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Is Adrenal Fatigue Real?

  • Alternative Medicine calls it Adrenal Fatigue.
  • Conventional Medicine has other names for it ... several names.

Regardless of the name used for the condition, Chronic stress eventually leads to extreme fatigue and illness.

Even conventional medicine recognizes this, although it is poorly understood by almost all doctors.

So people are usually given several prescriptions to treat specific symptoms, without getting to the root cause.

Something for anxiety disorder, something for depression, something for insomnia, something for libido, etc.

Except for mild cases of adrenal fatigue, these prescriptions usually don't help very much. They might reduce a few symptoms, while many many others remain.

And if you complain too much about those other symptoms, it will be implied that it is all in your head, and you will likely be referred to a therapist.

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Goal #1 of this article is to show evidence within conventional medicine indicating that chronic stress eventually leads to exhaustion and illness.

Goal #2 of this article is to show that there are multiple names for this condition. Chronic stress is implicated in all of them.

Adrenal Fatigue is simply an alternate name for the condition called the General Adaptation Syndrome (GAS).

But .... there are also other labels given to chronic exhaustion and illness that results from chronic stress. Also, the symptoms of these other conditions are all the same.

Stress and Sickness

Before we get into the various labels applied to end result, let's take a look at just how damaging excessive stress is.

A 10-year study found that stress is so damaging to your body, it is more likely to cause cancer than smoking.16. You read that correctly... a relaxed smoker is less likely to get cancer than someone prone to stress.

Then there is the work of psychiatrists Dr. Thomas Holmes and Dr. Richard Rahe. In the 1960s, they completed research on the impact of various life events.

They developed the Holmes and Rahe stress scale, which rates various life events, such as:

  • Death of a spouse
  • Fired from work
  • Your kids moving away
  • Pregnancy
  • Change in residence
  • etc

Each event was assigned a value, with the death of a spouse being ranked the highest, at 100 points.

They found that when people reached a certain level of points, they had a high probability of becoming physically ill.

See the following article about the Holmes and Rahe stress scale, which was published in Canadian Family Physician in 1983: Life Stress and Illness (pdf).

Holmes and Rahe found that stressors are cumulative. The more events you are exposed to, the more likely it is you will become ill.

This matches perfectly the findings of the General Adaptations Syndrome. The more stressors the rats were exposed to, the quicker they advanced to the stage called Exhaustion.

One may argue over what name to use for the end result.
However, there is plenty of evidence that chronic stress leads to illness.

Multiples Names.... Same Condition

  • There are multiple names for Chronic Stress induced illness

Adrenal Fatigue is real, but accepted even less than other labels for stress induced illness.

Adrenal Fatigue is a term used mostly by Naturopathic Doctors and others in alternative medicine.

This article makes the case that chronic stress is the root cause of the following:

  • General Adaptation Syndrome (chronic stress condition discovered in the 1930's).
    Note: This is the one Adrenal Fatigue is based on
  • Chronic Fatigue Syndrome (defined by the CDC in 1988)
  • Burnout Syndrome (a term that first appears on Pubmed.com in 1982)
  • Adrenal Fatigue (Term used in alternative medicine since late 1990s. Book published in 2000)
  • Neurasthenia (introduced into psychiatry in 1869 by G. M. Beard, an American neurologist, but dropped from the Diagnostic and Statistical Manual (DSM) in 1980)
  • Post Traumatic Stress Disorder (PTSD). Added to the DSM in 1980, the same year that Neurasthenia was dropped.

This article will first cover how the name Adrenal Fatigue is based on the General Adaptation Syndrome.

Then we'll cover the other names (past and present) given to end result of chronic stress.

General Adaptation Syndrome

  • Adrenal Fatigue is based on the General Adaptation Syndrome

In conventional medicine textbooks, there is a section describing the General Adaptation Syndrome, which was discovered by Dr. Hans Selye in the 1930's.

Dr. Seyle conducted years of stress research on rats. He showed that regardless of the source of stress, the animals went through 3 stages, the last of which is exhaustion.

The 3rd stage of the General Adaptation Syndrome is actually called Exhaustion.

Here is an article from the Journal of Neuropsychiatry, discussing his research:
Hans Selye and the Field of Stress Research (pdf)

The following table provides a summary of the 3 stages. Regardless of the source of stress, the rats went through these stages.

Stage Name Description
Alarm
(Stage 1)

After the initial shock of stress, the rats had a lower than normal resistance to stress. The had not yet built up a tolerance for stress.

Adaptation or Resistance
(Stage 2)

Adrenals enlarge. Resistance to stress is above average. Animals have adapted and have increased adrenal output.

Exhaustion
(Stage 3)

Animals lose their enhanced resistance to stress and once again have a lower than normal resistance to stress

Excessive cold, excessive heat, excessive exercise, exposure to toxins, etc. The source of the stress did not matter, the end result was the same.

The stressors were also cumulative. If the rats were exposed to multiple chronic stressors at the same time, the moved through the stages more quickly.

The General Adaptation Syndrome is real, and still included in conventional medicine textbooks.

The following quote from his 1978 book, The Stress of Life describes what he observed with the adrenal glands.

  ...if an animal is continuously exposed to some stressor (say, cold), the adrenal cortex first discharges all of its microscopic fat granules which contain the cortical hormones (alarm reaction), then it becomes laden with an unusually large number of fat droplets (stage of resistance) and finally loses them again (stage of exhaustion)17.

That certainly sounds like something one might label as Adrenal Fatigue.

New Name for General Adaptation Syndrome

The first place I have been able to find the term Adrenal Fatigue was in the 1995 book Adrenaline and Stress, by Dr. Archibald Hart. He used the term once in the book. He also mentions the General Adaptation Syndrome in his book.



Best book to start with if you want to learn about Adrenal Fatigue.

But the term Adrenal Fatigue really started to come into use after the 2001 book by Dr. James Wilson, a Naturopathic Doctor.

In his book, Dr Wilson also covers the research of Dr. Selye. It is unfortunate and confusing that he created a new name for the General Adaptation Syndrome.

Yes ... his book connected the dots between humans and the General Adaptation Syndrome (tests performed on rodents in 1930s), and he did improve awareness. But the new name makes it seem like a made up condition.

When you hear about the Stages of Adrenal Fatigue, they are the same stages as the General Adaptation Syndrome.

If you compare the names of the stages between Adrenal Fatigue and the General Adaptation Syndrome, they are the same.

The General Adaptation Syndrome is real, which makes adrenal fatigue real since it is simply an alternate name for the syndrome.

Burnout Syndrome

  • Burnout Syndrome sounds a lot like Adrenal Fatigue

The term Burnout is showing up more and more in research and articles. When you read through the research, it sure sounds like adrenal fatigue.

Oddly enough, much of the research and concern related to Burnout pertains to the effect of chronic stress of Physicians and other health care workers9,10.

An 2014 article published on Pubmed.com states the following:

  Burnout is a common syndrome seen in healthcare workers, particularly physicians who are exposed to a high level of stress at work 9

So Conventional Medicine does not believe adrenal fatigue is real ..... but they are concerned about Burnout Syndrome in doctors? .....Sigh.

The article Burnout Syndrome vs Adrenal Fatigue connects the dots between the two conditions.

Chronic Fatigue

The first mention of the term Chronic Fatigue Syndrome on Pubmed.com is a 1957 article. In 1988, the CDC finally published a case definition for Chronic Fatigue Syndrome (CFS)11.

It was basically a list of symptoms that are needed in order to give a diagnosis of CFS. Although the root cause has not been agreed upon.

The article Causes of Chronic Fatigue makes the case that CFS is caused by chronic stress, just like Adrenal Fatigue.

Adrenal Fatigue is as real and CFS, and they are both connected to chronic stress.

For a symptom comparison, please see the article Chronic Fatigue Symptoms. People researching Adrenal Fatigue report the exact same symptoms as CFS, and at nearly the same frequency.

PTSD and Stress

    PTSD is more than a psychological issue.

Unfortunately, many still believe the Post Traumatic Stress Disorder is all in your head. i.e.... it is simple reliving the trauma in your mind.

But PTSD is real. There are differences in physiology that can be measured.

Not everyone exposed to trauma gets PTSD. Why? Because total stress load is a factor.

Total stress load shows up in the Holmes and Rahe stress scale, the General Adaptation Syndrome, and PTSD.

The article PTSD vs Adrenal Fatigue connects the dots.

Neurasthenia

In 1869, the term Neurasthenia was introduced by the American neurologist George Miller Beard. It was thought to be a physical problem, and not a psychological problem.

See the article: Neurasthenia vs Adrenal Fatigue for more info.

Neurasthenia eventually fell out of favor as theories emerged that it was a Psychogenic or Psychosomatic disease, meaning it was all in the head of the individual.

In 1980, it was finally removed from the Diagnostic and Statistical Manual of Mental Disorders (DSM), but had not been used much since the 1920's.

Note: During the same period that Neurasthenia was a popular diagnosis, women were often given a diagnosis of Female Hysteria.

Summary

Adrenal Fatigue is as real as the other names for chronic stress syndrome.

Unfortunately, many doctors believe all of these conditions come from your mind.

In his book about the General Adaptation Syndrome, The Stress of Life , Dr. Selye placed the following quote:

  Not only will men of science have to grapple the sciences that deal with man - and this is a far more difficult matter - they will have to persuade the world to listen to what they have discovered.
Betrand Russell, 1872 - 1970

The General Adaptation Syndrome faces a similar problem as Neurasthnia, which is an unwillingness to accept that chronic stress can create so many real physical problems and symptoms.

So doctors focus on psychological symptoms, without getting to root cause of the syndrome.


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References

1. Stress-induced hypocortisolemia diagnosed as psychiatric disorders responsive to hydrocortisone replacement
2. The psychobiology of burnout: are there two different syndromes
3. Burnout, anxiety, depression, and social skills in medical residents
4. Life Stress and Illness: A Systems Approach
5. Stress-induced hypocortisolemia diagnosed as psychiatric disorders responsive to hydrocortisone replacement.
6. www.psychologytoday.com: The Tell Tale Signs of Burnout ... Do You Have Them?
7. Acute cortisol administration reduces subjective fatigue in healthy women.
8. The morning salivary cortisol response in burnout
9. Burnout among physicians
10. Preventing occupational stress in healthcare workers
11. Chronic fatigue syndrome: a working case definition
12. Media exposure and sympathetic nervous system reactivity predict ptsd symptoms after the Boston marathon bombings
13. Childhood trauma and risk for chronic fatigue syndrome: association with neuroendocrine dysfunction
14. Childhood Abuse is Associated with Increased Startle Reactivity in Adulthood
15. Amygdala response to negative stimuli predicts PTSD symptom onset following a terrorist attack
16. Personality, stress and cancer: prediction and prophylaxis
17. Hans Selye. 1978. The Stress of Life

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