Adrenal Fatigue is a term applied to a collection of nonspecific symptoms such as fatigue, anxiety, joint pain, insomnia, hypoglycemia, depression, nervousness, sleep disturbances and digestive problems presenting in an otherwise healthy person with normal laboratory test results. Over 50 percent of adults suffer from Adrenal Fatigue at one point or another in their adult life. Most recover without knowing they had Adrenal Fatigue, but a minority fail to recover, and a small number continue to worsen. In its worst form, a person can be bedridden and incapacitated. The term often shows up in popular health books and on alternative medicine websites. An Internet search of the words "Adrenal Fatigue" yield over 2.4 million results, with search threads ranging from the Mayo Clinic to the Hormone Foundation and alternative health forums. What is clear is that to the vast majority of conventional physicians, other than the forward-thinking ones, this condition does not exist and is not real. Yet to the vast majority of sufferers, this condition is very real and indeed, can be quite debilitating.

How is it possible that such a widespread dysfunction that generates so much on-going interest among the public be rebuked by many of the world’s most brilliant and well-trained physicians? How does one explain the cognitive dissonance among most conventional physicians’ assessment that Adrenal Fatigue does not exist, while the real experience of many sufferers is that of incapacitation and the inability to hold down a job?

Clinical vs. Subclinical States of Illness

Eighty percent of the most common causes of death in age related illness results from cardiovascular disease, stroke, and cancer. These degenerative diseases gain a head start years before outward symptoms are detectable. For example, the average cancer takes over a decade to develop before a lump is felt or clinically detectable.

A lifetime of poor nutrition, stress, and environmental pollution erodes cellular protection, repair, and replacement—the very foundation of health. While outwardly one may appear normal and healthy by traditional standards, inward cellular damage and insult is taking place daily from pollution, stress, and the cellular oxidative process, coupled with endogenous and exogenous free radical attacks from a young age. By age 50, free radical attacks damage as much as 30 percent of our cellular protein. Fortunately, the body has endogenous self-repair mechanisms. However, this repair mechanism is not 100 percent efficient. Damage that escaped repair can lead to cellular mutation and ultimately organ dysfunction. Adrenal Fatigue may be the result of such continuous insult over time.

Modern laboratory and detection methods are far from perfect and lack the sensitivity to pick up signs early enough to warn us of impending danger. Modern medicine with its many tests are of tremendous value when symptoms turn catastrophic and gross system failure is obvious—when chest pain occurs, or brain function fails, or a lump appears. Until then, normal current testing results simply reinforce our denial that most adults who appear healthy have, in reality, already entered into a sub-clinical state of aging with multiple diseases well in place but undetectable by physical examination or laboratory tests. These progressive sub-clinical disease states include borderline hypertension, sub-optimal adrenal function and hormonal imbalance, reduced liver detoxification capacity, reduced gastric assimilation potential, metabolic imbalances, and sugar intolerance. They are mostly foreign to conventionally trained western physicians who are taught to think in terms of demonstrable pathology to define disease.

The Disease Continuum

It is not unusual to be seriously ill and symptom-free yet have normal laboratory values. Autopsy studies of those who died of sudden death from cardiac arrest have repeatedly shown a large proportion with clean coronary vessels and perfectly normal laboratory tests.

Health, in reality, comprises a full spectrum of wellness—a continuum that ranges from severe sickness at one end to optimum health at the other end. Each chronic disease exhibits a similar continuum. Traditional medicine tends to label a person as sick once they cross the threshold of normal laboratory reference based on data derived from general population statistics. Until one crosses the threshold, they are considered normal. This is an all-or-nothing approach. The body is not a light switch that flips from normal one day to become abnormal the next. Unfortunately, all that is in between is universally ignored. The advancement of preventive medicine as a medical specialty strives to arrest disease at its sub-clinical state and address these sub-clinical conditions well before they become serious.

Adrenal Insufficiency (Addison’s disease)

Conventional medicine’s view of Adrenal Fatigue as largely a myth has foundational validity. From their perspective, there is only one disease state when it comes to adrenal weakness, and it is called adrenal insufficiency, or Addison’s disease.

Both conventional and natural medicine physicians recognize adrenal insufficiency as a real disease diagnosed through blood tests. Addison’s disease afflicts 4 out of 100,000 people. Life-long steroid replacement therapy is usually required. Diagnosis is relatively straight forward with well defined protocols.

Mild Adrenal Insufficiency—is it real?

Adrenal Fatigue is advanced by natural medicine professionals to denote a mild form of adrenal insufficiency where regular laboratory tests are normal but a person is symptomatic. It is also called by a variety of other names, including mild non-Addison’s adrenal insufficiency.

Modern medical practice relies heavily on laboratory tests and other diagnostic procedures in mechanized fashion to confirm the presence or absence of disease. Any other approach is considered unscientific. The importance of taking a detailed history and recognizing the uniqueness of each body as the key foundation of arriving at any diagnosis is quickly becoming a lost art, replaced by the overreliance on laboratory tests. This works rather well for acute illness, because the clinical presentation is dramatic. For chronic conditions, this laboratory reliance model is less than ideal. Most, if not all, chronic conditions evolve through a sub-clinical state as mentioned above. In this state, symptoms are present but all relevant laboratory results are within normal limits.

At best, laboratory results serve to help physicians assess the clinical states. It was never designed to replace a detailed history and good clinical skills. Within the current medical framework of thinking, normal simply means the absence of detectable illness as evidenced by laboratory test results within a statistical range defined mathematically. The threshold of what is considered normal or abnormal is determined by man. It is therefore an imperfect science.

This approach to medicine is grossly incomplete in chronic conditions, to say the least. The problem is obvious. Sole reliance on laboratory test as diagnostic tool  is a flawed model. On one hand, many are not well but have normal test results. They are told nothing is wrong and sent home. On the other hand, by the time testing detects illness it may be too late. The result is the same: patients suffer unnecessarily.