Eleutherococcus gracilistylus, a species related to Eleutherococcus senticosus (Siberian ginseng), is traditionally used in East Asian herbal medicine as a general adaptogen to help the body resist various types of stress. The concept of "adrenal fatigue" is not recognized in conventional medicine, but in alternative and naturopathic circles, adaptogenic herbs like Eleutherococcus are often recommended to "support" adrenal function or help with stress-related exhaustion. Historical texts and traditional Chinese medicine (TCM) literature describe uses of Eleutherococcus species for boosting vitality, energy, and resilience to stress, which underpins their application for conditions resembling what is now called "adrenal fatigue."

Scientifically, while some studies on related species (notably E. senticosus) have investigated their effects on stress response and fatigue, there is very limited direct research on Eleutherococcus gracilistylus specifically. Most available evidence is indirect or extrapolated from similar plants, and human clinical trials are lacking. Thus, the use of E. gracilistylus for "adrenal fatigue" is primarily based on traditional knowledge and anecdotal reports rather than robust scientific data. The overall evidence supporting its efficacy for this condition is weak and should be considered with caution.