Adrenal insufficiency occurs when the adrenal glands don’t make enough of the hormone cortisol. You have two adrenal glands. They are located just above the kidneys. They work with the hypothalamus and pituitary glands in the brain. Cortisol helps break down fats, proteins, and carbohydrates in your body. It also controls blood pressure and affects how your immune system works.
Adrenal insufficiency can be primary or secondary:
Primary adrenal insufficiency is most often caused when your immune system attacks your healthy adrenal glands by mistake. Other causes may include:
A lack of the hormone ACTH leads to secondary adrenal insufficiency. That can happen if you must take certain steroids for a long time due to a health problem. For example, people with asthma or rheumatoid arthritis may need to take prednisone. Other causes include:
You may have mild symptoms when you are under physical stress. Each person’s symptoms will vary. Symptoms may include:
If not treated, adrenal insufficiency may lead to:
These symptoms may look like other health problems. Always see your healthcare provider for a diagnosis.
Your healthcare provider will ask about your medical history. You will also need an exam. Tests that can diagnose adrenal insufficiency include:
Your healthcare provider will figure out the best treatment for you based on:
You will need to take hormones to replace those that your adrenal glands are not making. That mainly means cortisol. But if you have Addison's disease, you may need to take aldosterone as well.
Addison's disease can be deadly. Treatment often starts with IV (intravenous) fluids and medicines called corticosteroids. You may take these medicines by mouth or by IV. You may have to take them for the rest of your life. You may also need to take other medicines (fludrocortisones). These can help keep your body's sodium and potassium levels normal.
You may have sudden severe symptoms. This is called acute adrenal insufficiency, or Addisonian crisis. This can occur when your body is stressed. That can happen for many reasons, such as an illness, fever, surgery, or dehydration. You may also have a crisis if you stop taking your steroids or lower the amount of your steroids suddenly. The symptoms of an Addisonian crisis include the symptoms of adrenal insufficiency or Addison’s disease. But if an Addisonian crisis is not treated, it can lead to:
Take your medicine exactly as prescribed. You should also carry a medical alert card or tag at all times. This can make sure you get proper treatment if there is an emergency. When traveling always carry an emergency kit with a shot of cortisol.
Any condition that stresses your body can affect how much medicine you need. Call your healthcare provider if:
Get medical help right away if you have sudden severe symptoms (Addisonian crisis).
Tips to help you get the most from a visit to your healthcare provider:
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