Re: dark skin pigment with addisons
Pretty much all the endocrine system (it is a system!!!) works together in some fashion or another and I know that when I adjust one me (I am panhypopit and rely entirely on meds for most of my hormones), I have to adjust others. MY doc knows this.
When I had the pit problem, my skin did not show up so bad... but now I am dark but no means um, mexican. I am more spotty. But I know others with high ACTH and we all show it in different ways. It looks like your doc is looking in a book, at one pic, and deriving all his experience from that. Yeah, it does not work that way.
However, fatigue is one of those symptoms that is very non-specific so it can belong to many disorders. How is your iron - too high - too low? Vitamin D? Thyroid - has all of it been tested not just TSH? There are so many many things that can cause fatigue that until all that can be ruled out, adrenals can be a factor, but you need to look at the rest of the picture too.
My advice, move on to an experienced doctor, please!