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Adrenal Insufficiency

The adrenal glands are two glands that sit on top of each kidney that are composed of an inner shell known as the “Medulla” and the outer shell, the “Cortex”. They each produce different hormones that regulate many body functions such as your metabolism, blood pressure, immune system, stress levels and more.

For example, the inner medulla produces stress hormones epinephrine and norepinephrine and is involved in the “fight or flight response”, like when you get scared in situations that happen suddenly and unexpectedly and is caused by the adrenal glands abrupt release of adrenaline. The adrenal glands are responsible for cortisol, DHEA, aldosterone and adrenaline production.


Adrenal insufficiency is a condition in which the adrenal glands do not function optimally and cannot produce enough of the “stress” hormone cortisol. Sometimes, adrenal insufficiency also involves low production of hormones aldosterone and androgens. Aldosterone helps with the maintenance of sodium and potassium in the body, which help regulate salt and water levels. Adrenal insufficiency (also referred to as adrenal fatigue) can be split into two categories called primary adrenal insufficiency and secondary adrenal insufficiency.

Primary adrenal insufficiency (also known as Addison’s Disease) is a rare condition when there is damage to the adrenal glands themselves and a result, they do not produce enough cortisone and aldosterone. This is most often caused by an autoimmune disorder in which your immune system accidently attacks your otherwise healthy adrenal glands. Other causes include abruptly stopping steroid medication, fungal infections and cancer.

Secondary adrenal insufficiency starts when the pituitary gland does not produce enough of the hormone ACTH (adrenocorticotropin). The main function of ACTH is to stimulate production and release of cortisol from the adrenal cortex; therefore, this results in the adrenal glands not producing enough cortisol. This can occur with chronic stress or infection or in cases where there is damage to the pituitary gland or hypothalamus (which controls the pituitary gland). People who have undergone surgery for a condition called Cushing’s syndrome are at an increased risk for developing secondary adrenal insufficiency.

What are some symptoms of Adrenal Insufficiency?

  • Chronic fatigue 

  • Energy crashes

  • Loss of appetite

  • Salt cravings

  • Low blood pressure that suddenly drops upon standing

  • Muscle weakness

  • Malaise

  • Abdominal Pain

  • Anxiety

  • Weight Loss

These are just some of the symptoms associated with this condition that you may or may not experience. Adrenal Insufficiency is a serious condition that requires treatment. Adrenal Insufficiency can lead to a serious condition called adrenal crisis and if not treated promptly, can lead to death. Severe lack of cortisol in times of physical stress, such as undergoing surgery, illness or injury can cause life-threatening symptoms such as low blood pressure, low sodium levels and high potassium levels. There is a major difference between primary and secondary adrenal insufficiency, therefore, it is important to obtain the proper diagnosis to come up with the best treatment options. Dr. Wulff is educated and experienced in identifying and treating this condition. Some treatment options include replacement or supplementation of hormones your adrenal glands aren’t producing, IV therapy to replenish fluids, essential vitamins and minerals, dietary and lifestyle changes and supplementation.

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