What are the signs/symptoms of adrenal fatigue and potential options for treatment?

Question

Dr. Anna Goldman, MD · Answer

Hi, thanks for the question. So what are the signs and symptoms of adrenal fatigue and potential options for treatment? So our adrenal glands are little triangular shaped glands that sit on top of the kidneys. And one of the hormones that the adrenals make is cortisol, which is our stress hormone. It helps to maintain blood pressure, it helps to maintain our immune systems, it helps to maintain our blood sugar levels. So it's really important, especially in the setting of stressful situations. The rule of thumb in endocrinology is that if you think somebody is deficient in a hormone, you wanna try and test it at the time of day that you think it should be highest. Cortisol secreted in a diurnal fashion, which means it's its highest first thing in the morning when we wake up, and then it tapers down over the course of the day into the night. So if I think that somebody has adrenal insufficiency because they have fatigue, nausea, unintentional weight loss, low blood pressure, low blood sugar, I will check an 8 a.m. fasting cortisol level to see, you know, is it low. In situations where we're not totally sure, we can do what's called a cosyntropin stimulation test, where you give somebody a synthetic hormone that mimics ACTH, which is the pituitary hormone that tells the adrenal glands to make cortisol. And after that test is done, we expect cortisol levels to rise. If they don't rise, then that suggests that there's a problem with the adrenal glands. And then we can make the diagnosis of adrenal insufficiency. And then the treatment would be giving somebody glucocorticoids back, like prednisone or hydrocortisone. Adrenal fatigue is not a recognized condition by the medical community. So I would not treat somebody just for adrenal fatigue, but I definitely would give them steroids if I did make the diagnosis of adrenal insufficiency. Thanks.

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"What are the signs/symptoms of adrenal fatigue and potential options for treatment?"