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.