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What is Adrenal Insufficiency? The Lowdown on Low Cortisol
Published: Dec 06, 2023
Adrenal insufficiency occurs when your body doesn't produce enough cortisol, an essential hormone. This condition can be life-threatening if untreated, but with proper management, people can lead normal, active lives.
What Causes Adrenal Insufficiency?
Adrenal insufficiency can be primary or central. Primary adrenal insufficiency, also called Addison's disease, results from damage to the adrenal glands themselves. Central adrenal insufficiency stems from problems in the brain regions that control the adrenal glands - specifically the pituitary gland or hypothalamus. Both types lead to low cortisol levels, but primary adrenal insufficiency also causes low aldosterone, another important hormone.
What Are the Symptoms?
Common symptoms include fatigue, weakness, loss of appetite, and weight loss. You may also experience dizziness, nausea, vomiting, and abdominal pain. In primary adrenal insufficiency, you might notice darkening of the skin. Symptoms often develop gradually but can worsen rapidly during times of stress, potentially leading to a life-threatening adrenal crisis.
How is it Diagnosed?
Diagnosing adrenal insufficiency involves blood tests to check hormone levels, especially cortisol. Doctors may perform an ACTH stimulation test, where they inject a hormone that should cause cortisol levels to rise. If cortisol doesn't increase as expected, it indicates adrenal insufficiency. Additional tests help determine if it's primary or central.
What's the Treatment?
Treatment involves replacing the missing hormones. For cortisol, this usually means taking hydrocortisone pills several times a day. People with primary adrenal insufficiency also need a medication called fludrocortisone to replace aldosterone. Patients must learn to adjust their medication during times of illness or stress. With proper treatment and education, most people with adrenal insufficiency can lead normal, active lives.
Frequently Asked Questions
No, but it's manageable with lifelong hormone replacement therapy.
A life-threatening condition requiring immediate medical attention and high-dose steroids.
Yes, but you may need to adjust medication for intense workouts.
Not usually, but some people may need extra salt.
Yes, but with proper management, most women have healthy pregnancies.
Living with Adrenal Insufficiency
While adrenal insufficiency is a serious condition, with proper treatment and self-care, most people can lead full, active lives.
References
- Bornstein SR, et al. J Clin Endocrinol Metab. 2016;101:364-389.
- Husebye ES, et al. Lancet. 2021;397:613-629.
- Grossman AB. J Clin Endocrinol Metab. 2010;95:4855-4860.
This article has been reviewed for accuracy by one of the licensed medical doctors working for Doctronic. Always discuss health information with your healthcare provider.
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