands on your adrenals.  Therefore, as a general rule, if morning fatigue is a symptom of the chronic disease, the adrenals are likely fatigued to some degree.  Also anytime a medical treatment includes the use of corticosteroids, diminished adrenal function is most likely present.  All corticosteroids are designed to imitate the actions of cortisol, a hormone secreted by the adrenals, and so the need for them arises primarily when the adrenals are not providing the required amounts of cortisol.

Is Adrenal Fatigue common in someone with cancer who is going through chemotherapy?

The extreme fatigue of cancer and any other chronic illnesses is often the result of decreased adrenal function.  Chronic illness and toxic treatments like chemotherapy are major stressors that the adrenals must respond to.  In addition, because of the side effects of chemotherapy, and sometimes the cancer itself, nutrient consumption and absorption is often decreased, further impairing adrenal function.  It is very important to provide adrenal support during this time.

Does Adrenal Fatigue increase susceptibility to infections?

Adrenal Fatigue often goes hand in hand with decreased immune function, which makes someone more prone to illnesses.  There is an especially strong association between Adrenal Fatigue and respiratory infections, such as bronchitis and pneumonia.

Does Adrenal Fatigue affect the thyroid gland?

Approximately 80% of the people suffering from Adrenal Fatigue also suffer some form of decreased thyroid function.  People shown to be low thyroid but unresponsive to thyroid therapy are most likely suffering from Adrenal Fatigue as well.  For these people to get well, the adrenals must be supported in addition to the thyroid.

Is Adrenal Fatigue related to fibromyalgia?

Most people with fibromyalgia have a form of Adrenal Fatigue and sometimes the Adrenal Fatigue precedes the fibromyalgia.  Many studies show that people with fibromyalgia also have reduced levels of the adrenal hormone, cortisol. Proper adrenal support improves adrenal function, including the production of cortisol. The subsequent higher levels of cortisol result in reduced signs and symptoms of fibromyalgia. Fibromyalgia and Hypothyroidism are linked.

Is Adrenal Fatigue linked to clinical depression?

It can be; a mild depression is often one of the symptoms of Adrenal Fatigue.  A saliva test for adrenal hormones will determine whether the adrenals are involved when depression occurs. If the test indicates adrenal involvement, proper adrenal support will help eliminate the depression.

Is Adrenal Fatigue related to chronic fatigue syndrome?

Adrenal Fatigue is a common, but usually unrecognised, component of chronic fatigue syndrome (CFS).  The adrenals can become overloaded with the lingering effects of the infectious agents that originally led to the CFS and the stress of the illness itself.  With new diagnostic procedures available for detecting the specific infectious agents responsible, there have been encouraging results using a combination treatment that eliminates the specific pathogens while strengthening the adrenals.

Is Adrenal Fatigue a factor in people with HIV or Hepatitis C?

Adrenal Fatigue is a common factor in people with Hepatitis C and HIV.  Unfortunately one of the treatments for Hepatitis C is the administration of corticosteroid drugs. This suppresses both the adrenals and the immune system, thus speeding the patient’s decline. A relationship has been demonstrated between survival of HIV infected patients and their levels of the adrenal hormone, cortisol.  In both Hepatitis C and HIV, adequate adrenal support can be of significant benefit.

Does Adrenal Fatigue cause or increase allergies?

It has been long observed that people suffering from Adrenal Fatigue definitely have greater allergic responses or become allergic to things that previously did not bother them. This is because cortisol, the major adrenal hormone, is the most powerful anti-inflammatory substance in the body. When the adrenals fatigue, cortisol levels drop and make it more likely that the body will have allergic (inflammatory) reactions and that these reactions will be more severe. It is therefore essential for allergic individuals to receive proper adrenal support regardless of what other allergy treatment they try.

Can Adrenal Fatigue affect my sex life?

Yes, a common complaint from both men and women suffering from Adrenal Fatigue is decreased sex drive.  This is because the sex hormones are manufactured by the adrenal glands, as well as by the sex organs themselves.  Low adrenal function can lead to low sexual performance and/or low desire.  If this diminished libido is the result of Adrenal Fatigue, proper adrenal support that results in adrenal recovery will usually restore sexual desire and performance as well.

Can Adrenal Fatigue affect a woman’s menstrual cycles?

Adrenal Fatigue can negatively affect many aspects of a woman’s hormone cycles, including menstrual flow, PMS, peri-menopause and menopause.

Does pregnancy set off Adrenal Fatigue?

No, usually pregnancy decreases Adrenal Fatigue because the fetus produces a greater amount of natural adrenal hormones than the amount in the non-pregnant female.  However, if the pregnancy is very stressful, it can lead to or increase Adrenal Fatigue.

Are there any pre-surgery precautions that will protect the adrenal glands?

Eat only high quality foods, especially good quality proteins and lots of dark green vegetables.  Also use self-hypnosis, visualisation and/or relaxation methods to remain mentally and emotionally calm and positive throughout the procedure, and to heal more quickly afterwards.  These measures will help protect the adrenal glands from the stresses of surgery.

Are prescription drugs necessary to treat Adrenal Fatigue?

No, most cases of Adrenal Fatigue can be remedied without prescription drugs.  The treatments combined with specialised dietary supplements created for Adrenal Fatigue are natural, relatively inexpensive and very effective.  The have been used by many aware physicians and those with Adrenal Fatigue themselves for recovery.

If a doctor says there is no such illness as Adrenal Fatigue, what options do patients have?

Unfortunately, this is the view of many conventional doctors, but they are not as well informed as they believe.  Adrenal Fatigue was first diagnosed over 100 years ago and has been successfully treated for decades.  However, for various reasons the medical community has ignored the existence of Adrenal Fatigue syndrome over the past 40 years.   It may also help to switch to a doctor who is familiar with Adrenal Fatigue syndrome.

Does smoking increase susceptibility to Adrenal Fatigue?

Yes, smoking is a chronic stress on the body that makes it more difficult for the adrenals to function. Smoking, by itself, does not lead directly to Adrenal Fatigue unless the adrenals are already weak, however, smoking is one of the body burdens that accelerate Adrenal Fatigue and prevent complete recovery from occurring.

Does diet have anything to do with Adrenal Fatigue?

Yes, diet plays a critical role in Adrenal Fatigue.  The phrase “garbage in, garbage out” aptly describes the relationship between poor diet and Adrenal Fatigue. A nutritionally inadequate diet that is high in sugar, caffeine and junk food places daily stress on the body that the adrenal glands have to respond to and , at the same time, deprives the adrenals of the nutrients they need to function.  This alone can lead to Adrenal Fatigue or make the body more vulnerable to Adrenal Fatigue when any additional stress is added.  Similarly, good nutrition helps protect and sustain adrenal function during stress. You may find the article Eating For Fatigue useful.  When Adrenal Fatigue is already present, a healthy diet that supports adrenal function combined with adrenal supplements can lead to recovery.

Are athletes or very fit people as susceptible as others to Adrenal Fatigue?

Athletes and very fit people can suffer from Adrenal Fatigue under certain circumstances. If they push themselves too hard, skip meals, take drugs (e.g. steroidal drugs), and have a lifestyle that is otherwise not conducive to their health, they can lead themselves into Adrenal Fatigue, the same as anyone else. Relentlessly pushing themselves, as some athletes do, is also a significant risk factor.  Additional factors, such as severe injuries, illnesses and emotional stresses can debilitate the adrenal glands of anyone, including athletes. Just because someone is an athlete does not necessarily mean they are in excellent health. The better overall health someone has, the less they will experience Adrenal Fatigue.

Is someone who cannot exercise because they are disabled at greater risk for Adrenal Fatigue?

Not necessarily, there are a variety of factors in addition to exercise that influence adrenal resiliency. It all depends on how many things are stacked in favour of health. anyone, including those with disabilities, can strengthen their adrenal glands.

Are New Zealanders and Australians more prone to Adrenal Fatigue than people from other nations?

Despite a relative abundance of resources, New Zealanders and Australians (just like people living in the USA and the UK) have increased their likelihood of suffering from Adrenal Fatigue because of their hectic lifestyle, poor food choices, lack of exercise, and drug, alcohol and caffeine consumption.

People of less wealthy nations may be subject to other factors that are individually worse than those New Zealanders and Australians experience, but their overall lifestyle, less processed diets and better family or social structures help counter-balance these.

Does Adrenal Fatigue cause ankle swelling after a long day of standing?

There are many causes of ankle swelling, but one of the causes is Adrenal Fatigue.  Your ankle swelling is more likely related to it if you have many other signs of Adrenal Fatigue.

Does anyone get through life without Adrenal Fatigue or Adrenal Fatigue problems?

Many people go through life with only a temporary decrease in adrenal function after an infection, the death of a loved one, loss of a job or other severe stress, because their adrenals are able to bounce back and recover.  However, these are usually people who are born with good constitutions and who look after their health as well.

What is the difference between Adrenal Fatigue and hypoadrenia?

Hypo-adrenia, as it is used in the medical sense, refers to adrenal failure or the extremely low adrenal function which is called Addison’s disease.  Although hypo-adrenia, in actuality, occurs in a spectrum ranging from almost normal to Addison’s , only the most extreme low end is recognised and called hypo-adrenia in medicine.  The less severe forms of hypo-adrenia are now referred to as Adrenal Fatigue.

Discussion (3 comments)

  1. Hello Eric,
    I am suffering from adrenal fatigue with high cortisol, I recently completed a Dutch Test. I also have high thyroid antibodies (102 on most recent blood test). I tested positive for Candida in 2021. I have very bad anxiety with depression. I was taking Physica HPA Axis LF for adrenal support for about two months, but found my anxiety was heightened, so my naturopath switched me to NFH Adrenal SAP. I just began taking it this week and I’m finding it makes my stomach burn.
    I am gluten free, dairy free, refined sugar free, alcohol free and caffeine free. My diet consists mainly of chicken, beef, vegetables, brown rice and fruit and I drink lots of filtered water and herbal teas. I am constantly EXHAUSTED. I can only stay awake for a few hours at a time. I have had to begin working from home and no longer leave my house very often.
    I would love to hear any suggestions you may have.
    Best regards,

  2. Hello Eric!
    I found out your article just now!
    I am probably going through a second episode of adrenal fatigue and been diagnosed a few month ago with deep endometriosis (I already have an auto immune desease with all the thyroid antidodies one could dream of…).
    Could adrenal fatigue contribute to endometriosis, as it leads to inflammation?
    Thanks for your coming answer and greetings from France!

    1. Bonjour! Yes, adrenal fatigue can certainly contribute as it will render your immune system quite weak, making it harder to fight any infection. Make sure you eat well, look at my article on eating for fatigue. Take B vitamins, and plenty of Vitamin C. Not any vin though, plenty of that stuff in France.

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