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Adrenal insufficiency happens when the adrenal glands do not make enough of certain hormones. In some people, adrenal insufficiency can affect stress response and the ability to maintain other essential life functions.

What causes adrenal insufficiency?

Long-term adrenal insufficiency can be caused by:

• Addison’s disease
• Surgery to remove the pituitary gland
• Surgery to remove the adrenal glands
• A genetic problem with the adrenal glands

Adrenal insufficiency can also be caused by:

• Physical stress (like illness, serious injury, or surgery)
• Infection
• High doses of steroids
• Complicated surgery

How can you tell if someone has adrenal insufficiency?

People with adrenal insufficiency often don’t feel well and may have one or more of these symptoms:

• Chronic or long-lasting fatigue
• Muscle weakness
• Loss of appetite
• Weight loss
• Stomach (abdominal) pain

If left untreated, other symptoms of adrenal insufficiency may include:

• Nausea or vomiting
• Diarrhea
• Low blood pressure that drops further when you stand up, causing dizziness or fainting
• Irritability and depression
• Joint pain
• Craving salty foods
• Low blood sugar
• Darkened skin (seen in people with Addison's disease)

Adrenal insufficiency symptoms may come on slowly over time, so they may be overlooked or confused with other illnesses. Call your doctor at once if you or your loved one have any of the symptoms listed above; always feel tired, weak, or experience weight loss.

How is adrenal insufficiency treated?

People with adrenal insufficiency must take medicine each day to replace the hormones that their bodies are not making. This medicine is called a “replacement dose.” A doctor may prescribe pills called hydrocortisone (high-dro-core-tih-zone), dexamethasone (deck-suh-meth-uh-zone), or prednisone (predd-nih-zone). Children often take hydrocortisone liquid instead of pills. They should take their adrenal insufficiency medicines every day, just as the doctor instructs. People with adrenal insufficiency who can’t keep the right amounts of salt and fluids in their body are given a medicine called fludrocortisone (flew-dro-core-tih-zone). It replaces the aldosterone in their body. Adults take this medicine as pills. Children can take these pills crushed or dissolved in water.

What should you do if you or your loved one with adrenal insufficiency feels sick?

If you or your loved one are sick or hurt, call the doctor right away.

For most of us, the body makes more cortisol during times of stress, like when we are sick or badly injured. But in people with adrenal insufficiency, the body can’t do that. That’s why they may need to take extra medicine.

At times, people with adrenal insufficiency may need to increase their dose of medicine as their doctor prescribes.

For example, if they have:

• Surgery
• A high fever (101°F or higher)
• Severe infection or diarrhea, or they are vomiting and can’t keep their corticosteroid pills down
• Severe injury or a serious condition (suddenly passing out)

You should not increase the dose for any other sort of stress (like having a bad day or feeling tense or sad).

Remember to take your medicine only as your doctor instructs.