Adrenal fatigue is a diagnosis used mostly in alternative medicine, usually among naturopathic physicians. The diagnosis is based on the theory that the adrenal gland, if underfunctioning, can fail to produce sufficient quantities of cortisol. Treatment often involves prescribing cortisol in addition to addressing diet, timing of eating, and amount of rest. I have two concerns about this diagnosis and its treatment. First, adrenal fatigue may actually be adrenaline dominance, a condition of adrenal overfunctioning rather than underfunctioning. Second, prescribing cortisol for a condition possibly already associated with a high cortisol level may have unintended consequences. Cortisol, if given inappropriately,...