How do you know which AI you are primary in?

Good question. I blame my Hashimoto's, because it activated first and then other things started breaking down a few years after that..

MG

Primary means your adrenal glands have stopped functioning. Secondary means something else is causing them not to function, like pituitary problems. I have complete pituitary failure, thus secondary Addison's. You can also get secondary Addison's from steroid use if it shuts down your adrenals. It takes a sharp doctor to know the difference. They originally thought mine was primary, but when my thyroid, adrenals, and growth hormone levels all bottomed out at once, they diagnosed panhypopituitarism. Hope this helps.

Thanks for the help. I always wondered how ones knew. I have a Bozo for a Dr. that does not know anything! So i don't think i will ever know what is primary or not. I have a alternative Dr. that has said that i have adrenal fatigue for 2 yrs and then in Nov i find out i have hashi's! My Dr. refuses to believe in Adrenal problems unless you are on deaths door in the hospital! LOL

Okay you wanted to know the difference between primary and secondary adrenal dysfunction. I have primary adrenal insufficiency. My pituitary is screaming for more from my adrenals and my adrenals are on a permanent vacation.

How does one tell?
ACTH is the pituitary's call for the adrenal glands to produce cortisol
Cortisol is the T4 to t3 conversion suppressant in the liver.. it is also a stress hormone. Too much and you have Cushings issues. Too little and you have Addison's/adrenal insufficiency.

If you are low in ACTH and low in cortisol... this is secondary insufficiency, if ACTH supplementation causes the adrenals to produce more cortisol. If adding ACTH doesn't increase cortisol.. you are looking at primary autoimmune polyglandular issues and both the pituitary and adrenals are kaput.

If you are high in ACTH and low in cortisol.. then the pituitary is doing its job there.. but the adrenals are not cooperating. Primary insufficiency

MG