Functional Medicine’s Approach to Diagnosing Addison’s Disease

One in 100,000 people in the United States has Addison’s disease, which is chronic adrenal insufficiency. Diagnosing Addison’s disease can be difficult because you must have lost 90% of your adrenal glands’ function to get a diagnosis.¹ In my decades of experience as a doctor, I find that most people fall somewhere between optimal health and full-blown Addison’s disease. 

As with all autoimmune diseases, conventional medicine’s approach is to put you on harsh medications for the rest of your life. These medications  suppress the immune system rather than get to the root cause. Functional medicine has a much different approach.

I will talk more about functional medicine’s approach to Addison’s disease, the difference between Addison’s disease and adrenal fatigue, diagnosing Addison’s disease, and the signs of Addison’s disease. First, I will go deeper into what Addison’s disease is.  

What is Addison’s Disease?

Addison’s disease is a rare autoimmune disease where the immune system attacks the adrenal glands. Your adrenal glands are small, triangular-shaped glands located on top of your kidneys. When you have Addison’s disease, or adrenal fatigue, your adrenal glands produce low levels of hormones, including the stress hormone cortisol, aldosterone, DHEA, and epinephrine (adrenaline) and norepinephrine. Epinephrine and norepinephrine are two hormones that regulate your heart rate. 

When functioning optimally, your adrenal glands secrete cortisol to alert your body to prepare for a fight. Epinephrine is also released to increase your heart rate to pump more oxygen filled blood throughout your body. Once the threat has passed, norepinephrine is released to lower your heart rate. 

Small amounts of stress are necessary to keep your immune system sharp and help you stay alive in dangerous situations. However, chronic stress keeps your adrenal glands constantly on alert. When your adrenal glands have to work hard to keep up with the constant stress, it can cause them to dysfunction and become tired. The longer this goes on, the further down the spectrum you get to having full-blown Addison’s disease. 

While Addison’s disease is rare, it does occur in both men and women with it being  most common in women between the ages of 30 and 50 years old. Addison’s disease can be life-threatening in extreme cases, yet I don’t want you to worry. There is a solution that I will tell you about later. 

It is important to remember that Addison’s disease is different from adrenal fatigue. You cannot be diagnosed with Addison’s disease and still have adrenal fatigue. Let’s talk about the differences. 

Addison’s Disease vs. Adrenal Fatigue

If you’ve been a member of my community or followed me for a while, you’ve heard me talk about the autoimmune spectrum. The health of your adrenal glands is similar. At the low end of the spectrum, your adrenal glands function optimally and provide a healthy stress response. 

We live in a very stressful world. So many people work 80-hour weeks, sacrifice their sleep, drink two cups of coffee to stay awake during the day, and reach for sugary foods for more energy. These habits affect us emotionally, mentally, physically, and spiritually. The longer your chronic stress goes unaddressed, your adrenal glands become tired from constantly being on, putting you further down the spectrum. 

Once your adrenal glands lose 90% of their function, you’ve reached the high end of the spectrum and are diagnosed with Addison’s disease. Anywhere between the low end and the high end of the spectrum is known as adrenal fatigue. 

Addison’s disease normally develops because of an autoimmune response to stress. However, you can also be diagnosed with Addison’s disease if you have your adrenal glands surgically removed.  

Symptoms of adrenal fatigue and Addison’s disease are very similar, yet a few signs are exclusive to Addison’s disease. I will tell you about the signs of Addison’s disease now. 

Signs of Addison’s Disease

Addison’s disease symptoms usually develop slowly and often over several months. Because Addison’s disease progresses slowly, symptoms often go ignored until they become severe. Here’s a look at the symptoms of Addison’s disease:

Extreme fatigue is the most prevalent symptom of Addison’s disease. Remember, cortisol plays a role in body weight, regulating glucose levels, and maintaining healthy blood pressure. If your adrenal glands cannot produce enough cortisol to respond to stress, it can cause an array of health issues related to Addison’s disease. 

Furthermore, androgen is a sex hormone in women produced in the adrenal glands. Because the adrenal glands have lost most of their functionality, androgen levels in women are low, resulting in body hair loss, diminished sex drive, and abnormal menstrual cycle. Low androgen levels are one of the most common signs of Addison’s disease, and why it is more common in women than men. ²

Conventional medicine often attributes the symptoms of Addison’s disease to other conditions and treats the symptoms rather than the root cause, which is the immune system. Diagnosing Addison’s disease can be done through blood tests and digital scans of your adrenal glands.  

Diagnosing Addison’s Disease

Your functional medicine doctor can order a few different tests, including some done at home. You can have the results emailed and go over them with your doctor. One of the primary indicators of Addison’s disease or adrenal fatigue is cortisol levels in the blood. Here are a few ways your doctor can diagnose Addison’s disease. 

Blood tests 

Blood tests are one of the most common tests for diagnosing Addison’s disease. Testing cortisol and thyroid hormone levels is an excellent indicator of adrenal function. The great news is that more at-home tests are available, so there’s no need to go to a lab or clinic for blood work. I recommend LetsGetChecked’s cortisol tests and thyroid tests. They send you a kit and will email you the results which you can share with your functional medicine physician based on the results I’ve outlined below. 

Optimal levels of cortisol are 6 to 23 mcg/dl. Anything below six could indicate adrenal insufficiency. 

Your thyroid is also essential. Most conventional medicine doctors only check your Thyroid Stimulating Hormone (TSH) levels and Free T4 levels to see if you are low on the storage form of thyroid hormones. 

However, optimal thyroid function involves many factors. I recommend ordering the following tests to get a complete picture of a patient’s thyroid problems and health.

• TSH 
• Free T4 
• Free T3 
• Reverse T3 
• Thyroid Peroxidase Antibodies (TPOAb)
• Thyroglobulin Antibodies (TgAb)

I believe the most optimal thyroid levels are:

• TSH levels of 1-2 UIU/ML or lower (Armour or compounded T3 can artificially suppress TSH)
• FT4  levels >1.1 NG/DL
• FT3 levels > 3.2 PG/ML
• RT3 levels < 10:1 ratio RT3:FT3
• TPO – TgAb levels < 4 IU/ML or negative

ACTH stimulation tests 

To administer the adrenocorticotropic hormone (ACTH) stimulation test, your healthcare provider will give you a shot of artificial ACTH and measure your pituitary glands’ response. Your pituitary gland produces in response to cortisol. If your adrenal glands produce lower cortisol levels, it could be a sign they’re not functioning correctly, and you have adrenal insufficiency. This test is often combined with an insulin-induced hypoglycemia test. 

Insulin-induced hypoglycemia test 

If your doctor has determined that you have adrenal insufficiency, they may order an insulin-induced hypoglycemia test to check your pituitary gland. Here’s why: 

There are two types of adrenal insufficiency: Primary and secondary. Primary adrenal insufficiency is known as Addison’s disease. Secondary adrenal insufficiency occurs when your pituitary gland doesn’t produce enough ACTH. 

As with the ACTH stimulation test, the insulin-induced hypoglycemia test measures an insulin response. The test measures how blood glucose levels and cortisol change over a period of time, usually 4 hours. If your pituitary gland is functioning correctly, there should be a drop in glucose and a rise in cortisol. These two tests can help rule out secondary adrenal insufficiency as the cause of your symptoms. 

How Conventional Medicine Gets it Wrong

Conventional medicine believes you can do nothing to reverse an autoimmune disease once you develop one. Once you have it, you have it for life. Conventional medicine aims to manage the symptoms, typically done through harsh medications that suppress the immune system. 

These medications can or cannot be effective in relieving the symptoms since they suppress the entire immune system. However, they are not without many unwanted side effects. These include fatigue, weight gain, depression, and infections. 

When it comes to Addison’s disease, conventional medicine prescribes hormone replacement therapy for life, which replaces natural hormones with synthetic ones. Hormone replacement does nothing to address the root cause of Addison’s disease, it only masks the issue. 

Functional medicine views the body as a whole unit instead of individual systems or specialties. Instead of focusing on the symptoms, functional medicine focuses on supporting and strengthening the immune system by getting to the root cause of your autoimmunity.

As a functional medicine doctor and an autoimmune patient, I know there is a better way, and you can reverse your condition and eliminate your symptoms by getting to the root cause – which lies within your immune system. I will tell you about my proven approach to autoimmune disease, which I’ve used with thousands of patients and seen amazing results. I call it The Myers Way®.  

Functional Medicine’s Approach to Addison’s Disease 

About 10 years ago, I developed an autoimmune condition, and conventional medicine failed me. Since then, I have made it my mission not to have it fail you, too. As a doctor, I don’t like to criticize other doctors, let alone their standard protocols. However, the truth must be told. When it comes to the treatment of autoimmune conditions, conventional medicine has failed miserably. That’s why I developed The Myers Way®.

The Myers Way® is a proven approach to chronic illness that gets to the root of symptoms. This lifestyle rests on four pillars to get to the root cause of your autoimmunity so you can reverse your condition and get off harsh medications. Let me tell you about it: 

Pillar I: Heal Your Gut 

You begin by healing the gut. In functional medicine, we use the proven 4R approach: 

1. Remove the bad – Get rid of things that negatively impact the environment of your gastrointestinal tracts, such as toxins and inflammatory foods, as well as intestinal infections such as SIBO and yeast overgrowth.  
2. Restore what’s missing — Add HCL and digestive enzymes to your daily regimen to help support digestion and nutrient absorption.
3. Reinoculate with healthy bacteria — Restore beneficial bacteria with a probiotic supplement to re-establish a healthy balance of bacteria to heal your gut. 
4. Repair the gut — Provide the necessary nutrients to help the gut repair itself. Leaky Gut Revive® Max supports your immune system and gut lining. It now comes in three different flavors to satisfy different taste buds. Adding collagen protein or drinking bone broth will also help to heal your gut.

Pillar II: Get Rid of Gluten, Grains, and Legumes

Once you’ve healed your gut, it’s time to make diet changes. Start by eliminating foods such as gluten, grains, and legumes that cause damage to your intestinal tract and inflammation. I also recommend that those with autoimmune diseases avoid vegetables in the nightshade family, which includes peppers, tomatoes, and potatoes. These plants are very high in lectins that damage the gut lining, quickly enter the bloodstream, and do not break down in cooking.

Pillar III: Tame the Toxins 

Many patients notice improvement after addressing the first two pillars. If you do not see progress, it may be because you’re exposed to too many toxins. We are exposed to thousands of toxins every day. They are found in the water you drink, the air you breathe, the food you eat, and the cookware, cleaning products, and cosmetics you use.

Unfortunately, we cannot avoid toxins altogether. As such, the solution is to reduce your body’s toxic burden by: 

• Buying clean skincare and body products 
• Cleaning your air by getting a HEPA filter for your home. I use AIRDoctor® air filters in my home.
• Buy clean food and eat organic whenever possible. It can be expensive, so if anything, buy free-range chicken, grass-fed beef, and wild-caught seafood.
• Clean your water by installing water filters on your shower taps and sinks. I have a complete filtration system from Aquasana. 

Pillar IV: Heal Your Infections and Relieve Your Stress 

If your symptoms haven’t cleared up after addressing the first three pillars, it’s time to dig deeper. The fourth pillar of The Myers Way® focuses on healing your infections and relieving your stress. 

To relieve stress, I suggest adopting daily stress-relieving strategies. A few of my favorites include breathing exercises, listening to music, dancing, taking a long walk, or practicing yoga.

To support optimal adrenal gland health and healthy energy levels, I recommend adding Adrenal Support. Adrenal Support promotes a more balanced physical and emotional stress response using a cutting-edge blend of adaptogenic herbs. 

For total support, The Myers Way® Autoimmune Kit combines four of the most important nutritional supplements for anyone concerned with autoimmunity. Your immune system is a complex puzzle influenced by multiple aspects of health.

 The integrity of your gut barrier, oxidative damage done by free radicals, inflammation, toxic load and detoxification, and much more all play a role in how your immune system functions. 

Conventional medicine will tell you that you will live with Addison’s disease for the rest of your life. I’m here to tell you that following The Myers Way®, you can reverse your autoimmunity and achieve optimal health. I know because I have seen the success in my patients!