A misnomer, derived from a misconception
The adrenal glands sit like caps, one above the upper pole of each kidney. They produce an extensive range of hormones, including the Neurosteroids, DHEA and Cortisol, which is said to be deficient in “Adrenal Fatigue” (a popular urban myth).
Diurnal Cortisol levels: the black dots represent results of testing saliva samples.
Results lying within the area in blue are normal.
“Adrenal Fatigue” (AF), a term invented in 1998 by Naturopath and Chiropractor, James Wilson, is a misnomer, derived from a misconception.
The misnomer
As the Wikipedia article says, “adrenal fatigue” is a pseudo-scientific term, applied to suggest that the adrenal glands are exhausted and unable to produce adequate quantities of hormones, primarily cortisol, due to chronic stress or infections. “Adrenal Fatigue” bears no relation to true adrenal insufficiency (Addison’s disease), in which, due to accident, pituitary failure or local disease, the adrenal glands fail to produce cortisol and aldosterone.
The misconception
The misconceived term,“Adrenal fatigue”, is based on the idea that cortisol, the “stress hormone”, is curative – that it has a positive effect in terms of healing and a direct, positive effect on alertness, mood, strength, motivation and fatigue.
The truth
The truth is precisely the reverse: Cortisol’s main action is to shut all metabolic systems down, not to stimulate, or actively heal them. Cortisol deters healing, reduces cognition, causes depression and generally interferes with normal brain function.
Further, via reduction of intracellular triiodothyronine availability, it has negative effects on all bodily functions. Therefore to attribute negative symptoms, such as fatigue, cognitive loss, reduced motivation and psychological depression, to insufficient cortisol supply is an obvious “oxymoron”.
The “clincher” is that if the alleged “adrenal fatigue symptoms” were due to reduced cortisol availability, administration of exogenous cortisol would be a therapeutic success: a quick perusal of articles on “AF” reveals no suggestion of corticoid therapy for adrenal fatigue.
A question:
is “adrenal fatigue” important enough to warrant a post in the “aging and your hormones” substack?
The answer:
Absolutely. The term is applied to ubiquitous symptoms: the sheer volume of citizens complaining of low-thyroid symptoms should command the full attention of the research community.
Less-than-scientific, profit-oriented “health info” websites
However the less-than-scientific, profit-oriented “health info” systems/websites, dedicated to AF, sidetrack the public’s energies, reducing the impact of stress-related fatigue symptoms on the medical system and thereby, inhibiting research on the subject.
In brief, the symptoms of adrenal fatigue, as described by those who believe in it, are mainly those of Intracellular Hypothyroidism (IH). As such, they are due to intracellular T3 starvation, which results from stress-related cortisol overproduction, not to the adrenals failing to produce enough cortisol.
So let’s recognize the misconception and get rid of the misnomer:
There is no such disease as “adrenal fatigue”.
Pathogenesis of chronic-stress-related fatigue
Protracted exhaustion may follow viral illnesses like influenza, Covid 19, Chickungunya, Dengue fever, West Nile fever, Lyme disease etc. and it even presents a problem in diabetes, heart failure, chronic infections such as tuberculosis, conditions such as lupus, Cancers, malignancies involving bone marrow infiltration, major surgery, severe physical injury or other conditions in which the body’s healing processes are severely taxed.
However a chronic fatigue, of varying degree, accompanies all stressful diseases and situations. In these situations, the fatigue is the result of stress-related hypercortisolemia, leading to cortisol-mediated suppression of intracellular T3 production and manifesting as the “low T3 syndrome”, or as I prefer to call it, “intracellular hypothyroidism”.
The Low T3 Syndrome
This is the situation in which the symptoms of LT3S, a symptomatically severe form of hypothyroidism, are interpreted by laypersons and poorly informed professionals as “adrenal fatigue”. Any condition in which fatigue is a significant factor should be investigated for the presence of intracellular hypothyroidism (IH), which is the true cause of the symptoms.
Intracellular Hypothyroidism
IH, a condition which accompanies all severe illnesses, chronic diseases and life-threatening conditions, results from chronic stress, even in the absence of identifiable disease. It is endemic in our modern, high-stress civilization and it produces symptoms which are identical with those attributed to “adrenal fatigue”.
IH is reliably diagnosable, via the (serum) T3/rT3 ratio and easily, safely treatable. For an explanation of the metabolic background, diagnostic tests and therapy,
(1) consult “Undiagnosed Hypothyroidism”, at SUBSTACK, or “Intracellular Hypothyroidism” at ResearchGate (the two articles are almost identical) and
(2) See “stress causes hypothyroidism”, which will tell you why chronic stress causes intracellular hypothyroidism.
Caveat
IH is also called “Low T3 Syndrome”, “Nonthyroidal Illness”, “Euthyroid Sick Syndrome”, and “Subclinical Hypothyroidism”: however I prefer my term, ”intracellular hypothyroidism” because it explains the pathophysiology of the condition accurately and succinctly.
Why is Mainstream Medicine missing the boat?
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