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.