Fatigue can be an insidious ailment, creeping up on you day after day and night after night. For a while, you might think you are just tired; work has been rough, you haven’t been sleeping right, and you’ve had a lot on your mind. But as the days turn into weeks and your health suffers—or even deteriorates—you realize there is something very off, genuinely wrong, and potentially very dangerous.
That something could be adrenal insufficiency.
Adrenal insufficiency is a serious medical condition with several possible causes and a host of debilitating and even deadly symptoms. By recognizing the symptoms of adrenal insufficiency, you can ensure that you get the support you need to restore healthy function and start on the path to better health.
What Is Adrenal Insufficiency?
In a way, adrenal insufficiency suffers from its own name; “insufficient” sounds like a minor bother rather than a major issue. But that is far from the case. As a 2014 article published in Lancet describes:
Adrenal insufficiency is the clinical manifestation of deficient production or action of glucocorticoids, with or without deficiency also in mineralocorticoids and adrenal androgens. It is a life-threatening disorder that can result from primary adrenal failure or secondary adrenal disease due to impairment of the hypothalamic-pituitary axis. Prompt diagnosis and management are essential.
In other words, adrenal insufficiency is defined by a lack or dysfunction of critical hormones.
One of the most prominent of these hormones is cortisol—and its absence can have serious repercussions on your physical and emotional well-being.
Cortisol is commonly known as the stress hormone because the body produces more of it during times of stress, helping you manage your response in trying situations. However, cortisol also continually affects your body in a variety of significant ways—even when you are not experiencing overt stress. As the Hormone Health Network explains:
Cortisol can help control blood sugar levels, regulate metabolism, help reduce inflammation, and assist with memory formulation. It has a controlling effect on salt and water balance and helps control blood pressure. In women, cortisol also supports the developing fetus during pregnancy.
When you recognize the multitude of roles cortisol plays in the body, you can begin to understand why low levels are so dangerous. Not only is low cortisol associated with impaired quality of life, patients with adrenal insufficiency also have higher mortality rates than those with healthy adrenal function.
The Causes of Adrenal Insufficiency
In common reading, Addison’s Disease and adrenal insufficiency are essentially interchangeable. Addison’s Disease is an inadequate release of hormones (especially, though not exclusively, cortisol) by the adrenal cortex. This is, of course, a type of adrenal insufficiency.
But Addison’s isn’t the only cause. Indeed, according to the National Institute of Diabetes and Digestive and Kidney Diseases, “Anything that affects the pituitary’s ability to make ACTH can cause secondary adrenal insufficiency.” This can be from anything from the surgical removal of the pituitary gland to traumatic brain injury to a different type of autoimmune disorder. Possible causes can also include bleeding in the pituitary, pituitary tumors or infection, and genetic diseases that disrupt healthy pituitary development or function. While some of these conditions are easily recognized, others you might not recognize until they have already compromised your quality of life or present more significant health risks. That’s why it is vital to recognize the symptoms of adrenal insufficiency as early as possible.
The Symptoms of Adrenal Insufficiency
The symptoms of adrenal insufficiency are varied and can range in severity from mild to debilitating. They include:
- Chronic fatigue
- Sleep disturbances
- Weight loss
- Reduced appetite
- Muscle weakness
- Abdominal pain
- Low blood pressure (can lead to dizziness and fainting)
- Diminished sex drive
- Mood disorders, including depression
Many of these symptoms are not only uncomfortable in their own right, but reverberate throughout your work, your social life, your relationships, and your sense of self. They also have the potential to spiral and multiply, compounding each other.
Unfortunately, some patients fail to seek prompt medical attention for these symptoms. And it’s easy to understand why—many of the symptoms of adrenal insufficiency can be brushed off as the logical outcome of a stressful lifestyle, attributed to the natural aging process, or seen as a manifestation of burnout syndrome. In fact, even those who do seek treatment may experience delayed diagnosis in part because the symptoms overlap with those of so many other conditions, particularly psychiatric and gastrointestinal disorders. One research cohort found that “[l]ess than 30% of women and 50% of men with [adrenal insufficiency] were diagnosed within the first 6 months after onset of symptoms.” Furthermore, 20% experienced symptoms for more than 5 years before being diagnosed, 68% were initially misdiagnosed, and 67% consulted at least 3 different physicians before receiving an accurate diagnosis.
Getting the Best Treatment for Adrenal Insufficiency
If you are experiencing symptoms of adrenal insufficiency, it is critical to seek the guidance of a medical professional as soon as possible. Although adrenal insufficiency can be difficult to diagnose early on, blood work that shows low cortisol levels can be an indicator of adrenal dysfunction. To confirm diagnosis, a variety of other tests may be performed, including tests related specifically to Addison’s disease as well as conditions that may cause secondary adrenal insufficiency.
If you are diagnosed with adrenal insufficiency, there are a variety of treatment options available. The centerpiece of most treatment plans is hormone replacement therapy, including hydrocortisone, prednisone or methylprednisolone medications to replace cortisol. However, conventional therapies may not fully restore quality of life for all patients. As a result, there is growing interest in the use of other forms of hormone replacement therapy, including dehydroepiandrosterone (DHEA), to provide greater symptom relief. Although research is ongoing, some studies have “demonstrated beneficial effects of DHEA on health perception, vitality, fatigue, and (in women) sexuality” in patients with adrenal insufficiency. There is also some evidence that testosterone replacement therapy may play an important role in the treatment of adrenal insufficiency.
To ensure you get the best treatment possible, it’s important to seek out a practitioner who specializes in hormone health and will work with you to create a personalized treatment plan based on your body’s needs and your personal preferences. They can help you understand all of your treatment options and choose a path that makes sense for you—and fine-tune that path to improve treatment response. If your adrenal insufficiency is a secondary condition, they can also work with other members of your health care team to ensure the full scope of your medical needs is addressed.
Adrenal insufficiency is serious. It can damage your health, derail your life, and possibly prove fatal. Recognizing its symptoms is essential getting diagnosed, getting treated, and getting your hormones back where they need to be.
If you are experiencing symptoms of adrenal insufficiency, BodyLogicMD can help. The BodyLogicMD network is comprised of top medical professionals specializing in hormone health, hormone replacement therapy and integrative medicine. By creating personalized treatment plans tailored to the needs of each patient, BodyLogicMD-affiliated practitioners can help you address your symptoms and enhance your quality of life. Contact a local practitioner to schedule your first appointment, or take the BodyLogicMD Hormone Balance Quiz today.
Note: The practitioners in the BodyLogicMD network are not endocrinologists and while some HRT treatment may help relieve symptoms, seeking professional help from an endocrinologist is best.
Disclaimer: These statements have not been evaluated by the Food and Drug Administration. All content on this website is for informational purposes only. The content is not intended to diagnose, treat, cure or prevent diseases.
Charlotte is a patient care coordinator specializing in bioidentical hormone replacement therapy. She is committed to helping patients who struggle with the symptoms of hormonal change and imbalance explore their treatment options and develop effective strategies to optimize wellness.