Download Adrenal Insufficiency

Adrenal Insufficiency
Disclaimer
This is general information developed by The
Ottawa Hospital. It is not intended to replace
the advice of a qualified health-care provider.
Please consult your health-care provider who will
be able to determine the appropriateness of the
information for your specific situation.
P1149 (06/2014)
Printed at The Ottawa Hospital
What are adrenal glands?
The body normally has 2 adrenal glands, one above each
kidney. These glands make several hormones. Cortisol is
a hormone the adrenal gland makes that helps the body use
sugar, fat and protein for energy. Cortisol also keeps your
immune system in check and affects how bones are formed.
The body also needs more cortisol to cope with stress and
illness. Aldosterone is another hormone made by adrenal
glands that adjusts salt, potassium and water levels in the body.
This helps regulate blood pressure. The body needs cortisol and
aldosterone to function normally.
What is adrenal insufficiency?
Adrenal insufficiency happens when the body is not able to
make enough cortisol. This can occur if the adrenal glands are
damaged. Another type of adrenal insufficiency can occur if
the pituitary gland in the brain is not able to make enough of a
hormone called adrenocorticotropic hormone(ACTH). ACTH
sends a message to the adrenal glands to make more cortisol.
If the body is not making ACTH, then the adrenal glands will not
make enough cortisol to keep the body working normally. When
not treated with medication, adrenal insufficiency can cause
severe illness and even death.
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What is Addison’s disease?
This is the type of adrenal insufficiency that occurs when both
adrenal glands are not able to make enough hormones. When
a person has Addison’s disease, the body is not able to make
enough cortisol or aldosterone. Addison’s disease is also called
primary adrenal insufficiency.
What are the signs and symptoms of
adrenal insufficiency?
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Feeling tired or weak
Feeling lightheaded when standing up
Having low blood pressure
Nausea, vomiting, abdominal pain
Craving salt
Weight loss
Darkening of skin (like a tan without having had time in the
sun)
How is adrenal insufficiency treated?
People who have adrenal insufficiency must take medication
to replace the cortisol that adrenal glands are unable to make.
Taking this medication will help relieve the symptoms as well as
regulate how the body uses sugar, fat and protein for energy.
The medication will also help prevent low blood pressure.
Doctors normally prescribe one of the following medications to
treat cortisol deficiency:
• Hydrocortisone (Cortef®)
• Prednisone
• Dexamethasone (Decadron®)
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Usually people who have Addison’s disease must also take a
medication to replace aldosterone. Fludrocortisone (Florinef®)
is normally the medication used to treat aldosterone deficiency.
It is important that medications for adrenal insufficiency be
taken every day at the same time. People who have adrenal
insufficiency need to see a doctor regularly for blood pressure
checks and blood tests to check if they are on the right doses of
medications.
What are the side effects of the
medications used to treat adrenal
insufficiency?
At the correct doses, medications used to treat adrenal
insufficiency do not cause serious side effects. If higher doses
are used for a long time, high blood pressure, diabetes, weak
muscles, thin skin, easy bruising and osteoporosis (weak bones)
can occur.
How should adrenal insufficiency be
treated during times of stress and
illness?
The body needs more cortisol than usual at times of stress
and illness. A person with adrenal insufficiency who is sick
with an infection and fever (temperature higher than 38o C)
should take double the usual dose of cortisol replacement
medication (hydrocortisone, prednisone or dexamethasone) for
1-3 days. If the illness lasts longer than 3 days, then treatment
should be discussed with your doctor. If a person with adrenal
insufficiency is not able to take medication by mouth because of
nausea and vomiting, then the cortisol replacement medication
must be given by injection. A person with adrenal insufficiency
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who is feeling weak and is not able to take medications should
see a doctor right away. Your family doctor may be able to
examine you and advise you. If you or your family doctor are
unsure about how to adjust your cortisol replacement when you
are sick, contact your endocrinologist.
Not being able to take treatment for adrenal insufficiency can
lead to very serious illness. You should go to the nearest
emergency department if you:
o Are sick and unable to take your medication
o Are vomiting or have diarrhea
o Have bad abdominal pain (belly ache)
o Have muscle pain or cramps
o Feel dizzy
o Feel unusually weak and unwell
Are there other important precautions
that a person with adrenal insufficiency
should take?
People with adrenal insufficiency should wear a medical
identification tag at all times stating they have this condition.
Emergency health care providers must know when people
have adrenal insufficiency so that they can make sure that the
right treatment is given. You can buy an identification tag in a
pharmacy, online or you can ask your healthcare professional if
they can recommend where to buy one.
Additional information about adrenal
insufficiency can be found at the
following websites:
http://www.addisonsociety.ca/index.html
http://www.hormone.org/questions-and-answers/2010/adrenalinsufficiency
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