Adrenal insufficiency happens when your adrenal glands don’t make enough hormones, like cortisol, that your body needs.
When these hormones are out of balance, it can lead to various symptoms such as feeling tired all the time, having weak muscles, and experiencing pain in your stomach.
There are different kinds of adrenal insufficiency, with one called Addison’s disease, known as primary adrenal insufficiency.
Adrenal insufficiency isn’t very common. In the United States, only about 1 in 100,000 people have Addison’s disease. Secondary adrenal insufficiency is more frequent, but we don’t have as much information about how common central adrenal insufficiency is.
Types of Adrenal Insufficiency
The adrenal cortex are tiny gland located above your kidneys. They make important hormones, like cortisol, which your body needs to function properly.
When the suprarenal glands don’t make enough of these hormones, it’s called adrenal insufficiency. This means there’s not enough cortisol, a hormone that helps your body handle stress and does many other jobs.
There are three main types of adrenal insufficiency:
- Addison’s Disease: This occurs when the suprarenal glands themselves are damaged and can’t make enough hormones.
- Secondary Adrenal Insufficiency: Here, the problem is in the pituitary gland in your brain. It doesn’t produce sufficient of a hormone called adrenocorticotropic hormone (ACTH), which tells the adrenal cortex to make cortisol.
- Central Adrenal Insufficiency: This type occurs when the mammillary region in your brain, which also helps regulate hormone production, doesn’t make sufficient corticotropin-releasing hormone (CRH), which then affects cortisol levels.
These hormones from the adrenal cortex do lots of important things in your body. For example, cortisol helps regulate blood pressure, fights inflammation and helps with metabolism. Another hormone called aldosterone helps balance minerals in your blood.
When you don’t have enough of these hormones because of adrenal insufficiency, it can cause all sorts of symptoms, from feeling weak to having lower levels of blood sugar. If you’re experiencing any of these symptoms, it’s essential to talk to your doctor for proper diagnosis and treatment.
Symptoms of Adrenal Insufficiency
Adrenal insufficiency can lead to a variety of signs, which may start off mild but become more severe over time.
Regardless of the type, all forms of adrenal insufficiency share similar signs. The most common signs include extreme tiredness or fatigue, weak muscles, reduced appetite leading to losing weight, and stomach pains.
Additional symptoms may include joint pain, hypotension, dizziness, nausea, vomiting, irritability, depression, low blood sugar, irregular periods, and skin darkness, especially in areas like the elbows and knees.
In some cases, individuals with adrenal insufficiency may experience an adrenal crisis, where signs suddenly get bad. This often happens because of illness, infection, or injury.
An adrenal crisis is a medical emergency and needs immediate treatment. Without prompt medical involvement, the condition can become more dangerous. If you or someone you know experiences symptoms of adrenal crisis, seek medical help right away.
Treatment
Adrenal insufficiency doesn’t have a cure yet, but there are treatments available to help manage its symptoms. The type of treatment depends on how severe the symptoms are and what kind of symptoms you have. Your healthcare provider will also consider your age and overall health when deciding on the right treatment plan for you.
One common treatment for adrenal insufficiency is hormone replacement therapy. This intervention substitutes the hormones that your adrenal glands aren’t making enough of, like cortisol.
To substitute cortisol, your doctor may prescribe a medication called hydrocortisone, which you’ll take in pill form many times a day. They might also suggest a medication called fludrocortisone to help balance minerals in your body short of aldosterone.
For many people, these medications are something they’ll need to take for the rest of their lives. If you ever have an adrenal crisis, you might need medication through an intravenous drip to quickly replace the missing hormones.
Some individuals with primary adrenal insufficiency might find that specific diets can help manage their symptoms. For example, a diet high in sodium might be beneficial. It’s also important for people taking corticosteroids to get enough vitamin D and calcium to support their bone health.
Complications of Adrenal Insufficiency
The biggest complication of adrenal insufficiency is something called adrenal shock.
Adrenal shock can cause serious symptoms to suddenly appear without intimation. It usually happens when the body is under a lot of stress, like after surgery or injury. This condition needs urgent medical attention.
Without medication, adrenal shock can cause even more serious problems like seizures or even a coma, and it can be life-threatening.
Prevention
Unfortunately, it’s not always possible to stop many cases of adrenal insufficiency because it’s often caused by an autoimmune reaction.
However, there are steps you can take to prevent one type called tertiary adrenal insufficiency. This happens when people suddenly stop taking corticosteroid therapy. To prevent it, it’s important to follow your doctor’s instructions carefully and avoid stopping your medication suddenly.
Diagnosing Adrenal Insufficiency
Diagnosing adrenal insufficiency can be tricky because the symptoms can vary, and some of them might seem light at first, making them easy to miss.
When you visit the doctor with symptoms that could be adrenal insufficiency, they’ll look at your symptoms carefully. They might also want to do some tests, usually by taking a small sample of your blood. By looking at your mineral and hormone levels in the blood, doctors can see if there are any signs of the condition.
In some cases, the doctor might also recommend doing medical imaging tests, like an MRI scan. This allows them to get a closer look at the pituitary glands to see if there are any problems there. These tests help the doctor confirm whether or not you have adrenal insufficiency so they can plan the right treatment for you.
When to consult a healthcare provider
It’s common for people not to notice the early signs of adrenal insufficiency because they might be mild. But as time goes on, the symptoms can get worse and become more obvious. Feeling tired all the time, weak, or losing weight without trying are common symptoms of this condition.
If the symptoms start suddenly and get worse quickly, it could be a sign of something serious called adrenal shock. If this happens, it’s really important to get medical help right away.
Summary
Adrenal insufficiency happens when the suprarenal glands don’t make enough hormones, especially cortisol, which is crucial for the body.
This condition can lead to various symptoms and is usually treated with hormone replacement therapy. However, in some cases, it can lead to a medical emergency called adrenal shock.
Adrenal shock requires immediate treatment, so it’s important to seek medical help right away if you think you or someone else might be experiencing it.
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