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Adrenal Insufficiency vs Adrenal Fatigue

This article compares Adrenal Fatigue and Adrenal Insufficiency.

This article is one of several articles covering the topic of: Is Adrenal Fatigue Real. In this article, we compare Adrenal Fatigue to Adrenal Insufficiency.

Page Contents:

The demographics are the same. The symptoms are the same.

Conventional medicine currently does not accept that stress can damage your adrenal glands, even though Dr. Hans Selye proved that it does. He called it the General Adaptation Syndrome.

But this article also connects Adrenal Insufficiency to chronic stress.

For diagnosis of adrenal insufficiency, there is debate about just how sensitive the ACTH stimulation test is.

Car Engine Analogy

You can be very sick with Adrenal Fatigue, but just not bad enough to register on the ACTH stimulation test.

Think of your adrenal glands as a car engine.

Lets say a person who feels great has an engine that can produce 200 horsepower.

To get a diagnosis of Adrenal Insufficiency, you need to have less than 50 horsepower. And if you don't have Adrenal Insufficiency, you are called Normal.

If your engine was only producing 100 horsepower, your would have 1/2 the energy of someone who felt great, but just not bad enough to get a diagnosis.

You can't function like you used to, but your doctor tells you there is nothing wrong.

As we show later, there is some debate over how to measure your engine power (adrenal strength)

Demographics

Most common in middle-aged females

Let's compare the demographics. An article on the National Institute of Health notes that middle aged females are most likely to development Addison's (common term for primary adrenal insufficiency):

In autoimmune Addison’s, which mainly occurs in middle-aged females¹.....

If you spent any time on forums or Facebook groups for Adrenal Fatigue, you may notice that there are a lot more females than males.

People that land on this site are 70-80% female. These are people researching adrenal fatigue. There are a couple of sources for that data.

Here is a survey of site visitors. 84.7% Female. Multuple surveys have resulted in a similar percent females.

Google also estimates visitors to this sites are 71% female, based on 56,000 visits. Google guesses your gender based on the things you search for (I know....creepy).
Here is the Pie Chart

Google also estimates the age of visitors based on the things they search for. Based on the same 56,000 site visits, most visitors are 35 to 44 years old. Here is the Bar Chart

So the demographis of people researching Adrenal Fatigue is exactly the same as Adrenal Insufficiency.

By itself, the same demographics does not means that Adrenal Fatigue are Adrenal Insufficiency are the same conditions .... so let's continue.

Symptoms of Adrenal Insufficiency

The following list are the 5 most common symptoms of Adrenal Insufficiency, as listed by the National Insitute of Health¹.

And after each symptom is a survey result from this site, from people researching Adrenal Fatigue. The % after each symptom is the survey result. Here is the survey -->Survey #1

chronic, or long lasting, fatigue (83.3%)
muscle weakness (75.3%)
loss of appetite (35.9%)
weight loss (31.6%)
abdominal pain (53.5%)

The primary symptoms of Adrenal Insufficiency seem fairly common for folks researching Adrenal Fatigue.

The following 11 symptoms are noted by the NIH as Other symptoms of adrenal insufficiency can include.

Again, the % after each symptom is from surveys of visitor to this site.
Survey #2, Survey #3 Survey #4

nausea (44.1%)
vomiting (8.5%)
diarrhea (31.4%)
low blood pressure that drops further when a person stands up, causing dizziness or fainting (51.3%)
irritability and depression (94.2%)
craving salty foods (67%)
hypoglycemia, or low blood sugar (67.9%)
headache (53.2%)
sweating (51.4%)
irregular or absent menstrual periods. (61 of 106 women = 57.5%)
in women, loss of interest in sex
(73 of 106 women = 68.8%)
(14 of 24 men = 58.3%)

Except for vomiting (8.5%), visitors to this site experience the secondary symptoms at a very high rate as well. Possibly vomitting only happens in the most extreme cases.

But generally, people researching Adrenal Fatigue have the exact same symptoms as Adrenal Insufficiency.

Causes

This section compares the causes of Adrenal Fatigue vs Adrenal Insufficiency.

Cause of Adrenal Fatigue

The name Adrenal Fatigue is unfortunate. The condition already had a name, which is in medical text books. It is the General Adaptation Syndrome.

The following is a 1998 article from the Journal of Neurophychiatry. It describes the General Adapation Syndrome:
Hans Selye and the Field of Stress Research (pdf)

Dr.Hans Selye documented direct adrenal damage from chronic stress, over and over, regardless of the stressor. The stages of the General Adaptation Syndrome have become the stages of Adrenal Fatigue.

And it's a shame, because the new name lacks credibility. Your doctor can look up the General Adaptation Syndrome in his text book. However, your doctor still doesn't know how to diagnose or treat the General Adaptation Syndrome.

Cause of Adrenal Insufficiency

Conventional medicine believes that the main cause of adrenal insufficiency is autoimmune distruction.

In primary adrenal insufficiency, there is failure of production of all hormones from the adrenal cortex; it is most often caused by autoimmune destruction in developed countries ²

Up to 80 percent of Addison’s disease cases are caused by an autoimmune disorder, which is when the body’s immune system attacks the body’s own cells and organs¹

But guess what? Chronic stress is suspected to be a major factor in autoimmune disorder.

Physical and psychological stress has been implicated in the development of autoimmune disease, since numerous animal and human studies demonstrated the effect of sundry stressors on immune function. Moreover, many retrospective studies found that a high proportion (up to 80%) of patients reported uncommon emotional stress before disease onset.³

The article from the National Institute of Health on Adrenal Insufficiency does acknowledge that symptoms can suddenly become worse from stress:

The slowly progressing symptoms of adrenal insufficiency are often ignored until a stressful event, such as surgery, a severe injury, an illness, or pregnancy, causes them to worsen³

This sounds like crashing into Stage 3 Adrenal Fatigue (General Adaptation Syndrome). On adrenal fatigue forums people always mention the last straw, which could be a bad cold, mold exposure, pregnancy, running in a marathon, etc.

It does sound like Adrenal Insufficieny can be caused by stress. But apparanty, it is supposed to take the intermediate step of autoimmune disorder.

The General Adaptation Syndrome (and Adrenal Fatigue) connect stress directly to the organ that must create stress hormones.

Diagnosis Comparison

This section compares and discusses the diagnoses of Adrenal Fatigue vs Adrenal Insufficiency

Diagnosis of Adrenal Insufficiency

The tradtional lab test for Adrenal Insufficiency is to inject you with ACTH, which is a hormone normally produced by your pituitary gland.

When ACTH increases, it signals your adrenal glands to produce more adrenal hormones (cortisol, aldosterone, epinephrine). So when they inject you with ACTH, your adrenal glands should respond.

With the ACTH stimulation test, they inject you with ACTH and measure the response of your adrenal glands. It is like stepping on the gas pedal and measuring the output of your engine.

One of the problems with the ACTH stimulation test is that the amount they usually give is up for debate.

The ACTH-to-cortisol ratio did not differ between groups before or after dexamethasone, but the subjects with PTSD showed greater suppression of ACTH (as well as cortisol) in response to dexamethasone. ⁷

Some patients with PFS may have subnormal adrenocortical function. LDT is more sensitive than SDT or ITT in the investigation of the HPA axis to determine the subnormal adrenocortical function in patients with PFS ⁶

Diagnosis of Adrenal Fatigue

There is no disease code for Adrenal Fatigue (International Statistical Classification of Diseases). So you can't get officially diagnosed with Adrenal Fatigiue.