This past August the Hormone Foundation and Endocrine Society published and distributed their “Adrenal Fatigue Myth vs. Fact” sheet where they claim:
“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. There is no test that can detect adrenal fatigue. Supplements and vitamins made to “treat” adrenal fatigue may not be safe. Taking these supplements when you don’t need them can cause your adrenal glands to stop working and may put your life in danger.”
It is telling that they claim there is no scientific evidence to show that chronic stress affects adrenal function, yet their own article lacks a single scientific reference. Recall that in my blog in July, I discussed whether the name “Adrenal Fatigue” is a bit confusing considering that much of the phenomenon we see (mostly hypocortisolism) involves the whole HPA axis and may not reflect a tired adrenal gland per se. I asked Lena Edwards, M.D. (see bio below) to respond to some of the information from the Hormone Foundation’s “Fact” sheet.
Dr. Edwards’ response:
"Despite the extensive research that exists substantiating the effects of stressors/ chronic stress on human health and disease, there has been little recognition within the "traditional" medical community of such. I can vouch for this fact having learned little on this concept during my 12 years of medical training. Since the signs and symptoms of HPA axis dysfunction can be subtle and often fall outside the category of true "disease" (both physically and diagnostically), patients suffering from stress-related bodily disorders are often left to self-diagnose and self-treat without the knowledge, consent or approval from their medical health care provider.
There is absolutely no dispute within the medical literature (which spans almost 80 years) on the effects of both acute and chronic stress on aging, disease formation and early mortality. And though it is true the science does not validate the existence of primary adrenal gland failure independent of all other organ systems, the use of the term 'adrenal fatigue' has been beneficial in promoting the recognition of the relationship between stress and disease. Unfortunately, the use of this term has been detrimental in several respects. First of all, the adrenal glands are just one of many organs and structures involved in the stress response system, and, as members of a system, they cannotand do not act independently. To promote the adrenal gland as being an independently functioning, central component of the stress response system is not only inaccurate, but also diminishes the true complexity of the neuroendocrinological system.
My clinical experience concurs with what has already been proven ... namely that stressors (whether internal or external) can promote and propagate physical and emotional dysfunction and disease. However, as scientists practicing evidence-based medicine, we should promote the use of more appropriate and scientific terminology such as "HPA axis dysfunction", "hypocortisolism" and "adrenal dysfunction". Not only will this more accurately describe the true pathophysiological processes behind stress and disease, but perhaps it will also legitimize this issue within the eyes of the traditional medical community.
Unfortunately, as the tug of war in terminology persists, it is the patients who are paying the price physically, emotionally and financially.”
Lena Edwards, M.D. is board certified in Internal Medicine and is a graduate of the Fellowship in Anti-Aging and Regenerative Medicine. She has spent a considerable amount of time studying the impact of stress and HPA axis dysfunction on chronic clinical disease management. Her website is http://www.balancehealthandwellness.com