You are here>> Home >> Understanding AF >> Stages of Adrenal Fatigue >> Burnout Syndrome

Burnout Syndrome vs Adrenal Fatigue

Burnout Syndrome is chronic stress related disorder
Is Burnout Syndrome the same as Adrenal Fatigue?

The term Burnout Syndrome (or simply Burnout) is being used more and more in research.

Page Contents:

Symptoms of Burnout

Stages of Burnout?

Prolactin and Burnout

Cortisol and Burnout

HPA Axis: Hypo or Hyper?

The similarities between Burnout and Adrenal Fatigue are striking. Conventional medicine seems to be slowly discovering Adrenal Fatigue.

Actually, Adrenal Fatigue was discovered in the 1930's, by Dr Hans Selye. He proved that chronic stress leads to exhaustion. But he called it the General Adaptation Syndrome.

The name Adrenal Fatigue comes from the 2001 book by Dr James Wilson: Adrenal Fatigue: The 21st Century Stress Syndrome . Dr Wilson expanded on the General Adaptation Syndrome.

The term Adrenal Fatigue has been growing within alternative medicine ever since.

The term Burnout Syndrome is being used more and more in research to describe a condition caused by chronic stress. Sound familiar?

Burnout research seems to be gradually confirming that adrenal fatigue is real. But it will be years before Burnout Syndrome gets a disease code (ICD) and primary care doctors are aware of it.

A 2013 article, called The medical perspective on burnout, was published in the International Journal of Occupational Medicine and Environmental Health.

It had the following conclusion:

Chronic stress-related disorders often fall outside the category of a true disease and are often treated as depression or not treated at all. The evaluation of adrenal hormones via saliva samples helps to predict burnout.¹¹

Not treated at all is exactly what happens.

Which is why people with chronic stress related disorders end up turning to alternative medicine, where they learn about Adrenal Fatigue.

Let's see if we can connect the dots between Burnout Syndrome research and Adrenal Fatigue.

Burnout Symptoms

Symptoms of Burnout and Adrenal Fatigue are very similar

A 2013 article published in Psychology Today lists the following symptoms for Burnout Syndrome (the following is a summary of the article):

Chronic Fatigue: Emotional and Physically exhaustion
Insomnia: Exhausted, but can't sleep
Forgetfulness
Heart Palpitations
Shortness of Breath
Dizziness
More prone to flu and colds
Loss of Appetite
Anxiety
Anger
Depression
Loss of Enjoyment
Pessimism
Detachment
Apathy
Irritability

The above burnout symptoms are pretty much identical to what people complain about on adrenal fatigue forums. See the article Adrenal Fatigue Symptoms.

Burnout - Two Syndromes?

A 2007 article published in Neuropsychobiology was titled:
The psychobiology of burnout: are there two different syndromes?¹³

Researchers report inconsistencies in studies on Burnout patients.

Sometimes morning cortisol is low¹¹, sometimes it is high⁷
Sometimes prolactin (pituitary hormone) is low¹³, sometimes it is high¹³
Sometimes the HPA axis (hypothalamic-pituitary-adrenal) is under-active¹², sometimes it is over-active¹⁰

Are they stumbling upon the stages of the General Adaptation Syndrome ?

If you are unfamiliar with the stages of the General Adaptation Syndrome (renamed stages of Adrenal Fatigue by Dr James Wilson), here is a summary:

Graph of Stages

Stage 2 is a period of above average adrenal output.

Stage 3 is a period of reduced adrenal output. Stage 3 of the General Adaptation Syndrome is actually called Exhaustion.

In Table 1 below, I have attempted to connect the dots between Burnout Syndrome research and the stages of the General Adaptation Syndrome.

Stage of General Adaptation Syndrome	Prolactin	Vigor	Morning Cortisol
Stage 2	High	High	High
Stage 3	Low	Low	Low

Table 1 - Burnout Syndrome findings vs Stages of General Adaptation Syndrome

See below for an explanation of the table.

Prolactin Levels - Vary by Stage?

Prolactin is a hormone secreted by the pituitary gland, it is released during stress¹⁵.

Prolactin has anti-anxiety, anti-stress and antidepressant effects¹⁴.

Burnout subjects have either very high or very low prolactin levels¹³. This is why researchers are asking if there are actually two burnout syndromes.

The burnout subjects displayed an extreme distribution of basal prolactin levels, displaying higher or lower levels compared to the controls. ¹³

Note: Controls means normal people who do not have Burnout.

They are possibly stumbling upon the stages of the General Adaptation Syndrome. There are 3 stages of the General Adaption.

During Stage 2, there is an above average resistance to stress. It makes sense that Prolactin would be high during this stage.

During Stage 3, there is a below average resistance to stress. It makes sense that Prolactin would be low during this stage.

With the drop in Prolactin in advanced cases .... the condition could be called Pituitary Fatigue.

It also a hint that Adrenal Fatigue is not really the best name. There is much more to it than the adrenal glands.

The same study observed either high or low Prolactin levels also observed that the individuals with low Prolactin had to most extreme fatigue¹³. This again could explained by the progression from Stage 2 to Stage 3 of the General Adaptation Syndrome. They have advanced to Stage 3, their HPA axis can no longer keep up, and they are more exhausted.

Cortisol and Burnout Syndrome

Burnout has contradictory cortisol levels
Sometimes morning cortisol is high ... sometimes morning cortisol is low

Another contradiction researchers have found is that people with Burnout Syndrome can have either low or high cortisol. But those with low cortisol usually have more severe symptoms ¹¹.

Can the stages of Adrenal Fatigue (and the General Adaptation Syndrome) explain this contradiction.

Below are a couple of quotes from studies that found high morning cortisol ¹⁰:

..burnout patients showed elevated cortisol levels during the first hour after awakening in comparison to healthy controls. ¹⁰

The results of the present study indicate a dysregulation in hypothalamic-pituitary-adrenocortical axis (HPA axis) activity, characterized by elevated morning salivary cortisol levels, among female burnout patients. Among males, increased cortisol levels were observed among participants with moderate levels of burnout, but not among patients or healthy controls.⁷

However, for more severe cases of Burnout, morning cortisol is lower than normal^11,16.

Severe burnout symptoms are associated with a lower level or smaller increase of the cortisol awakening response (CAR).¹¹

After spending years on the adrenal fatigue forum on Curezone, it is obvious that those with low morning cortisol are much worse than those with high morning cortisol.

The switch from high cortisol to low cortisol for Burnout subjects is possibly the switch from Stage 2 to Stage 3 of the General Adaptation Syndrome.

HPA Axis: Hypo? ....or Hyper?

Some studies have found hypo function of the HPA Axis
Others found hyper function

Another contradiction that shows up in studies of Burnout subjects is the level of activity of the HPA axis (hypothalamus-Pituitary-Adrenal)

One study found elevated heart rate amongst Burnout subjects, as well as elevated morning cortisol. Sustained activation of the HPA axis was the conclusion of the study¹⁰.

Their nervous systems are essentially stuck on. Their HPA axis is over-active.

However, other studies have found hypo-function of the HPA axis:

Burnout is associated primarily with a hypo-function of the HPA-axis, which is a neuro-endocrine characteristic of exhaustion¹²

Once again, the switch from Stage 2 to Stage 3 of the General Adaptation Syndrome probably explains the switch from hyper to hypo function of the HPA axis.

Summary

The symptoms for Burnout, a chronic stress relates disorder, are nearly identical to adrenal fatigue symptoms.

Researchers have noted several contradictions that make them wonder if there are two different types of Burnout.

Some Burnout subjects have an overactive HPA axis. Others have an under-active HPA axis.

The contradiction is possibly explained by the stages of the General Adaptation Syndrome.

Stage 2 is a period of hyper-function of the HPA axis. The subject adapts to the high level of stress it is exposed to.

Stage 3 of the General Adaptation Syndrome is actually called Exhaustion, which would explain the more severe cases of Burnout.

It is somewhat hard to believe that people currently doing stress research have not connected the dots to the work of Dr Hans Selye in the 1930s .... sigh.

If you are Female, please answer .... 3 quick Questions about
Your Symptoms