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Addison's Disease Message Board

Addison's Disease Board Index

Dear friends,

I think the reason you may not have gotten answers on this board is that people tend to separate Adrenal insufficiency or Addison's or secondary Addison's from adrenal exhaustion. There are even those who argue about whether adrenal exhaustion (usually putting forth the idea that adrenal glands can be temporarily exhausted but then recoop and get better) is disputed by many. There are doubtless many who think this is a phenomenon that occurs, but there are also probably MORE who believe that these signs and symptoms are merely what occurs prior to complete adrenal failure. So many are afraid or reluctant to speak about your topic "adrenal exhaustion". I know, because I was trying to figure out whether you could have temporary exhaustion and recover or not, too, for my son's sake. He shows the early signs, as you two do, but is not tan, nauseaed or experiencing an actual adrenal CRISIS. What blood or urine tests, if any, have you had? You mention wanting to know the stages, but it seems that no matter what stage, the diagnosis would be very helpful to you. Have you had a morning cortisol draw done (blood)? Or a 24 hr. urine cortisol (which some doctors do)? Have you had an ACTH stim test? Have you ever had a thyroid panel done, taken your temps in the morning, had blood tests of your potassium, sodium, renin, aldosterone, ACTH in plasma, MRI of pituitary or adrenal glands? These with some other tests might be advisable. Some of the feelings you describe suggest hypoglycemia (which is common with adrenal malfunction, as well) and/or diabetes (probably hypo.). All of your symptoms are VERY indicative of low cortisol, no matter what stage of adrenal or pituitary weakening. I think the tests would help you more than identifying the stage of adrenal functioning you are in, if I may say so. ~ :wave: Tracy
Well then, that explains why there is less on adrenal exhaustion on this board than I was hoping for - and that makes sense, I think. Let's identify this disorder, for purposes of this post, as secondary hypoadrenia, in which full recovery is possible. Because adrenal exhaustion is a fairly common secondary condition to hypothyroidism, you will find some information, though limited, on that board.

Ok, I'm not the most knowledgeable, but I'll attempt to explain a little more, on top of Tracy's post, if that's ok.

In adrenal exhaustion, typically, the adrenals have been working over-time for years due to chronic stress - stress, meaning mental/emotional, allergies, illness, surgery, etc.... not just mental/emotional. The adrenals can only do this for so long, before they get exhausted. There is also some evidence that they can sort of get stuck in a hypo state from this exhaustion. Generally (I think) it is possible to recover from this exhaustive state, over the course of several months to a few years, give the right environment, nutrition, stress reduction, illness and allergy reduction, etc.

Because adrenal exhaustion is not full-blown adrenal failure, the testing needs to be more sensitive. A single blood test, or a 24 hour urine collection is not suitable to diagnose adrenal exhaustion. The best method for this is the 4 collection saliva test, taken over the course of one day, at morning, noon, evening and midnight. This will show how your cortisol output compares to what is normal for that time of the day. The blood or urine test above, will only average the day out. It is common with this disorder, to have normal output in the morning and midnight, for example, and low output during the day.

I would first, however, have some of the other tests Tracy mentions, to rule out other causes. The ACTH stimulation test, for example. Most of these tests are not uncomfortable, and are easy to have done.

I would also suggest having your thyroid hormones testes. Generally only TSH is tested. This is a useful screening test, but inadequate if you do have hypothyroidism. If so, you will need free T3 and free T4 (not the same as total T3 and total T4), and also TPO and TG antibodies (but this isn't the thyroid forum is it?).

How that helps .... my apologies in advance, on my lack of full adrenal knowledge.

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