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What is Adrenal Burnout Syndrome?

According to proponents of ‘adrenal burnout syndrome’, “Adrenal burnout syndrome is basically a mild form of Addison’s disease.  It is a low functioning or underactivity of the adrenal glands.  It may also be termed adrenal insufficiency or adrenal exhaustion.”

Indeed the adrenal glands are of paramount importance in our stress response system because they produce the essential hormone cortisol without which we could not live.  However, there is much more to this story than you may realize.

When your body is subjected to stress, whether psychological, environmental, nutritional, or otherwise, a complex chain of events occurs which involves every organ system in your body…not just your adrenal glands.  The type of stressors, how you perceive the stress, your genetic makeup, your development in the womb, and numerous other factors profoundly affect the type of stress response your body will generate.

Over one century of scientific research has never shown that the adrenal glands ‘burn out’ in response to chronic stress.  Low cortisol states absolutely exist and have been shown to be responsible for up to 25 % of all cases of stress related bodily disorders such as chronic fatigue syndrome, fibromyalgia, and PTSD.  However, the process through which low cortisol states evolve is often initiated in the brain.  You see, there are three very important structures in the brain that regulate the release of cortisol:  the hypothalamus, the pituitary gland, and the hippocampus.  The adrenal glands cannot make cortisol if they do not receive the message to do so, and research shows that this, by far, is the most common cause of low cortisol.  Other causes include:

  • Cortisol message is generated by the cells don’t hear it

  • Adrenals can’t make cortisol because they are diseased, damaged, or lack an important ingredient for cortisol production

  • The command centers in the brain don’t talk to each other

  • The cortisol message gets all the way to the cell, but the door to cortisol wont open

The list of additional causes is enormous but ‘adrenal burnout syndrome’ is not one of them.  For the proponents of this condition, I say show me the evidence!

Hypocortisolism (low baseline cortisol or suboptimal rise in cortisol in response to stress) has been misrepresented for many years as ‘adrenal fatigue’.  Rather than evolving as a consequence of ‘adrenal failure’, low cortisol states occur for many other reasons but most often because the ‘increase cortisol release’ message from the brain isn’t reaching the adrenal glands.  There is a very complex and sophisticated network of hierarchical communication between the brain and all hormone producing organs such that under normal circumstances, no organ can autonomously produce hormones.

Studies in patients with hypocortisolism have found the three most common symptoms to be:  sensitivity to stress, pain, and chronic fatigue. This is also known as the ‘symptom triad’ of hypocortisolism.  However, other signs and symptoms can also be seen and can mimic those seen in Addison’s disease (complete loss of adrenal hormone production) even though they are not as severe. It is for this reason that some in the medical community have nicknamed hypocortisolism “Subclinical Addison’s Disease” (not “adrenal exhaustion”!).

Some of the major symptoms seen in patients with low cortisol states include:

  • Chronic fatigue

  • Fever

  • Weakness

  • Muscle and joint pain

  • Headaches

  • Dizziness upon standing

  • Chronic pain syndromes (i.e. fibromyalgia)

  • Depression and irritability

  • Sleep disturbances

  • Difficulties with concentration and memory

  • Irritable bowel symptoms

  • Lack of appetite

  • Low blood sugar

  • Chemical and food sensitivities

Because many of these symptoms are vague and may be seen in other medical conditions, patients suffering from hypocortisolism often go undiagnosed or are misdiagnosed with chronic fatigue syndrome or a mood disorder and offered prescription medication for their symptoms. It is in these situations that the astute healthcare professional expands the differential diagnosis and assesses the integrity of the patient’s stress response system

Adrenal Glands

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