Medically Reviewed by Larry Siegel, APRN

Adrenal fatigue is not a recognized medical condition. The Endocrine Society makes it clear: there is no test for it. And a systematic review of thousands of cases reached the same conclusion — adrenal fatigue does not exist.

Your symptoms, though, are real.

Chronic fatigue, sugar cravings, brain fog, sleep disruption, and stress crashes show that your body is under strain. These patterns often point to underlying conditions or to a lifestyle that has driven your system past its limits.

This article breaks down what adrenal fatigue really means, why it isn’t a diagnosis, which conditions can look the same, and what steps actually move you toward recovery.

What Is “Adrenal Fatigue”?

Adrenal fatigue is a term that grew out of alternative medicine. It’s used to explain symptoms like exhaustion, brain fog, sugar or salt cravings, and stress crashes.

The theory is that long-term stress wears down the adrenal glands until they can’t keep up. (In reality, your adrenals don’t get tired — they ramp up to handle stress.)

The problem is that research doesn’t support this.

Even a meta-analysis that reviewed 3,470 articles and 58 studies summed up its findings in its title: “Adrenal fatigue does not exist.”

That’s different from adrenal insufficiency.

Adrenal fatigue, sometimes called adrenal exhaustion, is not recognized as a medical diagnosis. Adrenal insufficiency, on the other hand, is a serious disorder where the adrenal glands stop producing enough hormones. It comes with clear signs, like low blood pressure, unplanned weight loss, electrolyte changes, and even risk of adrenal crisis, and it requires urgent treatment.

Adrenal fatigue isn’t a real diagnosis, but the symptoms people describe are.

What Are the Symptoms of “Adrenal Fatigue”?

People who identify with adrenal fatigue often describe a familiar set of symptoms:

exhaustion that doesn’t improve with rest
brain fog, low motivation, and mood changes
sugar or salt cravings, sometimes with dizziness when standing up
disrupted sleep and heavy reliance on caffeine.

You may truly be dealing with some or all of these symptoms, but they aren’t specific to adrenal fatigue. They can come from many different conditions, which is why the next step is not to settle on a label but to work with a doctor who can sort through the possibilities and test for real causes.

What Are the Causes of “Adrenal Fatigue”?

The symptoms often linked to adrenal fatigue may come from stress biology and from conditions that can look almost identical on the surface.

Chronic stress and circadian disruption are common drivers. When sleep schedules are irregular or the body stays in a fight-or-flight mode too long, energy systems break down.

Several medical conditions overlap with the same complaints:

thyroid dysfunction
anemia or iron deficiency
sleep apnea
perimenopause or other hormonal shifts
depression or anxiety

Lifestyle can add another layer. Inconsistent sleep, too much caffeine, skipped meals, or diets heavy in sugar all magnify fatigue and stress crashes.

The label “adrenal fatigue” may not stand, but the symptoms point to biology that needs a closer look.

How Do You Test for “Adrenal Fatigue”?

There is no medical test for adrenal fatigue. Saliva kits and online panels claim to measure it, but they aren’t validated and often give misleading results.

If you’re struggling with fatigue, the most useful step is a doctor-led workup.

It may include checking thyroid function, blood counts, iron, vitamin levels, sleep patterns, and other causes that commonly explain the same symptoms.

I’m Feeling Fatigued. What Should I Do?

Start by partnering with a clinician who will take your symptoms seriously and look for real causes. The workup usually begins with basics that match your story:

thyroid panel
complete blood count and ferritin
metabolic panel and glucose markers
vitamin B12 and vitamin D
medication review
sleep apnea screening if symptoms point that way
orthostatic vitals to check blood pressure changes
adrenal testing only if there are red flags for insufficiency

A good plan includes a short reassessment window (often four to eight weeks) to review results and adjust. That way, progress is measured and you’re not left guessing.

Is Adrenal Fatigue Real? No. Are Your Symptoms? Yes.

Adrenal fatigue is not a real diagnosis. Medical experts have made that clear. But the exhaustion, cravings, brain fog, and stress crashes you feel are real.

The next step is working with a doctor who will run the right tests and do the legwork to uncover the cause.

Clarity only comes from evidence.

FAQ: Adrenal Fatigue

1. How to repair adrenal fatigue?

You can’t repair adrenal fatigue because it isn’t a real condition. What you can do is treat what’s really causing your symptoms. Doctors often start by checking thyroid health, iron levels, sleep quality, hormones, or mood. At the same time, better sleep, balanced meals, stress control, and regular activity help your body recover.

2. What mimics adrenal fatigue?

Thyroid problems, anemia, sleep apnea, perimenopause, depression, anxiety, and even certain medications can all cause fatigue, brain fog, and cravings. That’s why testing is key — each cause needs a different solution.

3. What are the symptoms of adrenal exhaustion?

Adrenal exhaustion is another term people use for adrenal fatigue. The usual list includes constant tiredness, brain fog, sugar or salt cravings, poor sleep, and feeling lightheaded when standing.

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