Adrenal insufficiency (AI) occurs when the outer layer of the adrenal glands, or the cortex, does not produce enough steroid hormones. There are two main types of AI. Primary adrenal insufficiency – also called Addison’s disease – occurs when the adrenal glands do not make enough hormones, primarily cortisol. Secondary adrenal insufficiency is when the pituitary gland in the brain does not signal the adrenal glands to make hormones, primarily cortisol. Secondary AI is much more common than Primary AI, but both types are considered rare. Common symptoms of adrenal insufficiency include fatigue, weight loss, decreased appetite, muscle weakness, muscle and joint pain, nausea, vomiting, diarrhea, low blood pressure, low blood glucose and darkened skin.
The main goal of treatment for people with adrenal insufficiency is to maintain a proper level and balance of hormones. This may include taking hormones daily and carrying extra hormones with them at all times in case of an emergency. It is important to carefully manage the disorder because without proper treatment, a person could experience a life-threatening adrenal crisis.
As long as someone with adrenal insufficiency is able to find and maintain an effective course of treatment, they can lead fulfilling life and participate in their usual routines and activities. One of the primary concerns for someone with AI is a sudden or severe drop in their level of cortisol. The body produces cortisol to respond to stress. Cortisol is also important in maintaining blood pressure and cardiovascular function, slowing the immune system’s inflammatory response, balancing the effects of insulin in breaking down sugar for energy and regulating the metabolism of proteins, carbohydrates and fats. Because of this, a significant drop in cortisol can have serious and life-threatening effects on the body. This drop is referred to as an adrenal crisis and a person with AI must keep a close watch on their body and its functioning at all times in order to prevent this type of medical emergency.
There are several resources available to provide information and support to people with adrenal insufficiency. Many of these organizations also aim to raise awareness about this rare condition.