Adrenal Insufficiency: Causes, Symptoms & Treatment Guide

When dealing with adrenal insufficiency, you’re facing adrenal insufficiency, a condition where the adrenal glands don’t produce enough cortisol and sometimes aldosterone. Also known as Addison’s disease, it can be primary (direct gland damage) or secondary (pituitary or hypothalamic problems). Cortisol is the main hormone that drops, leading to fatigue, weight loss, low blood pressure and cravings for salty foods. ACTH (adrenocorticotropic hormone) drives the adrenal response, so when ACTH is low the problem is usually secondary. The gold‑standard ACTH stimulation test shows whether the glands can ramp up cortisol, making it the key diagnostic tool. Because cortisol deficiency fuels the whole symptom picture, steroid replacement is the cornerstone of therapy, typically with hydrocortisone tablets and, when aldosterone is also low, fludrocortisone.

Key Factors and Everyday Management

Understanding the split between primary and secondary forms helps choose the right meds. Primary adrenal insufficiency usually means you lose both cortisol and aldosterone, so you’ll need a mineral‑corticoid like fludrocortisone to keep sodium and potassium balanced. Secondary cases often spare aldosterone, but you still need glucocorticoids to avoid the dreaded adrenal crisis—a sudden collapse that can happen if stress isn’t covered with extra steroids. Simple habits like carrying an emergency injection kit, wearing a medical alert bracelet, and doubling your dose during fever, surgery or intense exercise dramatically cut that risk. Nutrition matters, too: a modest increase in salt intake and regular meals prevent low blood sugar swings that can mimic crisis symptoms. Recent guidelines suggest splitting the daily hydrocortisone dose (morning, midday, early evening) to imitate the body’s natural cortisol rhythm, which reduces fatigue and improves sleep.

Beyond the basics, many patients ask about lifestyle tweaks. Regular moderate exercise is safe once you’re on a stable replacement dose; it boosts energy and counteracts the weight gain that high‑dose steroids can cause. Stress‑management techniques—mindfulness, adequate sleep, and staying hydrated—help keep cortisol demand low. If you’re on long‑term steroids, bone health surveillance with calcium, vitamin D and occasional DXA scans is prudent because reduced cortisol can affect bone turnover. And remember, any new medication, especially NSAIDs or antifungals, can interact with steroid metabolism, so always check with your doctor before adding a new drug.

The articles below dive deeper into each of these points. You’ll find detailed looks at how the ACTH stimulation test is performed, comparisons of hydrocortisone versus newer synthetic glucocorticoids, tips for managing adrenal insufficiency during travel, and real‑world stories of patients who’ve mastered stress‑dosing. Whether you’re newly diagnosed, a caregiver, or a health professional brushing up on the latest guidelines, the collection gives you practical, up‑to‑date insights to handle adrenal insufficiency with confidence.