Rooted in Violet & Co

Navigating Adrenal Insufficiency and Medical Bias

Beyond the “Strong Black Woman”: The Reality of Chronic Exhaustion

For many of us, a condition such as adrenal insufficiency can feel like a foreign concept. We work hard. We ignore signs that our health is calling out for our attention. Being a “Strong Black Woman” feels like a badge of honor. We carry the weight of our families, careers, and communities without missing a beat.

But in the doctor’s office, this strength can become a trap. When we are expected to “handle it all,” our real physical pain and exhaustion are often pushed aside as just “stress.” This is more than just feeling “burnt out.” When your body is signaling that something is deeply wrong, being told to “just practice mindfulness” isn’t just frustrating—it’s dangerous. If you are experiencing weight loss, intense salt cravings, or changes in your skin tone along with soul-crushing fatigue, your body might be telling you that your adrenal glands are failing.

The Story of Maya

Take Maya, a 34-year-old professional. For four years, she told her doctor she was beyond exhausted. She lost 15 pounds without trying and started craving salt like never before. She even noticed her skin and gums getting darker. Her doctor told her it was just “anxiety” and “work stress.” In reality, Maya had Adrenal Insufficiency (AI)—a life-threatening condition where the body doesn’t make enough essential hormones.

Understanding Your Body: What Are the Adrenal Glands?

To be your own best advocate, you need to understand how your “machinery” works. You have two small, triangle-shaped organs called adrenal glands sitting on top of your kidneys. They are small, but they do big work. These glands produce three “life-essential” hormones:

  1. Cortisol: Your “stress hormone.” It helps manage blood pressure, blood sugar, and your body’s response to inflammation.
  2. Aldosterone: This manages your salt and water balance. Without it, your blood pressure can’t stay steady.
  3. Androgens: These help with your stamina and overall mood.

When these glands stop working (Primary AI, also called Addison’s Disease) or when the signal from your brain to these glands is broken (Secondary AI), your body begins to shut down.

The ROOT Framework for Adrenal Advocacy

At Rooted in Violet, we believe your voice is the strongest medicine you have. Use the ROOT Framework to move from being “ignored” to being “empowered” during your next medical visit.

R — Reveal What’s Going On

Don’t just say “I’m tired.” Start tracking the specific ways your body is acting differently.

  • Track your patterns: For two weeks, write down when you feel most dizzy. Is it when you stand up quickly?
  • Check your skin: Look for deepening pigmentation (like a tan that won’t fade) on your palms, gums, or old scars.
  • Log your cravings: Are you suddenly eating jars of pickles or shaking extra salt on everything? Document it.

O — Offer Your Observations

When you meet with your provider, share your data clearly and firmly.

  • Use factual language: “I have lost 10 pounds in two months without changing my diet, and I am experiencing intense salt cravings.”
  • Challenge the ‘Stress’ label: If the doctor says it’s just stress, say: “Stress does not usually cause hyperpigmentation in my gums or significant weight loss. I am concerned about a hormonal issue.”

O — Outline What You Need

Don’t wait for the doctor to suggest the next step. Ask for the specific tests that can save your life.

  • Request the “Gold Standard” tests: “I would like to rule out Addison’s Disease. Please order a morning cortisol test (drawn between 8:00 AM and 9:00 AM) and an ACTH stimulation test.”
  • Ask for a Specialist: If your primary doctor is unsure, request a referral to an Endocrinologist.

T — Take Note and Follow-Up

Advocacy is about accountability.

  • Document the “No”: If a doctor refuses to run these tests, say: “Please document in my chart that you are refusing to order a morning cortisol test despite my symptoms of weight loss and hyperpigmentation.”
  • Keep your records: Always ask for a printed copy of your lab results.
  • Plan for “Sick Days”: If you are diagnosed, work with your doctor to create a “Sick Day Plan” to know how to adjust your medicine when you have a fever or the flu.

Adrenal Crisis: When It’s an Emergency

Untreated Adrenal Insufficiency can lead to an Adrenal Crisis. This is a medical emergency. Seek help immediately if you feel:

  • Sudden, severe pain in your lower back, abdomen, or legs.
  • Severe vomiting and diarrhea.
  • Confusion or extreme weakness.
  • Fainting or very low blood pressure.

The ER Script: If you are in crisis, tell the ER staff: “I am in adrenal crisis. I need 100mg of IV hydrocortisone and saline fluids immediately.”

Medical Alert

Adrenal Crisis Self-Advocacy

When It’s an Emergency

Untreated Adrenal Insufficiency can lead to an Adrenal Crisis. This is a life-threatening medical emergency. Seek help immediately if you feel:

  • Sudden, severe pain in your lower back, abdomen, or legs.
  • Severe vomiting and diarrhea.
  • Confusion or extreme weakness.
  • Fainting or very low blood pressure.

The ER Script

If you are in crisis, show this screen to the ER triage nurse or tell them clearly:

“I am in adrenal crisis. I need 100mg of IV hydrocortisone and saline fluids immediately.”