Many people who sleep eight hours and still wake up drained have been told it's adrenal fatigue, but a 2016 systematic review found no substantiation that adrenal fatigue is an actual medical condition. Board-certified internal medicine physician Dr. Remina Panjwani explains why that doesn't make the exhaustion any less real. In most cases of chronic stress, cortisol isn't gone, it's out of rhythm, and in the Framingham Heart Study, higher morning cortisol was linked to worse memory in adults averaging 48. Dr. Remina breaks down what's really happening in the HPA axis and shares three free steps that help: asking about the cortisol pattern across the day, slow breathing, and protecting sleep. To look at your own labs with her, book a discovery call at the link below.
Sources:
World Health Organization. Burn-out an "occupational phenomenon": International Classification of Diseases (2019). https://www.who.int/news/item/28-05-2019-burn-out-an-occupational-phenomenon-international-classification-of-diseases
Cadegiani FA, Kater CE. Adrenal fatigue does not exist: a systematic review. BMC Endocrine Disorders. 2016;16:48. https://doi.org/10.1186/s12902-016-0128-4
Echouffo-Tcheugui JB, et al. Circulating cortisol and cognitive and structural brain measures: The Framingham Heart Study. Neurology. 2018;91(21):e1961-e1970. https://doi.org/10.1212/WNL.0000000000006549
Birdee G, et al. Slow breathing for reducing stress: The effect of extending exhale. Complementary Therapies in Medicine. 2023. https://doi.org/10.1016/j.ctim.2023.102937
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Timestamps
00:00 - Introduction: The adrenal fatigue label
02:00 - What the WHO says about burnout
03:20 - Adrenal fatigue systematic review
04:45 - HPA axis dysregulation, not empty adrenals
05:55 - Cortisol, memory, and brain volume
07:25 - Ask about HPA axis function
08:00 - Slow breathing and box breathing
09:00 - Cortisol and sleep, both directions
09:25 - Care without the right label
Disclaimer: This show is medical education, not medical advice. I'm sharing general information to help you understand your body, and listening doesn't create a physician-patient relationship between us. Everyone is different, so please talk with your own physician before you make changes to your health care.