Addison's disease
Autoimmune adrenal insufficiency
Autoimmune conditionThe immune system damages the adrenal glands, so they can't make enough cortisol and aldosterone. It's rare but serious, and different from everyday stress-related fatigue.
What happens
Cortisol helps regulate energy, blood pressure, blood sugar, and your response to stress, and aldosterone balances salt and water. In Addison's disease, symptoms build slowly as the adrenal glands fail. A stress such as an infection, surgery, or injury can then trigger an adrenal crisis, which is a medical emergency.
Who gets it
Addison's disease is rare. It's more common in women and often appears between ages 30 and 50, frequently alongside autoimmune thyroid disease, type 1 diabetes, or vitiligo.
Common signs
- Deep fatigue and muscle weakness
- Weight loss and poor appetite
- Salt cravings
- Dizziness or lightheadedness when standing
- Nausea or abdominal pain
- Darkening of the skin, especially in creases, scars, and gums
- Low mood or irritability
Labs to ask about
- Early-morning cortisol and ACTH
- ACTH stimulation test
- 21-hydroxylase (adrenal) antibodies
- Sodium, potassium, and renin
How it's usually treated
- Lifelong replacement of cortisol (usually hydrocortisone) and often fludrocortisone
- 'Sick-day rules' for taking extra medicine during illness
- An emergency injection kit and a medical ID
Supportive steps to discuss with your provider
- Adrenal symptoms overlap with burnout. Salt cravings, darkening skin, and dizziness when standing need medical testing, not just stress support.
- Never stop steroid medicine suddenly.
- Bring your sick-day plan with you when traveling.
See a doctor promptly if you have
- Severe vomiting, confusion, fainting, or severe abdominal pain: call 911 (possible adrenal crisis)
- Darkening skin together with fatigue and weight loss
- Dizziness on standing with salt cravings
Related conditions
Hashimoto's thyroiditis
The most common cause of an underactive thyroid in the US. The immune system slowly damages the thyroid, so it makes less hormone over time.
Learn more →Type 1 diabetes
The immune system destroys the insulin-making cells in the pancreas, so the body can't make enough insulin to control blood sugar.
Learn more →Vitiligo & alopecia areata
Two autoimmune conditions of the skin and hair. Vitiligo destroys pigment cells, leaving white patches. Alopecia areata attacks hair follicles, causing patchy hair loss.
Learn more →
Wondering if your symptoms fit a pattern?
Dr. Lesher is a naturopathic doctor who specializes in women's autoimmune and chronic conditions. Since 2020, she has helped more than 900 patients overcome and heal from their conditions.