Adrenal Fatigue or Something Worse?

We hear about ‘adrenal fatigue’ on a daily basis. There are thousands of people in social media groups, making appointments at various doctor’s offices, and self-diagnosing with ‘AF’ because of being tired or showing ‘symptoms’ of Adrenal Insufficiency. This is dangerous for both the individual who feels something is wrong, as well as Adrenal Insufficiency patients.

If a person treats themselves for Adrenal Insufficiency but doesn’t have it, they can have fatal consequences if they discontinue steroids they’ve been taking without proper weaning, since the adrenal glands quit making cortisol when you are artificially supplying the body with them. Suddenly stopping the medication will cause you to go into an adrenal crisis, which can be fatal without immediate treatment. You cannot live without cortisol! That cannot be ‘stressed’ enough.

It is also dangerous to the Adrenal Insufficiency patient, because people start confusing their serious illness with a non-existent ‘condition’, and not take their treatment, care, or emergencies seriously.

While a person may have numerous symptoms, it is important for an endocrinologist—a doctor who specializes in hormonal disorders—to assess your symptoms, history, and order labs that they can interpret. Many illnesses have similar symptoms, and there is a lot of important information found by those trained in a physical exam and laboratory or even imaging analysis.

Adrenal Insufficiency is an endocrine disorder that occurs when the adrenal glands do not produce enough of certain hormones. These hormones are necessary for life. These hormones are typically cortisol and/or aldosterone. However, other hormones can be involved depending on if you have Addison’s Disease, Secondary Adrenal Insufficiency or Congenital Adrenal Hyperplasia. There are forms of the illness which affect only cortisol, and there are also forms of Adrenal Insufficiency that affect only aldosterone on a daily basis, but at a certain point in the crisis pathway, also involve cortisol.

Humans have two adrenal glands—one on top of each kidney, located in the back of the upper abdomen, or near the stomach. They are also known as the Suprarenal Glands, and consist of two parts. The inside layer is called the ‘medulla,’ and it produces the hormone epinephrine. People are familiar with epinephrine, as it is often referred to as the ‘fight or flight’ hormone, and is also a necessary injection for people who are allergic to bee stings, or other allergies (‘epi-pen’ for example) or certain heart situations.

The outside layer of the adrenal is called the cortex, and it makes important hormones that help the body to function normally. The main hormones are cortisol (a glucocorticoid) and aldosterone (a mineralocorticoid).

Some patients are not diagnosed until they present with a life-threatening Adrenal Crisis. If any of the Adrenal Insufficiency diseases have not been suspected, it can be quite mysterious to medical personnel what is wrong. If the patient is a child that has not been screened for Congenital Adrenal Hyperplasia, they should be treated for adrenal crisis if showing symptoms before labs are drawn to seek diagnosis. There is no time to spare!

Adrenal Crisis is a life-threatening condition that occurs when there is not enough cortisol—or when there is a salt-wasting crisis, which crosses over in the pathway of events to use up cortisol.

While it is absolutely necessary to take pharmaceutical replacements if your body is not making enough cortisol and aldosterone, it is also possible to take care of your body in such a way that you don't have to take tons of the stuff. One book, Living with All Forms of Adrenal Insufficiency, helps victims of this disease learn to do just that. It is available on Amazon.