Healthy Living

What’s Adrenal Insufficiency?

When we’re stressed out, our adrenal glands are there to help.

But that’s not all they do. The tiny glands—each barely larger than a stick of gum—secrete the hormone adrenaline, which we all know keeps us going when we’re stressed. But they also release cortisol, which helps regulate the metabolism and our body’s stress response; and aldosterone, which helps control blood pressure.

And if our adrenal glands stop working? That’s a potentially life-threatening situation. “If you don’t have adrenal glands, you can die,” said Dr. Carlos Isales, director of the Adrenal Gland Center at Augusta University Health. “However, if you remove one, as long as the other functions normally, you’re fine. But if you lose both, the problem is that they make some key hormones that must be replaced.”

It’s called adrenal insufficiency, and while it’s rare, certain people are at higher risk for it, if they:

  • Are severely malnourished
  • Have an autoimmune disease like lupus or rheumatoid arthritis, diabetes, asthma, or cancer and suddenly stop taking a glucocorticoid like prednisone
  • Have tuberculosis
  • Are on blood thinners
  • Have an adrenal tumor

Symptoms, Both Early and Severe

Symptoms of adrenal insufficiency aren’t always very specific and could easily be mistaken for symptoms of something else, says Isales. They include:

  • Feeling tired
  • Muscle weakness
  • Dizziness or fainting
  • Low blood pressure
  • Low blood sugar
  • Nausea or vomiting
  • Weight loss
  • Pain in the abdomen or muscles

Some more unique symptoms are:

  • You stop having a period
  • You crave salty foods
  • You notice a darkening of the skin
  • You’re urinating a lot
  • You’ve lost your sex drive

Then, say your adrenal gland isn’t working as it should and you suddenly have a stressful situation—you get sick, are in an accident or have surgery. Your body could be thrown into an adrenal crisis, which is an emergency situation. Patients may have:

  • Sudden, severe pain in the lower back, abdomen or legs
  • Vomiting and diarrhea
  • Weakness
  • Confusion
  • Loss of consciousness

Anyone with adrenal insufficiency should always carry an emergency corticosteroid injection with them, which could help save their life. They should also wear a medical alert bracelet so first responders can know about their condition.

Adrenal insufficiency can also lead to hyponatremia, when you don’t have enough sodium in your blood, causing confusion, fatigue, muscle twitches and even seizures. Another problem is too much potassium in your bloodstream, which could cause abnormal heart rhythms or paralysis.

If you have adrenal insufficiency, you’ll need daily medication to replace your adrenal hormones for the rest of your life. You’ll also need to monitor your stress levels carefully, and take additional medication if you have a fever or have surgery, for example.

“The condition is very real—and can be very dangerous,” said Isales. “It’s not that one day you can stop taking your medication. If you have no adrenal glands, you can die from that.”

Adrenal issues?  We have the answers.

The Augusta University Adrenal Center multidisciplinary team consists of adrenal specialist from diverse disciplines including surgery, endocrinology, cardiology, radiology, pathology and research. It is one of only a few in the country that can provide complete care for patients with all aspects of adrenal disease. Learn more about the center at augustahealth.org/adrenal-center.

About the author

Augusta University Health

Augusta University Health

Based in Augusta, Georgia, Augusta University Health is a world-class health care network, offering the most comprehensive primary, specialty and subspecialty care in the region. Augusta University Health provides skilled, compassionate care to its patients, conducts leading-edge clinical research and fosters the medical education and training of tomorrow’s health care practitioners. Augusta University Health is a not-for-profit corporation that manages the clinical operations associated with Augusta University.