What is Adrenal Failure?

M. DePietro

The adrenal glands produce hormones including cortical, aldosterone, and epinephrine, which regulate body functions such as blood pressure and heart rate. When not enough hormones are produced, the condition is known as adrenal failure. Adrenal failure affects both men and women equally.

An adrenal gland on top of a kidney.
An adrenal gland on top of a kidney.

When symptoms develop quickly, it is known as acute adrenal failure or acute adrenal crisis. Acute adrenal failure is considered a medical emergency and needs immediate treatment. Acute adrenal failure may be caused by injury or trauma to the adrenal gland, infection, or by stopping medication required to treat adrenal disease.

CT scans can determine if the adrenal gland has changed, which may indicate damage.
CT scans can determine if the adrenal gland has changed, which may indicate damage.

Adrenal gland failure symptoms may include dehydration, fatigue, fever, abdominal pain, and confusion. Because the condition can be life threatening, treatment is needed immediately. Treatment usually includes an injection of hydrocortisone. Other treatments may include fluids to treat dehydration and prevent shock, which can develop. If an infection is the cause of acute adrenal failure, antibiotics may be given.

A variety of medical tests may be performed to confirm a diagnosis of adrenal gland failure. An ACTH test may be done to determine the level of cortisol in the blood. An insulin-induced hypoglycemia test may also be recommended. A CT scan of the abdomen may be performed to determine if there is a change in the size of the adrenal gland, which may mean it is damaged.

Before complete adrenal gland failure occurs, a condition known as renal insufficiency may develop. This occurs when the gland is still producing some hormones, but not enough for the body to function as it should. This condition often develops gradually and can be permanent or temporary, depending on the cause. One of the main causes of renal insufficiency is Addison’s disease. Symptoms may include nausea, muscle weakness, and loss of appetite.

If proper treatment is not given during renal insufficiency, or if treatment is stopped, renal failure can develop. The goal of treatment is to replace the hormones that are not being produced adequately. Cortisol is prescribed for renal insufficiency and needs to be taken orally in tablet form every day. Another hormone, aldosterone, which regulates fluids and salt in the body, can be replaced with a medication called fludrocortisone acetate, and is also taken daily. Most people can be treated successfully, and adrenal failure can be prevented.

Because medication is available, and adrenal insufficiency can often be treated, acute adrenal failure can often be prevented. People with conditions such as Addison’s disease should be diligent about take prescribed medication to treat their condition. In addition, they should know when and how to give themselves an injection of hydrocortisone, in the event of an emergency, such as acute renal crisis.

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