Adrenal Insufficiency

What is Adrenal Insufficiency?

Adrenal insufficiency occurs when the adrenal glands, located on top of each kidney, fail to produce adequate amounts of steroid hormones, primarily cortisol. Primary adrenal insufficiency (Addison's disease) results from damage to the adrenal glands themselves, while secondary adrenal insufficiency is caused by insufficient ACTH production from the pituitary gland. Cortisol plays a vital role in stress response, blood sugar regulation, and immune function. The condition requires lifelong hormone replacement and careful management during illness or stress.

Symptoms

• ●Chronic fatigue and muscle weakness
• ●Darkening of the skin (hyperpigmentation)
• ●Low blood pressure and dizziness
• ●Unintentional weight loss and decreased appetite
• ●Nausea, vomiting, and abdominal pain
• ●Salt cravings

What Causes Adrenal Insufficiency?

Primary adrenal insufficiency is most commonly caused by autoimmune destruction of the adrenal cortex. Infections such as tuberculosis, fungal infections, and HIV can also damage the adrenal glands. Secondary adrenal insufficiency often results from the sudden withdrawal of long-term corticosteroid therapy or pituitary tumors.

Risk Factors

• ⚠Autoimmune disorders (type 1 diabetes, thyroid disease)
• ⚠History of tuberculosis or chronic infections
• ⚠Long-term corticosteroid use
• ⚠Pituitary gland disorders
• ⚠Surgical removal of the adrenal glands

How to Prevent Adrenal Insufficiency

Gradual tapering of corticosteroid medications rather than abrupt discontinuation is critical. Patients with known adrenal insufficiency should carry emergency medical identification and have an emergency injection kit for adrenal crisis situations.

When to Get Tested

Testing is recommended if you experience chronic unexplained fatigue, low blood pressure, skin darkening, or salt cravings. A morning cortisol blood test is the initial screening step.

References & Sources

• [1]
  Mayo Clinic — Addison's DiseaseAccessed: 2026-02-24
• [2]
  NHS — Addison's DiseaseAccessed: 2026-02-24
• [3]
  Cleveland Clinic — Adrenal InsufficiencyAccessed: 2026-02-24