Just about everyone has heard of adrenal fatigue, adrenal exhaustion, or adrenal insufficiency. But what happens when it goes beyond supporting energy production, and an autoimmune process affects the adrenal glands? That’s what’s known as Addison’s disease, an autoimmune condition made famous by two celebrities who may have suffered from it: novelist Jane Austen and former President John F. Kennedy.
What is Addison’s Disease?
Addison’s disease is also known as primary adrenal insufficiency. It most often occurs when the immune system responds to an imbalance or dis-ease in the body by launching an attack against the adrenal glands. 
The adrenal glands sit on top of the kidneys. They’re part of the endocrine system and work very closely with the hypothalamus and pituitary glands in the brain.
The inner region of the adrenals, called the medulla, secretes adrenaline and noradrenaline. The outer region, the cortex, is responsible for producing three types of hormones: glucocorticoids (e.g., cortisol), mineralocorticoids (e.g., aldosterone), and androgens/male sex hormones (e.g., DHEA).
Cortisol (the “stress hormone”) and aldosterone are the main hormones affected by Addison’s disease. These two hormones have many roles in the body, impacting the stress response, blood sugar, metabolism, fluid retention, electrolyte balance, blood pressure, and inflammation.
So, when someone has Addison’s disease, their hormone secretion is massively reduced, which causes symptoms throughout the body.
Symptoms of Addison’s Disease
The most common symptom of Addison’s disease is unrelenting chronic fatigue lasting more than a couple of weeks. Beyond that, it may lead to: 
- Muscle weakness
- Low blood pressure
- Dizziness upon standing
- Changes in skin color (hyperpigmentation)
- Lack of appetite
- Weight loss
- Poor stress tolerance
- An overall feeling of being unwell
- Muscle and joint pain
- Cravings for salt, sugar, caffeine, and other stimulants
An Addisonian crisis (or adrenal crisis) is a life-threatening condition that occurs when there’s an acute adrenal failure. The crisis is brought on by something that stresses the body, like an infection, trauma, or surgical procedure, causing a sudden drop in cortisol. It can lead to low blood pressure, low blood sugar, and high potassium levels in the bloodstream.
According to the National Institutes of Health (NIH), some symptoms of an adrenal crisis can include extreme weakness, rapid heart rate, abdominal pain, vomiting, and if severe, can even lead a person to fall into a coma.
How is Addison’s Disease Diagnosed?
Severe fatigue may cause people to seek out medical advice. A doctor may diagnose Addison’s after a series of tests, such as a physical exam, blood tests, and urine testing. Blood tests can detect antibodies to the adrenal glands, and urine tests can show hormone abnormalities.
According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDKD), here are some standard tests done to confirm Addison’s disease: 
- Adrenocorticotropic Hormone (ACTH) Stimulation Test: The ACTH stimulation test is the most common for diagnosing Addison’s disease. Synthetic ACTH is injected into the bloodstream, and the healthcare professional watches for a rise in cortisol levels. If the adrenal glands are damaged, the response will be limited or nonexistent.
- Corticotropin-Releasing Hormone (CRH) Stimulation Test: This test is used when there are abnormal results from the ACTH test. It looks for secondary adrenal insufficiency often caused by poor pituitary function. It’s like the ACTH test in that CRH is injected into the bloodstream, and the medical professional watches for the response. If the adrenal glands cannot produce much cortisol in response, they may not be functioning well.
- Insulin-Induced Hypoglycemia Test: This test helps differentiate between problems with the pituitary gland and problems with the adrenal glands. Again, it looks for secondary adrenal insufficiency caused by poor pituitary function. To do so, healthcare professionals measure blood sugar before and after an insulin injection to see whether it leads to a drop in blood sugar and a rise in cortisol.
- Computer Tomography (CT scan): A CT scan uses imaging to show abnormal changes in the adrenal glands and/or the pituitary gland.
A medical doctor uses these results to determine which medication(s) to use and whether they should send the patient to an endocrinology specialist. Doctors typically don’t do testing to find out why there’s an autoimmune disease in the first place – they assume it runs in the family.
The Fireman vs. The Carpenter in Healthcare
At The Wellness Way, we describe the mainstream method of healthcare versus ours as the “fireman approach” or the “carpenter approach.”
“Fireman doctors” have two tools: an axe and a hose. The axe represents cutting things out in a surgical procedure. The hose is similar because it represents medications used to extinguish inflammation and symptoms.
The Wellness Way doctors are like carpenters. They first assess the damage with testing. Then they create a personalized plan to rebuild the body with the appropriate tools. These include the proper nutrients from foods and supplements.
Sunshine, rest, and positive relationships are additional natural therapies that help the body heal itself.
Mainstream Medicine’s Approach to Addison’s Disease
Mainstream medicine looks at Addison’s disease as a condition of low cortisol. So, doctors respond by prescribing cortisol replacements, called corticosteroids.
Common Medications For Addison’s Disease
Medications for Addison’s are all types of hormone replacement therapy. They’re meant to replace the hormones cortisol and aldosterone that the body cannot produce when the adrenals are under attack. These are some of the medications endocrinologists most frequently prescribe for Addison’s Disease: 
- Hydrocortisone is most frequently used as a glucocorticoid replacement. Sometimes other longer-acting ones, like prednisone or dexamethasone, are used.
- Fludrocortisone as a mineral corticoid replacement (aldosterone)
- Dehydroepiandrosterone (DHEA) may be used for androgen replacement in women.
These medications are to replace gluco- and mineralocorticoids, but they don’t address the reason(s) these steroid hormones are low in the first place. Taking these synthetic drugs has been linked to lower bone density and an increased risk of osteoporosis, and they can also cause sleep issues and mood swings. As we frequently point out, there’s always a risk of side effects from taking medications.
What Causes Addison’s Disease?
Mainstream medicine says the reason for an autoimmune response to the adrenal glands is unknown. They don’t know why the immune system turns on the body. We at The Wellness Way know genes “load the gun,” but the environment “pulls the trigger.” The chiropractic profession describes those environmental factors as traumas, toxins, and thoughts.
Traumas (Physical Stressors)
Traumas or physical stressors can be acute or chronic. Chronic subluxations in the spine can inhibit nerve and blood flow to the small intestine, leading to dis-ease and triggering an autoimmune response. Other potential traumas may include:
- Car accidents/Whiplash
- A fall
- Physical abuse
The initial physical trauma may lead to biochemical stressors, like an infection following surgery or medication following an injury.
Toxins (Biochemical Stressors)
Toxins are biochemical stressors that may be either natural or synthetic. Mold is a natural toxin that may contribute to Addison’s disease. Man-made pollution may also overwhelm the body, leading to Addison’s.
- Infections like tuberculosis may initially set off Addison’s disease.  Mycobacterium abscessus, a soil and water contaminant, has also been shown to cause Addison’s. 
- Antifungal medications may also set off processes leading to Addison’s. 
- Etomidate, a type of general anesthesia, has been linked to Addison’s. 
- Cancer immunotherapy may lead to Addison’s in some cases 
- A poor diet or eating food allergens, which cause inflammation and damage to the gut, increases the risk of all autoimmune conditions.
- Nutrient deficiencies, such as low magnesium, may also increase the risk of low adrenal function. 
- Lack of sleep, leading to a buildup of toxins in the brain, may trigger the stress response, leading to a compromised gut and increased risk of autoimmune disease.
Anything that compromises the integrity of the gut lining, leading to “leaky gut” can lead to autoimmune conditions like Addison’s disease.
Thoughts (Emotional Stressors)
Emotional stress is not to be underestimated. It’s as powerful as physical and biochemical stressors in triggering autoimmune dis-eases. Our thoughts can be influenced by:
- Relationship issues
- Financial stress
- Watching the news (fear/worry)
- A feeling of overwhelm due to significant life changes, like a recent marriage, a new baby, graduation, a divorce, or even moving to a new city.
- Holding a grudge/pent-up anger
- Grief/feelings of loss
The cumulative effect of these traumas, toxins, and thoughts can create inflammation and increase the risk of dis-ease in the body and brain.
The Wellness Way Approach to Autoimmune Conditions like Addison’s
At The Wellness Way, we dig deeper to solve the health challenges others can’t. That includes autoimmune conditions like Addison’s disease. We don’t just address symptoms; we run tests to find out what’s really going on behind the scenes.
Important Tests For Assessing Your Gut and Immune Health:
Here are some commonly recommended tests at The Wellness Way:
- Food Allergy Test: Immuno Food Allergy Test
- Hormone Panel: Male Hormone Panel or Female Hormone Panel
- DUTCH Hormone Test: DUTCH Complete Hormone Panel
- Gut Health Test: Genova GI Effects with Parasitology
- Antibody Test: Aurora Life Sciences – Autoimmune 30+
Your Wellness Way practitioner will order tests based on what he or she considers most relevant based on your health history.
Dietary Changes For Those With Autoimmune Diseases:
It’s critical to, first and foremost, lower inflammation so the gut can heal. That means avoiding your food allergies and following a personalized nutrition program, as your Wellness Way practitioner recommends. These are some additional guidelines for inflammatory and autoimmune conditions:
- No sugar or processed foods.
- Adequate salt (Salt may improve levels of cortisol in the body)
- Overall low carbohydrate, non-inflammatory diet of organic whole foods.
- Personalized nutrition, based on your food allergy test results
- Specific nutrient-dense foods: Liver/organ meats, sauerkraut, and microgreens for added nutrition
Diet is paramount, but supplements can help the body heal the digestive tract.
Lifestyle Changes For Supporting The Gut and Adrenal Glands
- Get plenty of sleep and turn in by 10 pm
- Take care of your circadian rhythm – Get morning light and avoid the blue/white spectrum after 6 or 7 pm.
Supplements For Supporting The Gut and Adrenal Glands
Every patient is different, but supplements often used at The Wellness Way for those struggling with digestive and immune imbalances, including Addison’s, include a few of the following:
- Licorice (Glycyrrhiza glabra) can help increase the absorption of cortisol into the tissues, especially when combined with grapefruit juice. (11)
- Ashwagandha (Withania somnifera) is an adaptogenic herb that can help increase energy levels.
- Cordyceps, a medicinal mushroom found in our Mushroom Immune supplement, has been shown in animal studies to help the body produce and balance cortisol levels. (12)
- Coenzyme Q10 — Coenzyme Q10 helps create ATP, the energy currency of the cell.
- B Complex Vitamins — B5 and other B complex vitamins, like in Wellness B Complex, help improve adrenal function, especially under stress. (13)
- DHEA — DHEA stands for dehydroepiandrosterone. It’s a potent steroid hormone naturally produced in the adrenal cortex. If the adrenal glands aren’t adequately producing DHEA, supplementing it may help. (14)
- Magnesium – A magnesium-deficient diet results in many of the same symptoms as low adrenal function. (15)
- Adrenal Glandular – Taking desiccated adrenal glands as a supplement can provide missing nutrients needed for healing.
- Well-Zyme Complex Chewable Tablets – Digestive enzymes can help with digestion and nutrient absorption, helping the gut to heal itself.
Where to Start with Addison’s Disease
If you you’re concerned about autoimmunity and suspect Addison’s disease, the first thing is still to get tested. Find out what’s causing inflammation (including food allergens) and where you’re suffering damage from the autoimmune response. From there, it’s all about healing the gut, making lifestyle changes, and incorporating herbal supplements based on your needs.
Educational Resources For Addison’s Disease
To start educating yourself on Addison’s Disease, here are some video trainings and articles here on TWW website:
Videos & Webinars Related to Addison’s Disease
Articles to Support Addison’s Disease
- Autoimmune Disease is NOT an Immune Issue
- What Causes Leaky Gut and How Can You Heal It?
- Normalizing Autoimmune Disease –Is It Really a Lifelong Diagnosis?
- Adrenal Glandular
- Chronic Fatigue: Are You Just Tired or Is it Something More?
- 6 Awesome Adaptogens (and Their Potential Benefits)
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- Definition & Facts of Adrenal Insufficiency & Addison’s Disease – NIDDK (nih.gov)
- Addison’s disease – Symptoms and causes – Mayo Clinic
- Diagnosis of Adrenal Insufficiency & Addison’s Disease – NIDDK (nih.gov)
- Addison’s Disease – Physiopedia (physio-pedia.com)
- Infections in Endocrinology: Tuberculosis – PubMed (nih.gov)
- Addison’s disease triggered by infection with mycobacterium abscessus, but not by adrenal tuberculosis or MAC pulmonary disease, in a subject with type 2 diabetes mellitus: case report – PubMed (nih.gov)
- Symptoms & Causes of Adrenal Insufficiency & Addison’s Disease – NIDDK (nih.gov)
- Etomidate puts patients at risk of adrenal crisis – PubMed (nih.gov)
- Immunotherapy-induced Addison’s disease: A rare, persistent and potentially lethal side-effect – European Journal of Cancer (ejcancer.com)
- Adrenal gland factors in magnesium-deficient rats – PubMed (nih.gov)
- Grapefruit juice and licorice increase cortisol availability in patients with Addison’s disease – PubMed (nih.gov)
- The in vivo effect of Cordyceps sinensis mycelium on plasma corticosterone level in male mouse – PubMed (nih.gov)
- Nutritional and botanical interventions to assist with the adaptation to stress – PubMed (nih.gov)
- Improvement in mood and fatigue after dehydroepiandrosterone replacement in Addison’s disease in a randomized, double blind trial – PubMed (nih.gov)
- Adrenal gland factors in magnesium-deficient rats – PubMed (nih.gov)