Alarm over ‘adrenal depletion’ wellness trend
A growing alternative health trend to label people with ‘adrenal depletion’ and treat them with potentially dangerous steroid supplements has been criticised by a leading endocrinologist.
Naturopaths and wellness practitioners are claiming that people who feel run down and burnt out are displaying symptoms of “adrenal fatigue”.
However, this is unscientific and potentially harmful, says Professor David Torpy, deputy director of the endocrine and metabolic unit at the Royal Adelaide Hospital.
Professor Torpy told Australian Doctor he was increasingly seeing patients who had been given hormone supplements and synthetic steroids by alternative health practitioners, resulting in excessive cortisol levels and Cushing’s syndrome.
“This is a trend, and in our practice, we are seeing cases where people have developed symptoms of excess cortisol,” he said.
“It is an example of overmedicalisation of life. There’s no doubt some people’s lives are giving them excessive stress that is wearing them down and they are developing mood disorders and even physical problems.
“However, the problem here is not the adrenal glands,” he said. “Adrenal insufficiency is a real disorder, but it is very uncommon and is not a result of excessive life stress.
“These people don’t need evaluation of their adrenal glands and nor do they need adrenal hormone supplementation — the treatment should be centred around lifestyle,” he said
The prevalence of adrenal insufficiency was about 3/10,000, which meant the average GP with 2000 patients was unlikely to see many cases, Professor Torpy said.
“It’s a pity to see the naturopaths resorting to a physical explanation for things that they know are due to lifestyle factors.”
However, a Melbourne GP who practises integrative medicine but does not wish to be named, rejected the idea that adrenal insufficiency was uncommon and unrelated to stress.
“I see a whole stack of patients who present with this complex symptomatology of adrenal insufficiency. I think we are on a spectrum, and the endocrinologists are only looking at a very small select group at one end of the bell-shaped curve … but there are all these other people in the middle of the curve who suffer from symptoms of adrenal insufficiency, such as fatigue and infections,” he said.
Adrenal insufficiency could be diagnosed with saliva tests, and patients responded well to treatments, including dehydroepiandrosterone, melatonin and ginseng, he said.