Adrenal fatigue does not exist. A systematic review of the medical literature

Detalhes bibliográficos
Ano de defesa: 2016
Autor(a) principal: Cadegiani, Flavio Adsuara [UNIFESP]
Orientador(a): Kater, Claudio Elias [UNIFESP]
Banca de defesa: Não Informado pela instituição
Tipo de documento: Dissertação
Tipo de acesso: Acesso aberto
Idioma: por
Instituição de defesa: Universidade Federal de São Paulo (UNIFESP)
Programa de Pós-Graduação: Não Informado pela instituição
Departamento: Não Informado pela instituição
País: Não Informado pela instituição
Palavras-chave em Português:
Palavras-chave em Inglês:
Link de acesso: https://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=4056701
http://repositorio.unifesp.br/handle/11600/46168
Resumo: Background: The term “adrenal fatigue” (“AF”) has been used by some doctors, healthcare providers, and the general media to describe an alleged condition caused by chronic exposure to stressful situations. Despite this, “AF” has not been recognized by any Endocrinology society, who claim there is no hard evidence for the existence. The aim of this systematic review is to verify whether there is substantiation for “AF”. Methods: A systematic search was performed at PUBMED, MEDLINE (Ebsco) and Cochrane databases, from the beginning of the data until April 22nd, 2016. Searched key words were: “adrenal” + “fatigue”, “adrenal” + “burnout”, “adrenal” + “exhaustion”, “hypoadrenia”, “burnout” + “cortisol”, “fatigue” + “cortisol”, “clinical” + “burnout”, “cortisol” + “vitalility”, “adrenal” + “vitality”, and “cortisol” + “exhaustion”. Eligibility criteria were: (1) articles written in English, (2) cortisol profile and fatigue or energy status as the primary outcome, (3) performed tests for evaluating the adrenal axis, (4) absence of influence of corticosteroid therapy, and (5) absence of confounding diseases. Type of questionnaire to distinct fatigued subjects, population studied, tests performed of selected studies were analyzed. Results: From 3,470 articles found, 58 studies fulfilled the criteria: 33 were carried in healthy individuals, and 25 in symptomatic patients. The most assessed exams were “Direct Awakening Cortisol” (n=29), “Cortisol Awakening Response” (n=27) and “Salivary Cortisol Rhythm” (n=26). Discussion: We found an almost systematic finding of conflicting results derived from most of the studies methods utilized, regardless of the validation and the quality of performed tests. Some limitations of the review include: (1) heterogeneity of the study design; (2) the descriptive nature of most studies; (3) the poor quality assessment of fatigue; (4) the use of an unsubstantiated methodology in terms of cortisol assessment (not endorsed by endocrinologists); (5) false premises leading to an incorrect sequence of research direction; and, (6) inappropriate/invalid conclusions regarding causality and association between different information. Conclusion: This systematic review proves that there is no substantiation that “adrenal fatigue” is an actual medical condition. Therefore, adrenal fatigue is still a myth.
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spelling Cadegiani, Flavio Adsuara [UNIFESP]Universidade Federal de São Paulo (UNIFESP)http://lattes.cnpq.br/1780670748106294http://lattes.cnpq.br/1250728429385385Kater, Claudio Elias [UNIFESP]São Paulo2018-07-27T15:49:39Z2018-07-27T15:49:39Z2016-12-31https://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=4056701CADEGIANI, Flavio Adsuara. Adrenal fatigue does not exist. A systematic review of the medical literature. 2016. 68 f. Dissertação (Mestrado em Medicina: Endocrinologia Clínica) - Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), São Paulo, 2016.http://repositorio.unifesp.br/handle/11600/46168Flávio Adsuara Cadegiani - PDF A.pdfBackground: The term “adrenal fatigue” (“AF”) has been used by some doctors, healthcare providers, and the general media to describe an alleged condition caused by chronic exposure to stressful situations. Despite this, “AF” has not been recognized by any Endocrinology society, who claim there is no hard evidence for the existence. The aim of this systematic review is to verify whether there is substantiation for “AF”. Methods: A systematic search was performed at PUBMED, MEDLINE (Ebsco) and Cochrane databases, from the beginning of the data until April 22nd, 2016. Searched key words were: “adrenal” + “fatigue”, “adrenal” + “burnout”, “adrenal” + “exhaustion”, “hypoadrenia”, “burnout” + “cortisol”, “fatigue” + “cortisol”, “clinical” + “burnout”, “cortisol” + “vitalility”, “adrenal” + “vitality”, and “cortisol” + “exhaustion”. Eligibility criteria were: (1) articles written in English, (2) cortisol profile and fatigue or energy status as the primary outcome, (3) performed tests for evaluating the adrenal axis, (4) absence of influence of corticosteroid therapy, and (5) absence of confounding diseases. Type of questionnaire to distinct fatigued subjects, population studied, tests performed of selected studies were analyzed. Results: From 3,470 articles found, 58 studies fulfilled the criteria: 33 were carried in healthy individuals, and 25 in symptomatic patients. The most assessed exams were “Direct Awakening Cortisol” (n=29), “Cortisol Awakening Response” (n=27) and “Salivary Cortisol Rhythm” (n=26). Discussion: We found an almost systematic finding of conflicting results derived from most of the studies methods utilized, regardless of the validation and the quality of performed tests. Some limitations of the review include: (1) heterogeneity of the study design; (2) the descriptive nature of most studies; (3) the poor quality assessment of fatigue; (4) the use of an unsubstantiated methodology in terms of cortisol assessment (not endorsed by endocrinologists); (5) false premises leading to an incorrect sequence of research direction; and, (6) inappropriate/invalid conclusions regarding causality and association between different information. Conclusion: This systematic review proves that there is no substantiation that “adrenal fatigue” is an actual medical condition. Therefore, adrenal fatigue is still a myth.Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Dados abertos - Sucupira - Teses e dissertações (2013 a 2016)68 f.porUniversidade Federal de São Paulo (UNIFESP)Insuficiencia adrenalEsgotamento adrenalCortisolFadigaAdrenal failureAdrenal depletionCortisolFatigueAdrenal fatigue does not exist. A systematic review of the medical literatureinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesisinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UNIFESPinstname:Universidade Federal de São Paulo (UNIFESP)instacron:UNIFESPSão Paulo, Escola Paulista de Medicina (EPM)Medicina (Endocrinologia Clínica)Ciências da saúdeMedicinaORIGINALFlávio Adsuara Cadegiani - PDF A.pdfFlávio Adsuara Cadegiani - PDF A.pdfDissertação de mestradoapplication/pdf424861${dspace.ui.url}/bitstream/11600/46168/1/Fl%c3%a1vio%20Adsuara%20Cadegiani%20-%20PDF%20A.pdf1235b6f64ace35b7fcbade2210a22734MD51open access11600/461682023-08-31 16:59:26.437open accessoai:repositorio.unifesp.br:11600/46168Repositório InstitucionalPUBhttp://www.repositorio.unifesp.br/oai/requestopendoar:34652023-08-31T19:59:26Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP)false
dc.title.pt_BR.fl_str_mv Adrenal fatigue does not exist. A systematic review of the medical literature
title Adrenal fatigue does not exist. A systematic review of the medical literature
spellingShingle Adrenal fatigue does not exist. A systematic review of the medical literature
Cadegiani, Flavio Adsuara [UNIFESP]
Insuficiencia adrenal
Esgotamento adrenal
Cortisol
Fadiga
Adrenal failure
Adrenal depletion
Cortisol
Fatigue
title_short Adrenal fatigue does not exist. A systematic review of the medical literature
title_full Adrenal fatigue does not exist. A systematic review of the medical literature
title_fullStr Adrenal fatigue does not exist. A systematic review of the medical literature
title_full_unstemmed Adrenal fatigue does not exist. A systematic review of the medical literature
title_sort Adrenal fatigue does not exist. A systematic review of the medical literature
author Cadegiani, Flavio Adsuara [UNIFESP]
author_facet Cadegiani, Flavio Adsuara [UNIFESP]
author_role author
dc.contributor.institution.pt_BR.fl_str_mv Universidade Federal de São Paulo (UNIFESP)
dc.contributor.authorLattes.pt_BR.fl_str_mv http://lattes.cnpq.br/1780670748106294
dc.contributor.advisorLattes.pt_BR.fl_str_mv http://lattes.cnpq.br/1250728429385385
dc.contributor.author.fl_str_mv Cadegiani, Flavio Adsuara [UNIFESP]
dc.contributor.advisor1.fl_str_mv Kater, Claudio Elias [UNIFESP]
contributor_str_mv Kater, Claudio Elias [UNIFESP]
dc.subject.por.fl_str_mv Insuficiencia adrenal
Esgotamento adrenal
Cortisol
Fadiga
topic Insuficiencia adrenal
Esgotamento adrenal
Cortisol
Fadiga
Adrenal failure
Adrenal depletion
Cortisol
Fatigue
dc.subject.eng.fl_str_mv Adrenal failure
Adrenal depletion
Cortisol
Fatigue
description Background: The term “adrenal fatigue” (“AF”) has been used by some doctors, healthcare providers, and the general media to describe an alleged condition caused by chronic exposure to stressful situations. Despite this, “AF” has not been recognized by any Endocrinology society, who claim there is no hard evidence for the existence. The aim of this systematic review is to verify whether there is substantiation for “AF”. Methods: A systematic search was performed at PUBMED, MEDLINE (Ebsco) and Cochrane databases, from the beginning of the data until April 22nd, 2016. Searched key words were: “adrenal” + “fatigue”, “adrenal” + “burnout”, “adrenal” + “exhaustion”, “hypoadrenia”, “burnout” + “cortisol”, “fatigue” + “cortisol”, “clinical” + “burnout”, “cortisol” + “vitalility”, “adrenal” + “vitality”, and “cortisol” + “exhaustion”. Eligibility criteria were: (1) articles written in English, (2) cortisol profile and fatigue or energy status as the primary outcome, (3) performed tests for evaluating the adrenal axis, (4) absence of influence of corticosteroid therapy, and (5) absence of confounding diseases. Type of questionnaire to distinct fatigued subjects, population studied, tests performed of selected studies were analyzed. Results: From 3,470 articles found, 58 studies fulfilled the criteria: 33 were carried in healthy individuals, and 25 in symptomatic patients. The most assessed exams were “Direct Awakening Cortisol” (n=29), “Cortisol Awakening Response” (n=27) and “Salivary Cortisol Rhythm” (n=26). Discussion: We found an almost systematic finding of conflicting results derived from most of the studies methods utilized, regardless of the validation and the quality of performed tests. Some limitations of the review include: (1) heterogeneity of the study design; (2) the descriptive nature of most studies; (3) the poor quality assessment of fatigue; (4) the use of an unsubstantiated methodology in terms of cortisol assessment (not endorsed by endocrinologists); (5) false premises leading to an incorrect sequence of research direction; and, (6) inappropriate/invalid conclusions regarding causality and association between different information. Conclusion: This systematic review proves that there is no substantiation that “adrenal fatigue” is an actual medical condition. Therefore, adrenal fatigue is still a myth.
publishDate 2016
dc.date.issued.fl_str_mv 2016-12-31
dc.date.accessioned.fl_str_mv 2018-07-27T15:49:39Z
dc.date.available.fl_str_mv 2018-07-27T15:49:39Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
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dc.identifier.citation.fl_str_mv CADEGIANI, Flavio Adsuara. Adrenal fatigue does not exist. A systematic review of the medical literature. 2016. 68 f. Dissertação (Mestrado em Medicina: Endocrinologia Clínica) - Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), São Paulo, 2016.
dc.identifier.uri.fl_str_mv http://repositorio.unifesp.br/handle/11600/46168
dc.identifier.file.none.fl_str_mv Flávio Adsuara Cadegiani - PDF A.pdf
url https://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=4056701
http://repositorio.unifesp.br/handle/11600/46168
identifier_str_mv CADEGIANI, Flavio Adsuara. Adrenal fatigue does not exist. A systematic review of the medical literature. 2016. 68 f. Dissertação (Mestrado em Medicina: Endocrinologia Clínica) - Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), São Paulo, 2016.
Flávio Adsuara Cadegiani - PDF A.pdf
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dc.publisher.none.fl_str_mv Universidade Federal de São Paulo (UNIFESP)
publisher.none.fl_str_mv Universidade Federal de São Paulo (UNIFESP)
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