Adrenal Insufficiency: Causes and Symptoms

What is adrenal insufficiency?

Adrenal insufficiency is a condition in which the adrenal glands do not produce enough of a hormone called cortisol. Cortisol has many important jobs in the body, including preventing low blood pressure and low blood sugar. Cortisol is also important for helping the body respond to stresses such as illness, injury, and surgery.

In some cases of adrenal insufficiency, the adrenal glands also do not make enough aldosterone. Aldosterone is a hormone that helps the body keep the right balance of water and the salts sodium and potassium.

Important words to know

• Adrenal glands
  The adrenal glands are located next to the kidneys. They make many hormones, including cortisol and aldosterone.
• Aldosterone
  Aldosterone is a hormone that helps your body keep the right balance of water and salts.
• Cortisol
  Cortisol is a hormone that helps prevent low blood pressure and low blood sugar. It also helps your body respond to illness, injury and surgery. It is the most common glucocorticoid in humans.
• Glucocorticoid
  Glucocorticoids are hormones with many jobs, including keeping blood sugar levels within a normal range. Artificial forms of glucocorticoids can be given to people whose bodies have trouble making enough of their own glucocorticoid.
• Stress-dosing
  Stress-dosing is when you give your child extra doses of a medication called glucocorticoid. You must give your child stress doses when he or she is sick, injured or having surgery.

Did you know?

It’s very important for your child to wear a medical ID, like a medical alert bracelet, that states he or she has adrenal insufficiency. If there’s ever an emergency, this will help make sure your child receives the right treatment by the medical team.

What are the symptoms of adrenal insufficiency?

In the early stages, you might not notice the symptoms of adrenal insufficiency because they’re often subtle. Your child might have these symptoms:

• Feeling tired more often than usual (fatigue)
• Stomach pain or nausea
• Muscle aches
• Feeling light-headed
• Darkening of the skin, often most noticeable on the gums, over the knuckles or in the lines of the hands

What causes adrenal insufficiency?

There are many causes of adrenal insufficiency, which can be divided into 2 categories. These categories are primary adrenal insufficiency and central adrenal insufficiency.

Primary adrenal insufficiency is when the adrenal glands do not work the way they should. Causes of primary adrenal insufficiency include:

• Genetic causes

• Autoimmune diseases or disorders that affect the adrenal glands

• Serious infections of the adrenal glands

• Having surgery to remove the adrenal glands

Central adrenal insufficiency is when the pituitary gland (a small gland underneath the brain that controls other glands) does not make enough adrenocorticotrophic hormone (ACTH). ACTH is a hormone that helps control how much cortisol your adrenal glands release. Causes of central adrenal insufficiency include:

• When the pituitary gland does not develop properly

• Injury to the pituitary gland, like trauma or radiation

• Tumors or other growths near the pituitary gland

• Having surgery to remove the pituitary gland

• Long-term use of high-dose glucocorticoid medications, like dexamethasone, prednisone, prednisolone or certain inhaled glucocorticoids

What is adrenal crisis?

Adrenal crisis is a life-threatening condition when your child’s blood sugar and blood pressure are too low and his or her salt levels are off-balance. Contact your doctor right away if he or she shows these signs and symptoms:

• Headache
• Stomach pain or nausea
• Feeling lightheaded
• Might look pale
• Might be confused
• Might be drowsy or difficult to arouse