The Common Myth of Adrenal Fatigue: Why “Puffy Eyes” Aren’t a Diagnosis

Keywords: common adrenal fatigue myth, cortisol and HIIT, adrenal glands, chronic fatigue syndrome, ME/CFS, SEID, overtraining, stress hormones, endocrine health, fitness misinformation

The Instagram Fatigue Diagnosis Problem

A “fitness expert” recently floated across my feed, claiming women shouldn’t do HIIT workouts on consecutive days because of adrenal fatigue—and that the puffiness under her eyes was evidence of it.

Let’s establish this clearly: that’s absolute nonsense.

Feeling tired, foggy, or unmotivated isn’t proof your adrenal glands are collapsing from stress. These symptoms have a differential diagnosis a mile long—from anemia and sleep apnea to autoimmune disease, thyroid dysfunction, depression, heart, lung, kidney, or liver disorders.

If you’re struggling with persistent fatigue, the first step is a medical evaluation, not an influencer’s reel.

When “Chronic Fatigue” Entered the Lexicon

Before “adrenal fatigue” became the wellness industry’s favorite buzzword, the term “chronic fatigue” dominated headlines in the 1980s and 1990s. It emerged as physicians tried to understand clusters of patients—often women—who experienced relentless exhaustion, cognitive fog, and post-viral malaise that conventional testing couldn’t explain.

Out of that effort came the formal recognition of Chronic Fatigue Syndrome (CFS)—now known as Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS)—an illness defined by immune dysfunction, post-exertional malaise, cognitive impairment, and autonomic instability.

The problem is that the loose public use of “chronic fatigue” blurred the boundary between a medically defined illness and a general feeling of tiredness—a confusion that opened the door for the next marketing myth: adrenal fatigue.

What “Adrenal Fatigue” Claims—and Why It’s a Myth

The term “adrenal fatigue” was popularized in the early 2000s to describe the idea that chronic stress can “overwork” the adrenal glands until they stop producing enough cortisol.

It’s catchy, marketable—and completely unsupported by science.

No major endocrinology society recognizes adrenal fatigue as a legitimate diagnosis. Multiple peer-reviewed studies have found no biochemical evidence of adrenal dysfunction in people labeled with the condition.

Even the systematic review published in BMC Endocrine Disorders concluded there is “no substantiation for adrenal fatigue.” The supposed syndrome doesn’t appear in ICD-10 codes,

Endocrine Society guidelines, or American Board of Medical Specialties listings.

And yet, the term thrives—thanks to wellness influencers, alternative medicine blogs, and supplement companies.

The Industry That Feeds on “Fatigue”

Self-diagnosed adrenal fatigue has become a billion-dollar business. Questionnaires created by “Dr. Wilson,” the chiropractor who coined the term, still circulate widely online. Some clinics sell “adrenal support” supplements or even prescribe low-dose corticosteroids, claiming they’ll “boost” depleted glands.

Here’s the catch: corticosteroids can make anyone feel temporarily energized—regardless of diagnosis. But prolonged use, even at “physiologic” doses, raises risks for psychiatric disorders, osteoporosis, muscle wasting, glaucoma, metabolic disease, and cardiovascular complications.

In other words, the supposed cure can create the very problem it promises to fix.

What’s Actually Happening in Your Body

Your adrenal glands aren’t fragile; they’re resilient. They’re part of a finely tuned feedback system called the hypothalamic-pituitary-adrenal (HPA) axis. When stress occurs, the hypothalamus releases CRH, prompting the pituitary to secrete ACTH, which in turn signals the adrenals to release cortisol.

Cortisol mobilizes energy, regulates inflammation, stabilizes blood pressure, and maintains glucose balance. When stress resolves, cortisol naturally declines.

That’s not dysfunction—it’s adaptation.

Don’t Confuse “Adrenal Fatigue” with Adrenal Insufficiency

A real endocrine disorder called adrenal insufficiency (Addison’s disease) does exist. It’s rare, serious, and diagnosed through an ACTH stimulation test.

True adrenal insufficiency causes weight loss, nausea, vomiting, low blood pressure, and hyperpigmented skin—not caffeine cravings or “puffy eyes.”

It’s a medical emergency, not a wellness trend.

What About HIIT, Cortisol, and Overtraining?

HIIT—high-intensity interval training—is one of the most effective forms of exercise. But, like any stressor, too much without recovery can backfire.

Excessive HIIT may cause fatigue, performance dips, or elevated stress hormones—not because your adrenals are “burned out,” but because your recovery systems need time to reset.

A 2021 study found that prolonged high-intensity exercise can temporarily impair mitochondrial function, the cell’s energy generator. That’s overreaching, not adrenal failure.

The fix is simple: rest, nutrition, hydration, and sleep—not supplements promising to “heal” your adrenals.

Cortisol Isn’t the Villain

Cortisol often gets a bad rap as a “catabolic” hormone blamed for fat gain or muscle loss. But its rise during exercise is essential for fueling movement and facilitating recovery.

Cortisol is part of the adaptive stress response—helping you grow stronger, not weaker. Suppressing it through supplements or pseudoscience can actually undermine adaptation and delay recovery.

Stress doesn’t destroy the adrenals; it challenges them to evolve—and they do.

So What Should You Do If You’re Always Tired?

Before you assume “adrenal fatigue,” try these evidence-based steps:

1. See your doctor to rule out medical conditions like anemia, thyroid disease, or sleep disorders.

2. Evaluate mental health. Depression, burnout, and anxiety can mirror physical fatigue.

3. Balance effort and recovery. Alternate high-intensity days with mobility, rest, or low-impact work.

4. Stabilize blood sugar. Avoid long fasting periods and manage carb intake to prevent crashes.

5. Protect your sleep. Keep a consistent schedule, limit caffeine, and reserve your bed for sleep.

Your body isn’t failing—it’s signaling. Listen before you supplement.

The Takeaway

Adrenal fatigue isn’t a diagnosis. It’s a marketing myth wearing a lab coat.

When someone blames “puffy eyes” or tired mornings on adrenal burnout, remember: your endocrine system isn’t fragile—it’s adaptive, ancient, and far more intelligent than an influencer’s algorithm.

What it needs isn’t detox powder or cortisol-blocking pills. It needs sleep, nutrition, and balance