I spent a lot of evenings and weekends at the beach this past summer. There I espied hundreds of beautiful, nearly naked girls, many of who were candidates for future lower back problems, if you catch my drift.
Now, however, I have no energy. I have mild depression and anxiety, and it takes increased effort to just do my daily tasks. It can only be one thing: testicular fatigue.
Yes, that's right, all that female flesh made my testicles work overtime in pumping out testosterone and they plum got tuckered out. Now they just make a sad little wheezing sound.
Oh, so you're skeptical, huh? Sure you are, because it's not a real condition. But neither is adrenal fatigue!
Endocrine glands, whether they're testicles or adrenals, don't work that way. They're not like your great aunt Jules who worked as a scrubwoman for 50 years and finally died of exhaustion while mopping out the crapper.
But for whatever reason, the huge majority of people in fitness believe in adrenal fatigue. How the hell did this come about?
The Origin of a Fake Diagnosis
Adrenal fatigue, as it's currently defined, is a condition brought on by chronic stress where the glands have allegedly lost the ability to produce cortisol. Victims often start taking supplements or medications to increase cortisol levels.
Naturopath James L. Wilson coined the term. He wanted to differentiate stress-induced, sub-optimal adrenal function from Addison's disease, which is a life threatening disease where your adrenals truly don't manufacture enough steroid hormones. Wilson's term caught on and is now part of our imagined-disease vocabulary.
Somehow, though, the word and definition was misappropriated to describe a hodgepodge of unrelated symptoms.
Yes, stress induced, sub-optimal adrenal function is a real thing, but it's not produced by tired adrenals. Instead, it's a result of a hypothalamic pituitary adrenal (HPA) axis dysfunction. It's more brain and nervous system than it is glandular.
Even so, the symptoms of adrenal insufficiency from a dysfunctional HPA differ from those commonly ascribed to adrenal fatigue. People with "adrenal fatigue" claim to have crummy sleep and trouble getting out of bed. They feel anxious or rundown.
People with true adrenal insufficiency, though, suffer from weight loss, anorexia, joint pain, confusion, vomiting, diarrhea, dry skin, and low blood pressure, in addition to fatigue.
Sure, there's a tiny bit of overlap, but not enough to convince a jury that adrenal fatigue is a real thing.
But My Spit Test Says I'm Low in Cortisol!
Most people who claim to have adrenal fatigue point to a positive spit test. There are a couple of problems here. First, there isn't a medical consensus on whether saliva tests are reliable, at least as far as determining cortisol levels. The standard, accepted test is the corticotropin (ACTH) stimulation test, using blood samples.
Secondly, even if saliva tests are reliable, saliva is often sampled at the wrong time. Cortisol is highest in the first 15 to 30 minutes after waking up. This "cortisol awakening response" accounts for about 50% of your daily cortisol total.
Unless you take your spit sample in this first 30 minutes, you're probably going to test low and some naturopath with parsley breath is going to tell you to start taking cortisol-raising supplements.
Low Cortisol, But Probably Not From Adrenal Fatigue
If your cortisol is truly low, you could have Addison's, but it's really rare. You could also have the aforementioned dysfunctional HPA axis.
A third possibility is cortisol resistance, which is similar to insulin resistance. Your cortisol levels have been high for so long that the receptors have become resistant to binding with cortisol, and it eventually leads to low circulating cortisol.
None of these things, however, suggest an adrenal gland that's too fatigued to produce cortisol. Besides, as explained above, the symptoms usually ascribed to adrenal fatigue don't match up well with what happens when cortisol is truly low or your body is resistant to it.
So What Do I Really Have?
You feel tired, anxious, have insomnia, and your training sucks. There are several possible causes that are non-adrenal related:
- Psychological stress
- Physical stress
- Fluctuating blood sugar levels
- Poor sleep
- Poor diet
- Systemic inflammation in general
Give yourself an honest assessment. What's your work situation? How's your love life? Is something keeping you up at night? Is your diet spot-on? Are you taking anti-inflammatory supplements like:
Are you eating an anti-inflammatory diet?
Addressing these issues might cure your "adrenal fatigue."