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Hyperpigmentation and fatigue???
I am a 46 year old female.  I have developed mild vitiligo on the sides of my face as well as hyperpigmentation of my gums.  The gum pigmentation has increased over the past few weeks. I am also noticing spots of hyperpigmentation on the dorsal aspects of my forearms and the top of my thighs. I have had increasing fatigue for years and notice increased respiratory rate (especially at night).  I am loosing hair, have nausea and occasional vomiting.  I have frequent abdominal bloating.

My rheumatoid factor was 80 and my ANA 1:320 and speckled.  I had a quick adrenal stimulation test.  Base line ACTH was 12 and cortisol 9.2.  At 30 min the cortisol was 20.1 and 60 min 26.2.  My understanding is that this rules out adrenal insufficiency.  Is this correct?

Also, should I ignore all this?  See a dermatologist? Endocrinologist?
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Hi
I have have been diagnosed with Addison's Disease for 8 years and the pigmentation and fatigue are certainly part of that.  My advice would be to se an endocrinologist.
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You will see me say this a lot on this site. You need to have your immune levels checked as well as testing for Celiac Disease. A good immunologist will be worth his weight in gold. Good Luck!
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