Persistent fatigue, sleep disruption, dizziness, changes in weight, low blood pressure, or difficulty coping with stress can have many possible causes. Our approach is to evaluate these symptoms medically rather than assume they are caused by an unproven diagnosis.
The term “adrenal fatigue” is not recognized as an established medical diagnosis. The Endocrine Society notes that there is no scientific proof supporting adrenal fatigue as a true medical condition and warns that labeling nonspecific symptoms this way can delay identification of the real cause.
That does not mean symptoms such as fatigue, poor sleep, weakness, brain fog, or lightheadedness should be dismissed. These symptoms deserve a careful evaluation for recognized conditions that may include thyroid disease, anemia, sleep disorders, medication effects, mood disorders, metabolic problems, nutritional deficiencies, menopause-related changes, or true adrenal insufficiency.
Adrenal insufficiency is a recognized endocrine disorder in which the body does not make enough cortisol and, in some cases, aldosterone. Depending on the history and symptoms, evaluation may include morning cortisol, ACTH, metabolic testing, and—when medically indicated—an ACTH stimulation test. The NIDDK describes the ACTH stimulation test as the most commonly used test to diagnose adrenal insufficiency.
Dr. David Nazarian is board certified in Internal Medicine. Evaluation is individualized and may include a detailed medical and medication history, sleep and stress review, physical examination, and targeted laboratory testing. The goal is to identify a medically recognized cause whenever possible and to avoid unnecessary hormone or supplement treatment.
Testing may include thyroid studies, blood count, metabolic testing, iron or vitamin assessment, sex-hormone testing when appropriate, and cortisol/ACTH evaluation when the clinical picture suggests an adrenal disorder.
There is no single treatment for fatigue or stress-related symptoms. Management depends on the underlying cause and may include treatment of a documented endocrine condition, sleep optimization, nutrition and exercise guidance, medication review, correction of deficiencies, or referral to another specialist. Hormone therapy is considered only when there is a clear medical indication and after an individualized discussion of benefits, risks, and alternatives.
If you have persistent fatigue or symptoms you believe may be related to cortisol or adrenal function, schedule a comprehensive evaluation in Los Angeles. We can review your symptoms, medications, prior laboratory results, sleep, thyroid function, and other potential contributors before recommending treatment.
David Nazarian, M.D., is Board-Certified in Internal Medicine and provides physician-led hormone evaluation and individualized care for women and men. His approach emphasizes comprehensive assessment, patient education, individualized treatment, safety, and ongoing follow-up. Dr. Nazarian specializes in bio-identical hormone replacement therapy in men & women. He has extensive training and knowledge in treating andropause and testosterone replacement therapy in men and menopause and estrogen replacement therapy in women. Supported by his experienced medical team, Dr. Nazarian treats men and women with hormone deficiencies and imbalances and enjoys the one-on-one relationship between patient and doctor.
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