How to Tell the Difference Between Fatigue and Adrenal Fatigue

If you feel chronically tired, it can be extremely frustrating not knowing the cause. Fatigue, lethargy, and lack of motivation are three general symptoms that can be attributed to anything from depression to serious viral infections.

One common cause of fatigue is adrenal fatigue, which is thought to be caused by a dysfunction of your adrenal glands. While the symptoms of general fatigue and adrenal fatigue are similar, it’s important to make a distinction.

Fatigue can be a symptom of adrenal fatigue, but adrenal fatigue is not a symptom of fatigue. If you’re still confused, here’s an analogy: all lions are cats, but not all cats are lions. Adrenal fatigue always causes fatigue, but not all fatigue is caused by adrenal fatigue.

What is Adrenal Fatigue?

Adrenal fatigue is thought to be caused when your adrenal glands become overworked and aren’t able to keep up with the production of essential hormones that combat stress like epinephrine and cortisol.

Cortisol is also known as your stress hormone and breaks down sugar, fats, and protein so that your body has immediate energy available during times of stress. (1) Both physical and mental forms of stress can stimulate the release of cortisol. When this stress hormone remains elevated, it can lead to several negative effects like lethargy, lack of motivation, sleep impairment, and weight gain. (2)

Epinephrine, otherwise known as adrenaline, is responsible for your flight or fight response. When adrenaline remains elevated because of chronic stress, it can have negative effects on your health like elevating your blood pressure. (3)

It’s thought that poor lifestyle habits are principally responsible for causing adrenal fatigue. These habits include not sleeping enough, eating a diet high in sugar and processed foods, and drinking too much caffeine. If you improve these lifestyle habits and your symptoms of fatigue improve, adrenal fatigue may be the cause.


Other Causes of Fatigue

Some causes of fatigue are fairly obvious. If you’ve been living off of three hours of sleep for the past week, you probably need to get more rest. However, when you feel tired with no obvious cause, chronic fatigue can become more worrisome. If this is the case, it’s a good idea to see your doctor or a medical professional to get a proper diagnosis.

Here are a few possible causes of fatigue that may not have an obvious cause. However, keep in mind that this isn’t meant as a diagnostic tool but as a list for general interest.


Your thyroid gland is located on the front of your neck and produces the hormones T3 and T4. These hormones play a role in regulating your metabolism, so if you suffer from hypothyroidism, one of the first symptoms is general fatigue without an obvious cause.

Hypothyroidism can be caused by dysfunction of your thyroid gland. However, problems with your anterior pituitary gland or hypothalamus can also lead to hypothyroidism.

Other symptoms include the following: (4)

  • Weight gain
  • Low pulse
  • Feelings of being cold
  • Weakness
  • Hair loss
  • Joint pain
  • Depression

Low Iron (Anemia) or Vitamin B12

The majority of the blood in your body is found in your red blood cells. A protein in your red blood cells called hemoglobin uses iron to help transport oxygen throughout your body. When iron levels are low, your body isn’t able to efficiently transport oxygen and your energy levels decline.

Causes of anemia can include hormonal dysfunction, nutritional deficiencies, internal bleeding, and genetic disorders. (5)

Vitamin B12 is an essential vitamin that plays a role in brain and nerve function as well as energy production. It’s found primarily in animal products so vegetarians and vegans may be at a higher risk of developing deficiency than meat eaters. (6)


Being overweight can also lead to chronic lethargy. On average, people who are obese have more metabolic problems than non-obese individuals such as impaired insulin or leptin sensitivity. Research shows that obese individuals show greater amounts of central nervous system fatigue after stressful events than non-obese people. (7)

Generally, people with a BMI over 30 are considered obese. However, BMI is an inaccurate measure of obesity in people who are more muscular than average or pregnant.  

Chronic Anxiety and Depression

Chronic anxiety and depression may also lead to a greater feeling of fatigue. (8) These mental disorders can both cause sleep disturbances such as insomnia, which can exacerbate already present fatigue. Mental disorders can be difficult to diagnose, but depending on the cause of it, symptoms may improve with therapy or medication.

More Serious Causes of Fatigue

Several more serious diseases like cancer and heart disease can also cause fatigue. While they’re not the most common causes of lethargy, if you notice your energy levels drop without an obvious cause, visiting your doctor may be a good idea to rule them out.

Here are a few other serious causes of fatigue: (9)

  • Acute liver failure
  • Kidney disease
  • Concussions
  • Diabetes
  • Multiple Sclerosis
  • Brain injury

How Do You Know What Type of Fatigue You Have?

If you’re chronically feeling tired, you can try improving your lifestyle habits to see if the symptoms go away. You can improve your diet by replacing highly processed foods with more natural foods.

Generally, it’s better to stick to foods with one ingredient than multiple ingredients. For example, pretzels are a highly processed snack food that includes white flour, sugar, salt, yeast, flavoring, etc. Sweet potato is an unprocessed single ingredient food that has a higher nutrient density and is low glycemic.

You can improve your sleep quality by setting an alarm for the same time each morning. Waking up at a consistent time helps stabilize your body’s circadian rhythm. It’s also a good idea to cut back on caffeine since it can disturb your sleep and increase levels of your stress hormones.

Concluding Thoughts on Fatigue

If you’ve been chronically feeling fatigued, improving your lifestyle habits may improve your energy levels. However, if your fatigue is caused by a nutrient deficiency or serious disease, you may need medical intervention. If you’re not sure what’s causing your fatigue, it’s a good idea to visit your doctor for a proper diagnosis.

Quick Disclaimer

This content is for informational and educational purposes only. It is not intended to provide medical advice or to take the place of medical advice or treatment from a personal physician. Readers of this content are advised to consult their doctors or qualified health professionals regarding specific health questions. Neither the author(s) nor the publisher of this content takes responsibility for possible health consequences of any person or person reading or following the information in this educational content. All readers of this content, especially those taking prescription or over-the-counter medications, should consult their physicians before beginning any nutrition, supplement or lifestyle program.


1. Thau L, Sandeep S. Physiology, Cortisol. NCBI. 2015.

2. McEwen BS. Central effects of stress hormones in health and disease: Understanding the protective and damaging effects of stress and stress mediators. Eur J Pharmacol. 2008;583(2-3):174-85.

3. Majewski H, Alade PI, Rand MJ. Adrenaline and stress-induced increases in blood pressure in rats. Clin Exp Pharmacol Physiol. 1986;13(4):283-8.

4. Underactive Thyroid. 2014.

5. Turner J, Badireddy M. Anemia. NCBI. 2019.

6. Rizzo G, Laganà AS, Rapisarda AM, et al. Vitamin B12 among Vegetarians: Status, Assessment and Supplementation. Nutrients. 2016;8(12)

7. Mehta RK. Impacts of obesity and stress on neuromuscular fatigue development and associated heart rate variability. Int J Obes (Lond). 2015;39(2):208-13.

8. Targum SD, Fava M. Fatigue as a residual symptom of depression. Innov Clin Neurosci. 2011;8(10):40-3.

9. Fatigue. Mayoclinic.

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