Adrenal Insufficiency Support Group

Hey all has anyone out there been told u have Adrneal Fatique? How serious is this and what do u do to fix it? I love my doctor but stsrting to doubt his fix it method. Help. I cant take this exhustion. Im a non stop go all the time person but not anymore. Thanks all

I haven't. My docs more or less went straight to AI. In symptom terms the effect is pretty similar, so the line between the two is kind of blurry.

The fix for a "temporary" state of both AI and AF is more or less to wait it out for self repair. In some cases minimal gluco-corticoid support is given (eg Prednisone of Hydrocortisone), but that's a double edge sword. They can create an AI state as well. Downstream support of systems impaired by the low cortisol can also be undertaken. These are mainly aimed at better energy etc metabolism with B, C and sometime D group vitamins.

Care to elaborate? Any cortisol or ACTH testing done? How long and what symptoms? What did the doc suggest was the root cause? It would be smart to establish if you have AI instead.

Bob (Australia)

Hi Lovetofly,

I was given the diagnosis adrenal fatigue by my general doctor who admitted he was clueless on AI and SAI, and was basically trying to find something else wrong with me that he knew more about. He ordered quite a few tests, including ruling out ALS. I did find out along the way that I have low ferritin/iron and Vitamin D, but from reading others posts on here, I now believe those go hand in hand with AI much of the time. The doctor finally gave me a referral to an endocrinologists, which it took over three months to get into. He did give me a prescription for prednisone to hold me over until I got into the endo. I have now seen the endo twice and do have a diagnosis of SAI and was switched to HC.

Nevertheless, I'm with Bob, it would be to your benefit to determine if it is actually AI. I do have a friend that had the temporary fatigue experience that was pretty severe due to a series of cortizone shots she received from an ortho surgeon. Good luck on your journey.

Tanya

Hi and sorry to hear about your fatigue. However, if he is a "good doc" he would have done testing, such as a cortisol and/or ACTH blood draws. I was in adrenal crisis when I was dg, yet still underwent a 3 hour cortisol test. And now I'm on pred for the rest of my life. And the constant fatigue is only part of this rare disease. I see our member, Bob, posted to you. He's our most knowledgeable person about this illness, and I hate to tell you that it's not fixable, meaning it cannot be cured. Also ask your doc if you have primary or secondary addisons.

Hi there and thanks. My doc did do a siliva test and I have extremly low cortisol in the AM and very high in the afternoon. And my thyroid when checked was not normal either. He is trying a more natural way then the predisone or the other things. My hormones also were very low (have had a comp. hysterectomy). He has put me on a low dose of bio hormones. Mine came on pretty quick (at least I think). The fatigue is the most awful thing I am always on the go. No more of that. What is addisons? Thanks for your response. Not to many people out there understand this.

The actual definition of Addisons kind of varies from place to place. It generally implies "low adrenal output" of the cortex end of the gland. This roughly means three basic steroid systems are or can be affected, gluco-cortcoids (cortisol), mineralo-corticoids (aldosterone) and androgens (DHEA, testosterone etc). The confusion happens though when you realize that the "low output" can not only be damage to those glands, but also the pituitary or hypothalamus. These disease names tend to be called primary, secondary or tertiary AI. The hypothalamus/pituitary "measures" the adrenal outputs and regulates them by sending control hormones out. For AI that's mainly ACTH.

So it's all kind of complex and there are many interdependencies. Low adrenal gluco-cortcoids tend to lower thyroid activity for example and low androgens can affect sex hormones, cycles and the like. Even having a hysterectomy can affect the feedback/control loop via the pituitary. Think of the adrenal glands supplying the substrate hormones for the reproductive system and you won't be far wrong.

It's important to note that with such a complex system that everyone's experiences can be different and one treatment doesn't fix all.

In terms of day to day severity the lack of cortisol seems to be the most important. The most common treatment is 3-4 declining size daily doses of hydrocortisone. Other gluco-corticoids (like Pred) can also be used and they each have their pluses and minuses.

They usually use the "ACTH stimulation test" or "Synacthen stimulation test" to determine if the AI is primary or not.

The mineralo-corticoid side is very important for hydration, BP control, K and Na balance. This is what can make untreated primary AI a fatal illness. It's pretty obvious if you have it though!

This description of course is only a rough summary. I don't want to make it a hundred pages long!

Bob

Hi Lovetofly,

My doc thought I had adrenal fatigue but now it's looking as though I have an autoimmune disease. It seems that the endocrine system and the immune system are very tightly intertwined. So, if you have eliminated AI and not improving your adrenal fatigue with treatment, that may be something else to look into - diseases such as lupus, Crohn's, rheumatoid arthritis, to name just a few.

Best,

Nymph