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Adrenal fatigue does not exist: a systematic review

Overview of attention for article published in BMC Endocrine Disorders, August 2016
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About this Attention Score

  • In the top 5% of all research outputs scored by Altmetric
  • One of the highest-scoring outputs from this source (#1 of 669)
  • High Attention Score compared to outputs of the same age (99th percentile)

Mentioned by

news
26 news outlets
blogs
8 blogs
twitter
1313 tweeters
facebook
65 Facebook pages
wikipedia
7 Wikipedia pages
reddit
1 Redditor
video
4 video uploaders

Citations

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19 Dimensions

Readers on

mendeley
375 Mendeley
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Title
Adrenal fatigue does not exist: a systematic review
Published in
BMC Endocrine Disorders, August 2016
DOI 10.1186/s12902-016-0128-4
Pubmed ID
Authors

Flavio A. Cadegiani, Claudio E. Kater

Abstract

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". 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. 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). 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. This systematic review proves that there is no substantiation that "adrenal fatigue" is an actual medical condition. Therefore, adrenal fatigue is still a myth.

Twitter Demographics

The data shown below were collected from the profiles of 1,313 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 375 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Brazil 2 <1%
Unknown 373 99%

Demographic breakdown

Readers by professional status Count As %
Student > Bachelor 68 18%
Student > Master 58 15%
Student > Doctoral Student 42 11%
Other 40 11%
Researcher 39 10%
Other 79 21%
Unknown 49 13%
Readers by discipline Count As %
Medicine and Dentistry 121 32%
Nursing and Health Professions 76 20%
Sports and Recreations 26 7%
Agricultural and Biological Sciences 22 6%
Biochemistry, Genetics and Molecular Biology 21 6%
Other 44 12%
Unknown 65 17%

Attention Score in Context

This research output has an Altmetric Attention Score of 827. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 11 August 2022.
All research outputs
#16,622
of 21,802,481 outputs
Outputs from BMC Endocrine Disorders
#1
of 669 outputs
Outputs of similar age
#326
of 285,793 outputs
Outputs of similar age from BMC Endocrine Disorders
#1
of 1 outputs
Altmetric has tracked 21,802,481 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 99th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 669 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 6.0. This one has done particularly well, scoring higher than 99% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 285,793 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 99% of its contemporaries.
We're also able to compare this research output to 1 others from the same source and published within six weeks on either side of this one. This one has scored higher than all of them