Good question. There is so much that mainstream medicine doesn't know how to address and adrenals/thyroids is another one besides:

--gluten intolerance

--silent inflammation

--infertility, impotence, MOOBIES (boobs on men), premature hair loss or grey/white, multiple sclerosis, heartburn/GERD, caries/cavities, dental disease (ala Weston A Price), hypertension, hypothyroidism, T2DM (diabetes), heart disease, cancer, IBS, indigestion, gallbladder disease, kidney stones, depression, bipolar, autism, ADHD, etc

--toxicity and obesogens like the endocrine disruption from gluten, n-6 pufas, heavy metals, GMO 'products', xenoestrogens, plastics, high fructose corn syrup, pesticides, etc

--true cause of autoimmune disorders and 99% of western civilization diseases is related to the GUT and subsequent permeability and immune effects...

Have you seen this from our paleo community???

Diane Sanfilippo of Balanced Bites: http://balancedbites.com/2011/12/balanced-bites-podcast-episode-15-adrenal-fatigue-part-1.html

Robb Wolf (and his podcasts): http://robbwolf.com/2009/10/12/my-training-and-adrenal-fatigue/

Recovering: http://www.livingpaleo.com/guest/paleo-diet-and-organic-eating-with-antonio.html

http://www.paleovillage.com/2011/08/08/adrenal-fatigue-the-conventional-or-the-alternative/

Previous PH threads:

http://paleohacks.com/questions/7459/how-can-i-diagnose-treat-adrenal-fatigue#axzz1ftGQQh78

http://paleohacks.com/questions/27941/test-for-adrenal-fatigue-weakness#axzz1ftGQQh78

http://paleohacks.com/questions/17259/healing-adrenal-fatigue-the-paleo-way#axzz1ftGQQh78

http://paleohacks.com/questions/73626/can-intermittent-fasting-cause-or-worsen-adrenal-fatigue#axzz1ftGQQh78

Yes it is it just doesn't go by that name. It goes by "HPA axis dysfunction". It is well studies in medical literature but doesn't seem to have much clinical significance today, mostly because tools don't exist, the disease isn't well understood or characterized, and there are no treatments. I went to an Endocrinologist asking about it to see if there was a connection to an autoimmune disorder and he gave me a puzzled look when I mentioned it. I read one study claiming that an ACTH stimulation test had a 50% successful diagnosis rate if you want to give it a shot but it's not a trivial test.

I'd say it's real -- it stands to reason that there's a progression between healthy adrenals and full-blown Addison's -- but it's so vaguely defined that it's hard to diagnose with much confidence. If you routinely experience tiredness, moodiness or depression, mental fog, weak libido, insomnia, and sugar cravings, you might have adrenal fatigue -- or hypothyroidism, or strong reactions to gluten, or hyper/hypoglycemic cycles due to poor insulin production and/or sensitivity, or clinical depression, or probably a dozen other conditions that could lead to the same general list of symptoms. In fact, I've wondered sometimes if "adrenal fatigue" is a symptom rather than a disease: when your body gets chronically stressed, your adrenals get sprained and under- or over-produce; but that would mean to fix the problem you'd have to address the original stressor, not the adrenals themselves (at least not first thing).

I have seen claims of symptoms that are pretty specific. For instance, in the book Adrenal Fatigue, Dr. Wilson says that the inability for your pupils to stay closed for long when presented with a bright light in the dark is a fairly sure sign. Another is supposed to be if a line scratched on your skin, as with a fingernail (not breaking the skin, just enough to leave a white line) stays white for more than a couple minutes. I haven't seen those listed as symptoms for other conditions. On the other hand, I don't think he explained why those are evidence of adrenal fatigue, either. Seems like those could just be signs that your body is weak and tired, which would probably mean your adrenals are weak and tired too, but the cause could be all sorts of things.

Twenty years ago, a chiropractor diagnosed me with adrenal fatigue. He gave me some pills that were chopped-up cow adrenals, which I rarely took because they tasted extremely bad and I had a thing about swallowing pills back then -- and told me to stay off "white" foods like flour and sugar. I did feel better, but I assume that was from cutting out the refined carbs. But he also told me to rub a spot a couple inches up and to each side of the navel, which was very sore. He said that would help stimulate the adrenals (although now I wonder whether it makes sense to 'stimulate' something that's fatigued), and that the soreness signified adrenal problems. For twenty years, those spots have always been sore any time I've thought to check them, so either I've had adrenal fatigue for 20+ years (possible) or those spots are just sore on anyone anytime, like rubbing directly on a nerve (also possible). Seems a little sketchy.

One thing that's clear is: many people conclude they suffer adrenal fatigue when they have no specific verification for the conclusion. It may be a fact but in a good many instances the fact is not demonstrated nor is an attempt made to do so. There are indeed adrenal stressors in our lives; that's not up for debate. "Having trouble losing weight or losing fat? Your cortisol levels must be elevated." A reasonable hypothesis, especially with high volume and/or intensity of exercise. Key word: hypothesis.

Quantifiable maybe not, but real, I think so. I was diagnosed with adrenal fatigue 2 years ago by a nutritionist recommended to me by a colleague, who I went to see despite my massive reservations and suspicions of quackery. I now take supplements and have been 100% better since.

It's real. I just heard a podcast on this, this morning.

Chronic stress is the cause.

Also see: http://www.drrind.com/therapies/metabolic-symptoms-matrix and http://www.adrenalfatiguerecovery.com/adrenal-exhaustion.html

It is not a recognized medical diagnosis in mainstream medicine. As to whether or not it's real...it's hard to say. I do suspect, at the very least, it is over-self-diagnosed. Clearly there is something going on in people suffering from the symptoms, but there could be many other possible causes.

It does seem to be getting more mainstream attention lately, so perhaps some more definitive research will result.

Yes, it is real. Many doctors do not recognize or treat it until it becomes very advanced, at which stage it is known as Addison's disease:

http://en.wikipedia.org/wiki/Addison's_disease

I believe I had it. It was a combination of work stress and to much training. I was waking up at 4:30, commuting a total of 3 hours a day to and from work, and doing hard workouts when i got home.

Im a cyclist and I got to the point where sitting on my bike and coasting down a hill made me want to pull over and sleep.I actually crashed once and I think i actually fell asleep while sitting on the ground. Thats when I called it quits and did some research. I could not sleep well or concentrate on anything and just felt weird in general. It took a whole month of sleep and relaxing before I was 75 percent then another month before I could start training again.

I was eating paleo for 3 months before this happened. It was just to much stress for my adrenal glands to handle.

This doctor thinks its real and is the what I used to help reverse it. http://www.drlam.com/articles/adrenal_fatigue.asp

This podcast by Dr Bryan Walsh talks about adrenal fatigue: http://www.blogtalkradio.com/undergroundwellness/2010/10/07/the-truth-about-adrenal-fatigue-with-dr-bryan-walsh

An article about it by Dr Bryan Walsh: http://www.t-nation.com/free_online_article/sports_body_training_performance_nutrition/the_truth_about_adrenal_fatigue

"Adrenal gland dysfunction is real. However, the way it's explained and treated by many integrated practitioners today is an outdated and incomplete model."

I don't think it's accepted as such, but I don't know if there are any hormonal systems that are evolved for chronic overuse. So it's probably somewhere in the gap between being easily quantifiable and being 'woo-woo'. Sorry if that doesn't fit your dichotomy.

According to Danny Roddy, it's "bogus."

http://www.dannyroddy.com/main/2012/4/16/the-road-to-nowhere-part-ii-thinking-you-have-adrenal-fatigu.html

There's a lot of fuss on Westside about this from the use of "psyching up" techniques too often for big lifts in training. From my experience I couldn't say 100%; but I can say for certain that sometimes I can't hit my targets in a given training session because my mind isn't in the right place. Is this what is meant by adrenal fatigue? Or is it just general unpreparedness? Could it be overtraining? Indeed, are the two things linked?

I don't have the answers, but there does seem to be some merit.