Adrenal support supplements, like adrenal cortex glandular, DHEA and licorice extract, are not steroids but they have the same end result of causing fatigued adrenals, to produce their own needed cortisol (what hydrocortisone steroids replace). Patients do need to research these and study the manufacturer's recommendations before using them and it's even better if your Doctor is behind you in taking them and monitoring progress and possible unwanted effects.
This seems so obvious and yet the medical community; for reasons I cannot understand, are reluctant to recognize adrenal support as treatment for adrenal fatigue, possibly because it is not a prescribed treatment or because it is not lab-developed or synthetic but is instead natural treatment.
Who knows for sure why many Doctors don't pay attention to studies stating the existence of sub-clinical hypoadrenalism, by very reputable groups, including the NIH, which found low cortical levels in syndromes like CFS and Fibromyalgia and the studies are out there go back many years but many still do not recognize it.
Since there are other hormone imbalances and conditions that have similar symptoms, my opinion, is that a person who suspects they may have an adrenal fatigue syndrome, should be tested to see where their adrenal hormone levels are.
Keep in mind as stated above, that many Doctors do not recognize adrenal fatigue but only the severe type of adrenal hypo-function, called Addison's Disease. Because of this, they will believe that a patient who passes a test called the ATCH Stimulation Test, which is designed to detect full blown adrenal insufficiency, needs no further investigation however, adrenal fatigue is sub-clinical (milder) and yet still causes serious symptoms. A patient with adrenal fatigue, will pass this test, every time but what they actually need tested for, are the "free levels" of the major adrenal hormones, namely "DHEA & Cortisol".
The ACTH Stimulation Test gauges the adrenals reaction to being stimulated by the pituitary hormone ACTH, the
problem is, with adrenal fatigue, the adrenals can be stimulated and react but they still produce low levels of adrenal hormones consistently and they usually crash afterward from extra stimulation because adrenal reserves are low. Being stimulated chemically from the outside as opposed having ongoing reserves, are not the same thing.
Adrenal fatigue and the other syndromes that have adrenal fatigue as a feature have as one proposed cause, a blunted HPA Axis. This is referring to the group of endocrine glands that supply our bodies with needed hormone. These glands are the Hypothalamus, Pituitary and Adrenals and they work in sync (axis) with each other but in these adrenal fatigue disorders, the response by these glands becomes "blunted" or slowed down, according to research that has been conducted. This is found commonly in conditions like CFS and Fibromyalgia and though some out there believe this to be a bogus idea, there are actually many U.S. Gov/NIH medical studies to back it up! Because of this fact, adrenal fatigue syndromes should be looked at as real illnesses, with reputable medical research behind them!
Many medical Doctors do not seem to be aware of these findings as mentioned above but it is referred to by several departments of the National Institutes of Health, including the CDC, NIAMS and also The American Journal of Psychiatry.
You can get saliva home test kits, inexpensively, that test these adrenal hormones. Check with your local Pharmacy and if they don't carry them (they do in many states), you can order adrenal hormone saliva tests, online.
If you test the hormones and see they are consistently low-normal and even near borderline or even clinically low, then it would be time to check into adrenal support, first through your Doctor who will first want to test to make sure you don't have full-blown adrenal insufficiency. If it is found to be the milder adrenal fatigue and not actual adrenal disease causing the more severe adrenal insufficiency but your Doctor does not believe in treating this lesser form of low-adrenal, you might try finding an Osteopath or Naturopath Physician, who does recognize adrenal fatigue and the treatments for it.
If these avenues are not available, you may want to purchase the over-the-counter adrenal support supplements and treat yourself. Should you do this, I would of course recommend taking only the manufacturer's recommended doses and also do research on the support supplements you may choose to take, to make sure they are safe for you and there are no contraindications that might affect you meaning; they will not interact negatively due to any other treatments you may already be on for other health issues.