Adrenal Insufficiency (e.g. Addison Disease) Quiz

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Easily tired

Malaise

Low blood pressure

Hyperpigmentation

Dizziness

Brain fog

Dark skin

Weight loss

Muscle weakness

Skin discoloration

Extreme fatigue

Fainting

Not seeing your symptoms? No worries!

What is Adrenal Insufficiency (e.g. Addison Disease)?

The adrenal gland is an organ that releases hormones to control blood pressure and metabolism. In this condition, there are low hormone levels, and the causes include damage to the adrenal glands themselves or parts of the brain that control the adrenal gland. It can present with darkened areas of skin, extreme loss of body water, also known as dehydration, fatigue, weight loss that doesn't happen on purpose, nausea, vomiting or belly pain, lightheadedness or fainting, salt cravings, muscle or joint pains.

Typical Symptoms of Adrenal Insufficiency (e.g. Addison Disease)

Diagnostic Questions for Adrenal Insufficiency (e.g. Addison Disease)

Your doctor may ask these questions to check for this disease:

  • Do you have darkened skin?
  • Do you feel overwhelmed or frightened every day?
  • Do you have difficulty concentrating?
  • Have you noticed any blood in your stool?
  • Have you been experiencing decreased motivation recently?

Treatment of Adrenal Insufficiency (e.g. Addison Disease)

Treatment involves replacing the missing hormones. Regular follow-ups are necessary to ensure the hormone dose is correct. The doctor may also recommend a "sick day dose" to increase hormone levels when fighting an illness.

Reviewed By:

Unnati Patel, MD, MSc

Unnati Patel, MD, MSc (Family Medicine)

Dr.Patel serves as Center Medical Director and a Primary Care Physician at Oak Street Health in Arizona. She graduated from the Zhejiang University School of Medicine prior to working in clinical research focused on preventive medicine at the University of Illinois and the University of Nevada. Dr. Patel earned her MSc in Global Health from Georgetown University, during which she worked with the WHO in Sierra Leone and Save the Children in Washington, D.C. She went on to complete her Family Medicine residency in Chicago at Norwegian American Hospital before completing a fellowship in Leadership in Value-based Care in conjunction with the Northwestern University Kellogg School of Management, where she earned her MBA. Dr. Patel’s interests include health tech and teaching medical students and she currently serves as Clinical Associate Professor at the University of Arizona School of Medicine.

Hidetaka Hamasaki, MD

Hidetaka Hamasaki, MD (Endocrinology)

Dr. Hamasaki graduated from the Hiroshima University School of Medicine and the Graduate School of Medicine, Jichi Medical University. He completed his residency at the Department of Diabetes, Endocrinology and Metabolism, National Center for Global Health and Medicine Hospital and the Department of Internal Medicine, Kohnodai Hospital, National Center for Global Health and Medicine. He has served in the National Center for Global Health and Medicine Hospital and Kohnodai Hospital and joined Hamasaki Clinic in April 2017. Dr. Hamasaki specializes in diabetes and treats a wide range of internal medicine and endocrine disorders.

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Content updated on Dec 6, 2024

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Symptoms Related to Adrenal Insufficiency (e.g. Addison Disease)

Diseases Related to Adrenal Insufficiency (e.g. Addison Disease)

FAQs

Q.

Can cortisol be the reason I’m gaining weight?

A.

Yes, cortisol, a hormone released during stress, can contribute to weight gain by affecting how your body stores fat.

References:

Hewagalamulage SD, Lee TK, Clarke IJ, & Henry BA. (2016). Stress, cortisol, and obesity: a role for .... Domestic animal endocrinology, 27345309.

https://pubmed.ncbi.nlm.nih.gov/27345309/

Moyer AE, Rodin J, Grilo CM, Cummings N, Larson LM, & Rebuffé-Scrive M. (1994). Stress-induced cortisol response and fat distribution in .... Obesity research, 16353426.

https://pubmed.ncbi.nlm.nih.gov/16353426/

Roberts CJ, Campbell IC, & Troop N. (2014). Increases in weight during chronic stress are partially .... European eating disorders review : the journal of the Eating Disorders Association, 24123563.

https://pubmed.ncbi.nlm.nih.gov/24123563/

See more on Doctor's Note

Q.

Can I safely make a ‘cortisol cocktail’ every morning instead of coffee?

A.

Drinks with adaptogens and caffeine may offer benefits, but it's important to understand their effects and consult a healthcare provider before replacing coffee with a 'cortisol cocktail.'

References:

Boolani A, Fuller DT, Mondal S, Wilkinson T, Darie CC, & Gumpricht E. (2020). Caffeine-Containing, Adaptogenic-Rich Drink Modulates .... Nutrients, 7399841.

https://pmc.ncbi.nlm.nih.gov/articles/PMC7399841/

Baba Y, Inagaki S, Nakagawa S, Kobayashi M, Kaneko T, & Takihara T. (2021). Effects of Daily Matcha and Caffeine Intake on Mild Acute .... Nutrients, 8156288.

https://pmc.ncbi.nlm.nih.gov/articles/PMC8156288/

Almudhi A, & Gabr SA. (2022). Green tea consumption and the management of adrenal .... Biomedical Reports, 8889529.

https://pmc.ncbi.nlm.nih.gov/articles/PMC8889529/

See more on Doctor's Note

Q.

Can stress alone mess up my hormones?

A.

Yes, stress can affect your hormones, causing changes in your body and mood.

References:

MacLean CR, Walton KG, Wenneberg SR, Levitsky DK, Mandarino JP, Waziri R, et al. (1997). changes in hormone levels and responses to stress after 4 .... Psychoneuroendocrinology, 9226731.

https://pubmed.ncbi.nlm.nih.gov/9226731/

Wolkowitz OM, Epel ES, & Reus VI. (2001). Stress hormone-related psychopathology. The world journal of biological psychiatry : the official journal of the World Federation of Societies of Biological Psychiatry, 12587196.

https://pubmed.ncbi.nlm.nih.gov/12587196/

Charmandari E, Kino T, Souvatzoglou E, & Chrousos GP. (2003). Pediatric stress: hormonal mediators and human .... Hormone research, 12649570.

https://pubmed.ncbi.nlm.nih.gov/12649570/

See more on Doctor's Note

Q.

Do I actually have adrenal fatigue?

A.

Adrenal fatigue is not recognized as a real medical condition by experts. If you have symptoms like feeling very tired, it's important to talk to a doctor to find out the true cause.

References:

Ross IL, Jones J, & Blockman M. (2018). We are tired of 'adrenal fatigue'. South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde, 30182895.

https://pubmed.ncbi.nlm.nih.gov/30182895/

Cadegiani FA, & Kater CE. (2016). Adrenal fatigue does not exist: a systematic review. BMC endocrine disorders, 27557747.

https://pubmed.ncbi.nlm.nih.gov/27557747/

Martin-Grace J, Dineen R, Sherlock M, & Thompson CJ. (2020). Adrenal insufficiency: Physiology, clinical presentation and .... Clinica chimica acta; international journal of clinical chemistry, 32035851.

https://pubmed.ncbi.nlm.nih.gov/32035851/

See more on Doctor's Note

Q.

Does coconut water really help with electrolytes?

A.

Coconut water can help with electrolytes and is a good choice for rehydration after exercise, similar to sports drinks.

References:

O'Brien BJ, Bell LR, Hennessy D, Denham J, & Paton CD. (2023). Coconut Water: A Sports Drink Alternative?. Sports (Basel, Switzerland), 37755860.

https://pubmed.ncbi.nlm.nih.gov/37755860/

Saat M, Singh R, Sirisinghe RG, & Nawawi M. (2002). Rehydration after exercise with fresh young coconut water .... Journal of physiological anthropology and applied human science, 12056182.

https://pubmed.ncbi.nlm.nih.gov/12056182/

Kalman DS, Feldman S, Krieger DR, & Bloomer RJ. (2012). Comparison of coconut water and a carbohydrate- .... Journal of the International Society of Sports Nutrition, 22257640.

https://pubmed.ncbi.nlm.nih.gov/22257640/

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Q.

How do I know if my cortisol is too high?

A.

High cortisol levels can be a sign of Cushing's syndrome, and tests like late-night salivary cortisol can help detect it. If you think your cortisol is high, talk to a doctor for proper testing.

References:

Ceccato F, & Boscaro M. (2016). Cushing's Syndrome: Screening and Diagnosis. High blood pressure & cardiovascular prevention : the official journal of the Italian Society of Hypertension, 27160717.

https://pubmed.ncbi.nlm.nih.gov/27160717/

Raff H, Raff JL, & Findling JW. (1998). Late-night salivary cortisol as a screening test for Cushing's .... The Journal of clinical endocrinology and metabolism, 9709931.

https://pubmed.ncbi.nlm.nih.gov/9709931/

Balomenaki M, Margaritopoulos D, Vassiliadi DA, & Tsagarakis S. (2022). Diagnostic workup of Cushing's syndrome. Journal of neuroendocrinology, 35979805.

https://pubmed.ncbi.nlm.nih.gov/35979805/

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Q.

How much potassium or sodium is actually healthy?

A.

Healthy sodium and potassium levels can help you feel better and live longer. It's important to eat the right amount of both to stay healthy.

References:

Liu D, Tian Y, Wang R, Zhang T, Shen S, Zeng P, & Zou T. (2024). Sodium, potassium intake, and all-cause mortality. BMC public health, 38225648.

https://pubmed.ncbi.nlm.nih.gov/38225648/

Salman E, Kadota A, & Miura K. (2024). Global guidelines recommendations for dietary sodium and .... Hypertension research : official journal of the Japanese Society of Hypertension, 38589606.

https://pubmed.ncbi.nlm.nih.gov/38589606/

National Academies of Sciences, Engineering, and Medicine; Health and Medicine Division; Food and Nutrition Board; Committee to Review the Dietary Reference Intakes for Sodium and Potassium, Oria M, Harrison M, & Stallings VA. (2019). Dietary Reference Intakes for Sodium and Potassium. Unknown Journal, 30844154.

https://pubmed.ncbi.nlm.nih.gov/30844154/

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Q.

Is it bad that I feel tired all the time, even if my labs are normal?

A.

Feeling tired all the time, even with normal labs, can still be a concern. It might be related to conditions like chronic fatigue syndrome, which aren't always detected by standard tests.

References:

Swanink CM, Vercoulen JH, Bleijenberg G, Fennis JF, Galama JM, & van der Meer JW. (1995). Chronic fatigue syndrome: a clinical and laboratory study .... Journal of internal medicine, 7738491.

https://pubmed.ncbi.nlm.nih.gov/7738491/

Valdini A, Steinhardt S, & Feldman E. (1989). Usefulness of a standard battery of laboratory tests in .... Family practice, 2632306.

https://pubmed.ncbi.nlm.nih.gov/2632306/

Lane TJ, Matthews DA, & Manu P. (1990). The low yield of physical examinations and laboratory .... The American journal of the medical sciences, 2337122.

https://pubmed.ncbi.nlm.nih.gov/2337122/

See more on Doctor's Note

Q.

Is it safe to self-treat fatigue with electrolytes and juice?

A.

Drinking electrolytes and juice can help with mild fatigue, but it's important to ensure you're not missing other health issues.

References:

Popkin BM, D’Anci KE, & Rosenberg IH. (2010). Water, Hydration and Health - PMC. Nutrition reviews, 2908954.

https://pmc.ncbi.nlm.nih.gov/articles/PMC2908954/

Rebelo-Marques A, Coelho-Ribeiro B, De Sousa Lages A, Andrade R, Afonso J, Pereira R, et al. (2024). Trends and Missing Links in (De)Hydration Research. Nutrients, 11174495.

https://pmc.ncbi.nlm.nih.gov/articles/PMC11174495/

Wang B, Wei X, Zhao X, Wang W, Deng J, & Yang H. (2024). A Review on In Vivo Research Dehydration Models and .... Nutrients, 11510460.

https://pmc.ncbi.nlm.nih.gov/articles/PMC11510460/

See more on Doctor's Note

Q.

Is there a way to test for ‘adrenal fatigue’ even if it’s not real?

A.

There is no scientific test for 'adrenal fatigue,' but stress and fatigue can be measured in other ways.

References:

Hosoyama T, Tachi C, Yamanouchi K, & Nishihara M. (2005). Long term adrenal insufficiency induces skeletal muscle .... Zoological science, 15738643.

https://pubmed.ncbi.nlm.nih.gov/15738643/

Azzinnari D, Sigrist H, Staehli S, Palme R, Hildebrandt T, Leparc G, et al. (2014). Mouse social stress induces increased fear conditioning, .... Neuropharmacology, 24907589.

https://pubmed.ncbi.nlm.nih.gov/24907589/

Chilcot J, Norton S, Kelly ME, & Moss-Morris R. (2016). The Chalder Fatigue Questionnaire is a valid and reliable .... Multiple sclerosis (Houndmills, Basingstoke, England), 26232100.

https://pubmed.ncbi.nlm.nih.gov/26232100/

See more on Doctor's Note

Q.

Is there any science behind adrenal cocktails?

A.

Adrenal cocktails are supplements that claim to support adrenal health, but their effectiveness is not well-supported by scientific evidence. Some ingredients may have effects on fatigue, but more research is needed.

References:

Akturk HK, Chindris AM, Hines JM, Singh RJ, & Bernet VJ. (2018). Over-the-Counter "Adrenal Support" Supplements Contain .... Mayo Clinic proceedings, 29502560.

https://pubmed.ncbi.nlm.nih.gov/29502560/

Panossian A, & Wikman G. (2009). Evidence-based efficacy of adaptogens in fatigue, and .... Current clinical pharmacology, 19500070.

https://pubmed.ncbi.nlm.nih.gov/19500070/

Jaroenporn S, Yamamoto T, Itabashi A, Nakamura K, Azumano I, Watanabe G, & Taya K. (2008). Effects of pantothenic acid supplementation on adrenal .... Biological & pharmaceutical bulletin, 18520055.

https://pubmed.ncbi.nlm.nih.gov/18520055/

See more on Doctor's Note

Q.

What are real signs of adrenal insufficiency?

A.

Adrenal insufficiency can cause tiredness, muscle weakness, weight loss, low blood pressure, and darkening of the skin.

References:

Martin-Grace J, Dineen R, Sherlock M, & Thompson CJ. (2020). Adrenal insufficiency: Physiology, clinical presentation and .... Clinica chimica acta; international journal of clinical chemistry, 32035851.

https://pubmed.ncbi.nlm.nih.gov/32035851/

Husebye ES, Pearce SH, Krone NP, & Kämpe O. (2021). Adrenal insufficiency. Lancet (London, England), 33484633.

https://pubmed.ncbi.nlm.nih.gov/33484633/

Hahner S, Ross RJ, Arlt W, Bancos I, Burger-Stritt S, Torpy DJ, et al. (2021). Adrenal insufficiency. Nature reviews. Disease primers, 33707469.

https://pubmed.ncbi.nlm.nih.gov/33707469/

See more on Doctor's Note

Q.

What does cortisol actually do in the body?

A.

Cortisol is a hormone that helps the body respond to stress, keep energy levels steady, and control inflammation.

References:

Knezevic E, Nenic K, Milanovic V, & Knezevic NN. (2023). The Role of Cortisol in Chronic Stress, Neurodegenerative .... Cells, 38067154.

https://pubmed.ncbi.nlm.nih.gov/38067154/

Amasi-Hartoonian N, Sforzini L, Cattaneo A, & Pariante CM. (2022). Cause or consequence? Understanding the role of cortisol .... Current opinion in endocrine and metabolic research, 35634363.

https://pubmed.ncbi.nlm.nih.gov/35634363/

Lightman SL, Birnie MT, & Conway-Campbell BL. (2020). Dynamics of ACTH and Cortisol Secretion and Implications .... Endocrine reviews, 32060528.

https://pubmed.ncbi.nlm.nih.gov/32060528/

See more on Doctor's Note

Q.

What’s the best time of day to drink a cortisol cocktail?

A.

The best time to consume a cortisol cocktail may depend on how your body reacts to caffeine, as it can increase cortisol levels. However, for specific timing recommendations, it is best to consult a healthcare provider.

References:

Lovallo WR, Whitsett TL, al'Absi M, Sung BH, Vincent AS, & Wilson MF. (2005). Caffeine Stimulation of Cortisol Secretion Across the .... Psychosomatic medicine, 2257922.

https://pmc.ncbi.nlm.nih.gov/articles/PMC2257922/

Takahashi M, Ozaki M, Kang MI, Sasaki H, Fukazawa M, Iwakami T, et al. (2018). Effects of Meal Timing on Postprandial Glucose .... Nutrients, 6266071.

https://pmc.ncbi.nlm.nih.gov/articles/PMC6266071/

Woods NF, Mitchell ES, & Smith-DiJulio K. (2009). Cortisol Levels during the Menopausal Transition and .... Menopause (New York, N.Y.), 2749064.

https://pmc.ncbi.nlm.nih.gov/articles/PMC2749064/

See more on Doctor's Note

Q.

Will people judge me if I believe in adrenal fatigue?

A.

People may have different views about adrenal fatigue, and it's important to understand how your beliefs can affect your emotions and well-being.

References:

Lu Y, Jin X, Feng LW, Tang C, Neo M, & Ho RC. (2022). Effects of illness perception on negative emotions and .... World Journal of Clinical Cases, 9791537.

https://pmc.ncbi.nlm.nih.gov/articles/PMC9791537/

Khammissa RA, Nemutandani S, Feller G, Lemmer J, & Feller L. (2022). Burnout phenomenon: neurophysiological factors, clinical .... The Journal of International Medical Research, 9478693.

https://pmc.ncbi.nlm.nih.gov/articles/PMC9478693/

Slagboom TN, Deijen JB, Van Bunderen CC, Knoop HA, & Drent ML. (2021). Psychological well-being and illness perceptions in .... Pituitary, 8270855.

https://pmc.ncbi.nlm.nih.gov/articles/PMC8270855/

See more on Doctor's Note

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