Studies in patients with hypocortisolism have found the three most common symptoms to be: sensitivity to stress, pain, and chronic fatigue. This is also known as the ‘symptom triad’ of hypocortisolism. However, other signs and symptoms can also be seen and can mimic those seen in Addison’s disease (complete loss of adrenal hormone production) even though they are not as severe. It is for this reason that some in the medical community have nicknamed hypocortisolism "Subclinical Addison’s Disease” (not “adrenal exhaustion”!).
Some of the major symptoms seen in patients with low cortisol states include:
· Chronic fatigue
· Fever
· Weakness
· Muscle and joint pain
· Headaches
· Dizziness upon standing
· Chronic pain syndromes (i.e. fibromyalgia)
· Depression and irritability
· Sleep disturbances
· Difficulties with concentration and memory
· Irritable bowel symptoms
· Lack of appetite
· Low blood sugar
· Chemical and food sensitivities
Because many of these symptoms are vague and may be seen in other medical conditions, patients suffering from hypocortisolism often go undiagnosed or are misdiagnosed with chronic fatigue syndrome or a mood disorder and offered prescription medication for their symptoms. It is in these situations that the astute healthcare professional expands the differential diagnosis and assesses the integrity of the patient’s stress response system.