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Secondary Adrenal Insufficiency: Care Instructions

Overview

Your adrenal glands sit on top of your kidneys. They make hormones that affect almost every organ in your body.

Secondary adrenal insufficiency means that your adrenal glands don't make enough of a hormone called cortisol. Cortisol helps maintain blood pressure. It helps break down sugar and fat for energy. It also helps manage stress.

The problem starts with the pituitary gland. It's located at the base of your brain. Normally it sends a signal to the adrenal glands to make more cortisol. The signal is a hormone that the pituitary gland makes, called ACTH. When the pituitary gland doesn't make enough ACTH, the adrenal glands won't make enough cortisol.

This can happen if the pituitary gland is damaged by things like a tumor or surgery.

Treatment involves replacing the hormones that your body needs. You might get some of these hormones in the hospital. Some people will take hormones at home for the rest of their lives. Hormones may be pills or injections (shots).

If possible, your doctor will treat the condition that damaged the pituitary gland.

Some people may need urgent care because they have what is called an adrenal crisis. It can be caused by severe infection or stress. Symptoms may include:

  • Severe vomiting and diarrhea.

  • Extreme weakness.

  • A high fever.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

How can you care for yourself at home?

  • Take your medicines exactly as prescribed. Call your doctor if you think you are having a problem with your medicine.

  • Wear medical alert jewelry. This lets others know that you have adrenal insufficiency.

  • Have a shot of emergency medicine with you at all times. Know when and how to give yourself the shot. Have instructions written out. Teach someone else how to give you the shot in case you can't give it to yourself.

  • Keep track of your blood pressure. Let your doctor know if it's high or too low. Also let your doctor know if you have swelling or you feel lightheaded. You may need to adjust your dose of medicine.

  • Work with your doctor to create a plan for what to do when you're sick or when your body is under stress. You may need to change your dose of medicine during this time.

  • Weigh yourself regularly, especially if you haven't felt like eating or you have been vomiting. Weigh yourself at the same time each day and wear the same clothes each time you weigh yourself. Let your doctor know if you're losing weight or vomiting often.

When should you call for help?

../images/Call-for-help_icn.jpgCall 911 anytime you think you may need emergency care. For example, call if:

 

  • You passed out (lost consciousness).

 

  • You have symptoms of an adrenal crisis. These may include:

    • Severe vomiting and diarrhea.

    • Feeling extremely weak or like you're going to faint.

    • Sudden pain in your belly, lower back, and legs.

    • Strange behavior, such as feeling confused or fearful.

    • A high fever.

    • A pale face, and blue lips and earlobes.

Call your doctor now or seek immediate medical care if:

 

  • You have trouble taking medicines by mouth.

 

  • You have a fever.

Watch closely for changes in your health, and be sure to contact your doctor if:

 

  • You do not get better as expected.

Current as of: October 2, 2023

Content Version: 14.0

Care instructions adapted under license by your healthcare professional. If you have questions about a medical condition or this instruction, always ask your healthcare professional. Healthwise, Incorporated disclaims any warranty or liability for your use of this information.

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