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Adrenal Insufficiency

Reviewed by: Larissa Hirsch, MD

What Are the Adrenal Glands?

There are two adrenal (eh-DREE-nul) glands, which sit above the kidneys. They make important that:

  • help the body handle stress
  • control blood pressure
  • balance salt levels

What Is Adrenal Insufficiency?

Adrenal insufficiency happens when the adrenal glands make fewer hormones than they should. This can cause:

  • weakness
  • tiredness
  • belly pain
  • loss of appetite
  • nausea
  • dehydration
  • skin changes

Some people with adrenal insufficiency have no symptoms unless they're exposed to stress.

adrenal glands illustration

What Causes Adrenal Insufficiency?

There are two types of adrenal insufficiency:

  1. In primary adrenal insufficiency, the adrenal glands either are damaged or have a genetic problem. They don't make enough of the hormone . Sometimes, they also don't make enough of the hormone , which helps control salt balance in the body.
  2. In central adrenal insufficiency, the doesn't make enough of the hormone adrenocorticotropic, which triggers cortisol production.

There's also a temporary type of adrenal insufficiency. This can happen if someone is being treated with high doses of cortisol-like medicines, such as prednisone, and the medicine is decreased or stopped.

How Is Adrenal Insufficiency Diagnosed?

Doctors diagnose adrenal insufficiency with:

  • blood tests, to check hormone levels
  • computed tomography (CT) scans, to check the size of the glands
  • magnetic resonance imaging (MRI), to check the size and shape of the pituitary gland

How Is Adrenal Insufficiency Treated?

Doctors treat adrenal insufficiency by giving replacement hormones. They might prescribe:

  • a corticosteroid taken by mouth several times a day to replace cortisol
  • a medicine called fludrocortisone taken by mouth once a day to replace aldosterone and balance the body's levels of salt and fluids

Sometimes, symptoms can suddenly become much worse, usually when someone is stressed by illness or injury. This is called an adrenal crisis. It needs medical treatment right away. This usually includes IV (given into a vein) injections of corticosteroids and fluids.

Reviewed by: Larissa Hirsch, MD
Date reviewed: October 2018