Adrenal Insufficiency: Symptoms & Treatment

Cortisol is an important hormone for the human body as it helps break down carbohydrates, proteins and fats. It affects how your immune system works and also controls blood pressure. High levels of cortisol lead to some common issues like fatigue, acne, high blood pressure, headache and weight gain.

But, did you know that a fall in cortisol and aldosterone levels can also trigger fatal conditions. One of these is an uncommon illness known as Adrenal insufficiency or Addison’s disease. 

Addison’s disease can be life-threatening and can affect anyone. This disease is categorised as primary, secondary, or tertiary. It can also affect your body’s ability to maintain essential life functions and respond to stress. It is treated by taking hormones to replace those that are missing.

Most people with adrenal insufficiency can have an active, normal life with treatment. If you are losing weight or feel weak and tired, ask your healthcare professional if you might have adrenal insufficiency as an early treatment can help avoid an acute adrenal crisis. 

What is Adrenal Insufficiency?

It is a condition in which some of our body’s significant hormones are not produced in adequate amounts by the adrenal glands. The adrenal glands normally secrete androgens, mineralocorticoids and glucocorticoids. These hormones are important for metabolism and in regulating electrolytes and blood pressure. 

Deficiency of These Hormones Leads to Symptoms Ranging from 

• Shock (in severe cases), 
• Organ Failure, 
• Mood and Personality changes (in mild cases), 
• Depression, 
• Low Blood Bressure, 
• Fatigue and Muscle Weakness, 
• Vomiting and Abdominal Pain. 

A life-threatening medical condition resulting from severe deficiency of cortisol in the body can arise if the body is subjected to stress, like severe infection, surgery, injury and accident and is referred to as an adrenal crisis. 

What are the Symptoms of Adrenal Insufficiency?

The symptoms of Addison’s disease normally happen slowly, over a few months. People who have it may ignore the symptoms at first as the disease can move slowly. The symptoms become worse by stress such as injury or illness. 

The Symptoms of Adrenal Insufficiency Include:

• Hypoglycemia (low blood sugar)
• Craving for salt
• Fainting or low blood pressure
• Areas of darkened skin
• Loss of appetite and weight loss
• Extreme fatigue
• Vomiting, diarrhoea or nausea
• Pain in the abdomen
• Joint and muscle pain
• Irritability
• Depression
• Sexual issues or loss of body hair in some people
• Dehydration

How do You Diagnose Adrenal Insufficiency?

Your physician will assess your symptoms and past medical history. Based on which further investigative procedures will be prescribed, such as: 

ACTH Stimulation Test

The adrenal glands are told to make cortisol by ACTH. A shot of human-made ACTH is administered and the cortisol levels in the blood are measured in this test before and after the shot

Insulin-induced Hypoglycemia Test

It is performed to check whether the pituitary gland is leading to secondary adrenal insufficiency or not. After a shot of insulin, the cortisol and blood sugar levels are checked in this test.

Also Read: How do You Manage Type 2 Diabetes?

Blood Test

The blood levels of ACTH (adrenocorticotropic hormone), cortisol, potassium and sodium are measured in this test. It can also measure antibodies related to autoimmune Addison’s disease.

Imaging Tests

CT scan of the stomach area is done to check the size of the adrenal glands and look for other issues. An MRI of the pituitary gland is done to check for secondary adrenal insufficiency.

How to Treat Adrenal Insufficiency?

Addison’s disease is treated by using medicines. Hormone replacement therapy helps in the correction of the levels of steroid hormones which the body is not making in sufficient amounts. Oral corticosteroids are included in some treatments like:

• Methylprednisolone, Prednisone or Hydrocortisone are used to replace cortisol. On a schedule, these hormones are given to act like the changes in cortisol levels the body goes through over twenty-four hours.
  
• Fludrocortisone acetate is given to replace aldosterone

Plenty of salt should be included in your diet, especially if you have digestive upsets like diarrhoea when the weather is hot or during heavy exercise.  If your body is stressed, then your healthcare provider may increase your medicine for a short time. A minor illness, infection or surgery can trigger such stress. You may need shots of corticosteroids if you are vomiting and can’t keep down your medicine. 

Some Other Treatments Include

Glucocorticoid Injection Kit

This kit contains injectable corticosteroids, a syringe and a needle for emergencies.

Keep Extra Medicine Handy

It’s vital to keep a small supply with you when you travel and at work because it can be dangerous to miss even one day of medicine. 

Keep in Touch with Your Care Provider –

Your hormone levels can be monitored by your care provider. Your provider might need to change the doses or when you take them if you face problems with your medicine. 

Have Your Yearly Check-ups

You should see your doctor or care provider who treats hormone problems at least once a year. Yearly screening for autoimmune diseases may also be recommended by your provider. 

Conclusion

A person suffering from adrenal insufficiency is unable to make some specific hormones sufficiently, which can hamper basic life functions and the stress response. This disease can also be life-threatening, hence it is always advisable to seek medical help from an experienced endocrinologist. Timely care and help can ensure the gradual stabilisation of a person’s hormone levels.

At the CK Birla Hospital, we ensure patients get holistic medical support which includes treatment in a compassionate environment. This patient-centric approach not only helps patients heal better but also ensures they are aware of the preventive measures as well. In case you need to consult an endocrinologist, do reach out to us, or book a direct appointment with Dr. Rajeev Gupta at the CK Birla Hospital. (Booking Link)

FAQ’s

Does Adrenal Insufficiency Cause Weight Loss?

Unintentional weight loss is one of the symptoms of Addison’s disease, which is normally accompanied by loss of appetite due to insufficient adrenal levels in the body. 

How to Reverse Adrenal Insufficiency?

Adrenal insufficiency can be reversed by the use of medicines, hormone replacement therapy and oral corticosteroids.

Is Secondary Adrenal Insufficiency Reversible?

Once patients with opioid-induced adrenal insufficiency are weaned off the drugs, then they can recover rapidly.