What are the signs of adrenal fatigue?

What’s often called “adrenal fatigue” is more accurately described as HPA-axis dysfunction. It reflects how effectively your brain and adrenal glands communicate under stress. Common signs include fatigue, trouble sleeping, brain fog, sugar or salt cravings, lower immune function, irritability, and feeling “tired but wired,” especially at night.

Many people search for “adrenal fatigue,” but the term is a bit misleading. Your adrenal glands don’t simply “burn out.” Rather, chronic stress, whether perceived or not, can functionally disrupt the hypothalamic-pituitary-adrenal (HPA) axis, the communication network between your brain and adrenals. Regardless of the technicalities, this dysregulation affects your cortisol biorhythms, leading to wide-ranging symptoms.

Common Signs of “Adrenal Fatigue”

  • Persistent fatigue (especially morning sluggishness)
  • “Tired but wired” at night or difficulty falling and staying asleep
  • Craving salty or sugary foods
  • Heavy reliance on caffeine to “get through the day”
  • Lightheadedness or dizziness especially when standing quickly
  • Brain fog
  • Depressed immune function
  • Depression and anxiety
  • Poor stress tolerance
  • Feeling regularly reactionary or overwhelmed

These symptoms develop gradually, often after periods of chronic stress, overtraining, infection, or poor sleep quality. If ignored, they can contribute to hormone imbalances, thyroid dysfunction, blood sugar swings, weight gain, and even DGBIs (disorders of gut-brain interactions).

Functional Medicine Approach to “Adrenal Fatigue”

Instead of just taking “adrenal supplements,” functional medicine evaluates your full stress response, often using salivary cortisol rhythm testing to map your HPA-axis function. Treatment focuses on restoring balance through lifestyle interventions as a foundation: stress reduction, blood sugar stability, nutrient repletion, and restorative movement as each of these influence cortisol biorhythms.

For a deeper dive, you can read Understanding HPA Axis Dysfunction: Looking Beyond “Adrenal Fatigue” to see how I approach the HPA axis.

Want to know if your symptoms are related to HPA-axis dysfunction?

Book Your Free Health Clarity Call here.

Answered by Dr. Kenny Mittelstadt, DACM, DC, IFMCP
Certified functional medicine practitioner specializing in advanced lab testing and personalized healing protocols to uncover root causes of health roadblocks.

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