What is Adrenal Insufficiency?

The adrenal glands (small glands on top of your kidneys) make Cortisol, a stress hormone essential for life. Adrenal Insufficiency means the glands do not produce enough cortisol.

Types:

• Primary Adrenal Insufficiency (Addison's Disease): The adrenal glands themselves are destroyed (usually autoimmune).
• Secondary Adrenal Insufficiency: The pituitary gland doesn't send the signal (ACTH) to the adrenals. Often caused by long-term steroid use.

Symptoms:

• Chronic Fatigue: Overwhelming, doesn't improve with rest.
• Weight Loss & Poor Appetite.
• Low Blood Pressure: Dizziness when standing.
• Salt Cravings: (Addison's disease specifically, because it also affects aldosterone).
• Hyperpigmentation (Addison's only): Darkening of skin, especially scars, knuckles, gums.

Diagnosis:

• Morning Cortisol: If very low, confirms the diagnosis.
• ACTH Stimulation Test: Give synthetic ACTH and measure cortisol response.

Treatment:

• Hydrocortisone (Cortef): Replacement steroid taken 2-3 times daily.
• Fludrocortisone (Florinef): For Addison's disease (replaces aldosterone).
• Stress Dosing: Double or triple your dose during illness, surgery, or major stress to prevent Adrenal Crisis.

Critical Rule:

NEVER miss a dose. Wear a medical alert bracelet. Carry an emergency injection kit (Solu-Cortef) for vomiting/unable to take pills.