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Thread: "Adrenal fatigue does not exist"

  1. #1
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    "Adrenal fatigue does not exist"

    Perhaps the most over diagnosed - often self diagnosed - syndrome around. This is worth a read by anyone interested in the topic. It's quite a provocative title, and perhaps overly dismissive, but it's a good review that makes important points about what's often way over generalized term of "adrenal fatigue" that could in fact be due to something more serious or easy to fix. I knew a gal who was diagnosed with adrenal fatigue who suffered a few years with it. I told her repeatedly to get another opinion, and once she finally did, her issue was she was anemic and low in B12. Correcting those two issues, the "adrenal fatigue" vanished. Even if adrenal fatigue exists, few suffer it and the cause of their problem 99 out of 100 times, due to other causes the review covers:

    Adrenal fatigue does not exist: a systematic review
    BMC Endocr Disord. 2016; 16(1): 48.

    Abstract
    Background

    The term “adrenal fatigue” (“AF”) has been used by some doctors, healthcare providers, and the general media to describe an alleged condition caused by chronic exposure to stressful situations. Despite this, “AF” has not been recognized by any Endocrinology society, who claim there is no hard evidence for the existence. The aim of this systematic review is to verify whether there is substantiation for “AF”.

    Methods

    A systematic search was performed at PUBMED, MEDLINE (Ebsco) and Cochrane databases, from the beginning of the data until April 22nd, 2016. Searched key words were: “adrenal” + “fatigue”, “adrenal” + “burnout”, “adrenal” + “exhaustion”, “hypoadrenia”, “burnout” + “cortisol”, “fatigue” + “cortisol”, “clinical” + “burnout”, “cortisol” + “vitalility”, “adrenal” + “vitality”, and “cortisol” + “exhaustion”. Eligibility criteria were: (1) articles written in English, (2) cortisol profile and fatigue or energy status as the primary outcome, (3) performed tests for evaluating the adrenal axis, (4) absence of influence of corticosteroid therapy, and (5) absence of confounding diseases. Type of questionnaire to distinct fatigued subjects, population studied, tests performed of selected studies were analyzed.

    Results

    From 3,470 articles found, 58 studies fulfilled the criteria: 33 were carried in healthy individuals, and 25 in symptomatic patients. The most assessed exams were “Direct Awakening Cortisol” (n = 29), “Cortisol Awakening Response” (n = 27) and “Salivary Cortisol Rhythm” (n = 26).

    Discussion

    We found an almost systematic finding of conflicting results derived from most of the studies methods utilized, regardless of the validation and the quality of performed tests. Some limitations of the review include: (1) heterogeneity of the study design; (2) the descriptive nature of most studies; (3) the poor quality assessment of fatigue; (4) the use of an unsubstantiated methodology in terms of cortisol assessment (not endorsed by endocrinologists); (5) false premises leading to an incorrect sequence of research direction; and, (6) inappropriate/invalid conclusions regarding causality and association between different information.

    Conclusion

    This systematic review proves that there is no substantiation that “adrenal fatigue” is an actual medical condition. Therefore, adrenal fatigue is still a myth.

    Full Paper:

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4997656/
    - Will

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  2. #2
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    CBC and CMP would be the first order of business.

    How did her doc come up with "adrenal fatigue"? That's a Dx of exclusion AFAIK.

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    Quote Originally Posted by scooter22 View Post
    CBC and CMP would be the first order of business.

    How did her doc come up with "adrenal fatigue"? That's a Dx of exclusion AFAIK.
    No idea. I just rolled my eyes and said "get another opinion." I don't want to throw alternative docs under the bus here as there are some that are very competent and "traditional" docs don't have all the answers either, but in this case, I think too many alternative types have adopted that diagnosis without firm evidence.
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    Quote Originally Posted by WillBrink View Post
    Perhaps the most over diagnosed - often self diagnosed - syndrome around.
    Hmmmm....seriously? I confess I've never heard of it. It sounds to me very much like it belongs in the wastebasket of factitious disorders like "chronic fatigue syndrome", or "fibromyalgia", or "Dercum's Disease".

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    Quote Originally Posted by Hmac View Post
    Hmmmm....seriously? I confess I've never heard of it. It sounds to me very much like it belongs in the wastebasket of factitious disorders like "chronic fatigue syndrome", or "fibromyalgia", or "Dercum's Disease".
    Fibromyalgia is taught in med school, and tested on the boards.

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    Quote Originally Posted by Hmac View Post
    Hmmmm....seriously? I confess I've never heard of it. It sounds to me very much like it belongs in the wastebasket of factitious disorders like "chronic fatigue syndrome", or "fibromyalgia", or "Dercum's Disease".
    Pretty much yup. It's the current rage among poorly supported syndromes at the moment.
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  7. #7
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    Quote Originally Posted by scooter22 View Post
    Fibromyalgia is taught in med school, and tested on the boards.
    I heard fibromyalgia best described as "the pain of living". I agree with that. Working with it defines the concept "treatment of incurable disease". I'm going to go with factitious.


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    Last edited by Hmac; 03-15-17 at 19:55.

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