Adrenal Fatigue vs. Addison’s disease – What is the difference?

Here at Healed by Bacon we suffer from a myriad of health problems – autoimmune diseases, adrenal insufficiency – you name it, we’ve got it! (All jokes aside, if we didn’t have them we wouldn’t be able to help everyone else struggling to find answers about why they feel the way they do).

If you have read my About section, you would know that I have Addison’s disease – an autoimmune disease whereby the body attacks the adrenal glands and therefore can’t produce enough cortisol. Addison’s is quite rare; affecting only 1 in 100,000.

However, in the later stages of adrenal fatigue the line between AF and Addison’s (or adrenal insufficiency) can become blurred.

While the two conditions are etiologically different (that is the causes are different), the symptoms they produce are quite similar – both resulting in the dysfunction of the adrenal glands (i.e. feeling like crap!).

addison's disease

So what is Addison’s disease anyway?

Addison’s is a hormone, or endocrine, disorder that occurs when the adrenal glands don’t produce enough cortisol and aldosterone. Adrenal insufficiency can be categorized as primary or secondary. Addison’s disease is the common term for primary adrenal insufficiency. Secondary adrenal insufficiency occurs when the pituitary gland fails to stimulate the adrenal glands to produce enough of the hormone cortisol.

Approximately 70% of diagnosed cases of Addison’s disease are caused by autoimmune disorders, where the body’s own immune system gradually destroys the adrenal cortex (the outer layer of the adrenal glands).

Symptoms of Addison’s disease

The symptoms of adrenal insufficiency usually begin gradually and can often be confused for the later stages of adrenal fatigue. Common symptoms include:

  • Salt cravings,
  • Irritability,
  • Muscle weakness,
  • Hyperpigmentation and/or vitiligo,
  • Hypoglycaemia,
  • Dizzy spells or fainting (due to low blood sugar),
  • Irregular or non-existent menstrual periods,
  • Loss of libido (especially in women),
  • Depression, and
  • Extreme fatigue (often chronic fatigue).

Diagnosing of Addison’s disease

In its early stages, adrenal insufficiency can be difficult to diagnose (due to the similarity of symptoms with the later stages of adrenal fatigue). Generally, the presence of hyperpigmentation and/or vitiligo will provide a significant indication of suspected Adison’s disease.

A diagnosis of Addison’s disease is made by biochemical laboratory tests. The aim of these tests is first to determine whether there are insufficient levels of cortisol and then to establish the cause. X-ray exams of the adrenal and pituitary glands also are useful in helping to establish the cause.

Adrenal Crisis

Sudden, severe worsening of adrenal insufficiency symptoms is called adrenal crisis or, when suffering from Addison’s disease, an Addisonian crisis. In the majority of cases, symptoms of adrenal insufficiency become serious enough that medical treatment is sought before an adrenal crisis occurs.

Common symptoms of adrenal crisis can include:

  • Sudden, severe pain in the lower back, abdomen, or legs,
  • Severe vomiting,
  • Severe diarrhoea,
  • Dehydration,
  • Low blood pressure, and
  • Loss of consciousness.

If not treated, an adrenal crisis can cause death.

How is adrenal crisis treated?

Adrenal crisis is treated with adrenal hormones. People with adrenal crisis need immediate treatment. Any delay can cause death. When people with adrenal crisis are vomiting or unconscious and cannot take their medication, the hormones can be given intraveneously.

A person with adrenal insufficiency should carry a corticosteroid injection at all times and make sure that others know how and when to administer the injection, in case the person becomes unconscious. They should also wear a Medicalert bracelet detailing their illness and medication requirements.

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The 4 Stages of Adrenal Fatigue

4 stages of adrenal fatigue

Adrenal Fatigue (AF) – sounds like a self-explanatory illness right? It’s when your adrenals become fatigued? Well yes, but it is also a lot more complex and debilitating than it sounds (as we’re sure you know if you are reading this)!

The interconnectivity and complexity of AF lead to an elaborate picture of conflicting symptoms that seem to defy conventional medicine logic – in one blood test your DHEA levels are elevated, in the next they are depleted. It seems like our body is having an ad-hoc response, but that’s not the case, it may seem like this because our medical understanding of AF is still in its infancy. (Who even knew there were 4 stages of AF anyway? We sure didn’t until we did some in depth research!).

In order to help you sift through the piles and piles of information on the internet about AF, we’ve used this post to compile a list of the 4 stages of AF and their symptoms. These are the common symptoms sufferers experience – because our bodies like to throw us curveballs now and again, you might be also experiencing different symptoms so it is important to seek out advice from an AF specialist to help with your recovery.

Stage 1 – The Alarm Phase

This is our body’s fight or flight response to a stressor. In order to manage this stress, our body launches an anti-stress response by increasing the production of the anti-stress hormone cortisol. During Stage 1 of AF, our body is quite capable in responding to this new stressor and usually produces a more than adequate response to it. During this phase, your blood test results might show:

  • Elevated cortisol, Insulin and DHEA levels, as well as
  • Increased blood sugar levels.

During this stage of AF, the fatigue experienced is quite mild and if noticeable, tends to strike around waking and/or mid-afternoon (and sometimes we just write that feeling off as not having a good night’s sleep or having a busy day at work).

As we continue to be exposed to this new stressor, cortisol levels remain elevated and we start to look for stimulants (e.g. coffee to wake us up and that 3pm choc chip cookie for energy). As higher insulin levels continue, our pancreas has to work harder and our blood sugar levels get further out of whack.

If we continue in this stage for longer periods of time we begin to experience a redistribution of fat from our bum and thighs to around our bellies.

Stage 2 – Resistance Response

With continued stress our adrenal glands realise they can’t tackle this problem by themselves and call on our hormones and neurotransmitters to help.

In this stage, the body will start to shift its supply of hormone precursor material from hormone production to cortisol production. If this stage of AF is not treated it can lead to long term hormonal imbalances and problems. Stages of adrenal fatigue

During this stage, your blood test results might show:

Despite a full night’s rest, in this stage of AF you probably wake up tired and not feeling refreshed. During stage 2 you might experience the following symptoms:

  • Anxiety,
  • Irritability,
  • Insomnia (it becomes harder to fall asleep and you begin to wake up more and more throughout the night),
  • Feeling sub-optimal,
  • Infections occurring more often as the immune system weakens,
  • Dehydration,
  • Low blood pressure,
  • Loss of libido,
  • PMS and menstrual irregularities, and
  • Symptoms suggestive of hypothyroidism – It’s during this stage that the thyroid gland starts to be affected. Sluggishness, feeling cold, and weight gain, despite exercise and diet, are predominant symptoms.

Stage 3 – Adrenal Exhaustion

As the name suggests, after continuous exposure to stress, the adrenal glands have become exhausted, unable to keep up with the ever increasing demand for cortisol production needed to overcome the stress.

The body enters this stage with the objective of conserving energy in order to survive. Systematically, the body goes into slow-down mode. In order to produce energy, the body will begin to break down muscle tissue, resulting in the breakdown of muscles and protein wastage.

Common symptoms of this stage are much more prevalent, including:

  • Exercise or general activity intolerance,
  • Extreme sensitivities to food you were once able to eat without problem,
  • Chronic fibromyalgia,
  • Brain fog,
  • Significant Insomnia,
  • Severe and constant depression.

As stage 3 progresses, metabolic, immunological and neurological organ systems dysfunction characteristic of Stage 2 become chronic. This is evidenced by multiple endocrine axis dysfunctions, including the ovarian-adrenal-thyroid axis imbalance in females and adrenal-thyroid axis imbalance in males. When these axis become imbalanced women may experience amenorrhea (loss of periods) and their fertility may become compromised (you could look at it as the body’s way of saying that it is not healthy enough to sustain a pregnancy).

As this stage progresses, the body slows down even further. The body’s pool of hormones eventually fall to levels too low to prime the adrenals and without sufficient levels of hormones, the body goes into a full-blown shut down mode. In this mode, the body tries to stop as much of the non-essential functions as possible to conserve energy in order to survive. Libido is suppressed, digestion slows down and metabolic rate declines to conserve body weight. Generally, at this stage of AF you are not able to work, predominantly bed ridden and requiring multiple naps throughout the day.

Stage 4 – Adrenal Failure

This is not a stage you want to come anywhere close to. This is the stage where the body has done everything it can in order to survive but is still being faced with significant stress that it cannot overcome. In this stage of AF there is a serious chance of cardiovascular collapse and death.

Symptoms of this stage include:

  • Sudden, penetrating pain in the lower back, abdomen or legs,
  • Severe vomiting and diarrhea,
  • Dehydration,
  • Low blood pressure, and
  • Loss of consciousness.

Given you are reading this post, the chance of you reaching stage 4 AF is probably pretty slim – you are doing everything you can to help your recovery. We hope that this blog post has shed some light on the types of symptoms you might experience during each of the stages (because as you know, they can often become blurred). Our next post will discuss recovery techniques for each of the 4 stages.

The 4 Stages of Adrenal Fatigue – Recovery Plan

Adrenal Fatigue Recovery

Are you tired, run down, gaining weight and feeling less than optimal? Have you read our post The 4 Stages of Adrenal Fatigue and recognised a cluster of symptoms that you are experiencing? Or have you just been diagnosed with Adrenal Fatigue? Well if you answered yes to any (or all) of these questions then you have come to the right place!

This post is about what methods and techniques you can use to help recover from the 4 different stages of Adrenal Fatigue. We tend to focus on Stage 1 and Stage 2 recovery techniques as these are the ones you are most likely able to recover from with minimal help from Nutritional Doctors and Adrenal Fatigue Specialists.

Stage 1 – The Alarm Phase

This is the first stage of AF and generally occurs without being noticed. Recovery from this phase of AF is often quick and can come from a good night’s sleep and reducing the amount of activity undertaken.

Examples of techniques you could use to reduce the amount of stress you face in everyday life might include:

  • Writing in a journal – there are 2 options here (1) each morning when you wake up, write down what it is you want to achieve, breaking each task down into measurable, quantifiable goals so you know exactly what it is you ‘need’ to get done and (2) each night when you get home or before you go to bed, write down how your day went, use this time to write about what has been stressing you out and how you can do something to remove or reduce that stress (for example you are stressed you can’t cook a healthy dinner for your family when you get home from a long day at work – take some time on the weekend for meal prep, that way when you get home everything is ready to go). Meditation_and_Autoimmune
  • Meditation – practicing mindful meditation throughout the day can help you manage stress levels. Take 5 mins in the morning, during your lunch break or at night to sit calmly in a quite spot and focus on deep breathing. We also like to use guided meditation to help calm our minds.
  • Reduce the amount of exercise you are doing – whilst we recommend getting in 10,000 steps a day, pushing yourself to the limit through long, intense workouts at the gym is not necessary.
  • Refresh your diet – there is no place in your diet for sugary drinks and processed foods. If you are eating these types of foods it is time to re-evaluate your diet and focus on fresh, wholesome foods.
  • Listening to your body – tired at 8.30pm, go to bed. Believe it or not, our bodies are pretty good at telling us what we need…we just have to listen!

Stage 2 – Resistance Response

Once Stage 1 AF has progressed to Stage 2 it is going to take longer to recover. During this phase it is important to put into action the stress-reducing techniques we talk about in Stage 1. It is also important to really focus on “constructive rest”.

“Constructive rest” is taking time out for yourself to rest and recoup. This might be taking more time to focus on meditation and breathing exercises, taking a nap during the day and going to bed earlier.

During this stage of AF it is important to reduce the amount of exercise you are doing and substitute intense workouts for more adrenally restorative exercises such as yoga and tai chi. As a rule of thumb, the more adrenally fatigued a person is, the more gentle the exercise needs to be. Exercising too much can push someone further down the AF spectrum. The timing of your workout also plays a part in your recovery – working out after 6pm can impact the production of epinephrine and norepinephrine, messing with your ability to wind down and fall asleep.

A focus on diet and lifestyle factors during this stage is imperative. For more information on what to eat for AF, what not to eat for AF and how to eat for AF, check out our other blog posts.

We also highly recommend seeing an Adrenal Fatigue specialist when you are trying to recover from Stage 2 (or Stage 3 and Stage 4) AF. They will be able to provide you with recovery advice tailored to your specific symptoms and requirements.

Stage 3 – Adrenal Exhaustion

Recover from Adrenal Fatigue

Recovery from Stage 3 needs to be taken extremely seriously. During this stage the body is beginning to shut down. Rest and lots of it is in order.

Holistic medical advice should be sought and generally supplementation needs to be used to provide the body with the nutrients and hormones it needs to recover.

Throughout Stage 3 of AF, exercise should really only consist of tai chi and walking. Any exercise that requires more energy than walking is using up energy that could be used for recovery.

Generally in Stage 3 AF our bodies can hardly function so it is unlikely you would be able to get out of bed to go to work anyway, but it would be recommended to take some time off work during this stage.

As with all stages of AF recovery, we should be giving our bodies less to do and giving it more time to rest and restore.

Stage 4 – Adrenal Failure

Go to hospital immediately.

When recovering from AF it is important to remember that it will take some time – we didn’t get to this stage overnight. It is common for AF recovery to take 3 – 6 months, and even longer for those in the later stages of the illness (or for those suffering from other illnesses). Be patient – and if you are sick and tired of being sick and tired, just think, these months of recovery is time for you to focus on yourself and put yourself first.