What is adrenal crisis?
Adrenal crisis is a serious medical problem that can cause you to pass out and can even lead to death. It happens when your adrenal glands are not working right. The adrenal glands are a pair of organs that are located on top of the kidneys. These glands make a lot of different hormones, including 2 hormones that are very important for normal body function:
- Cortisol: This hormone helps control how the body uses sugar and how it responds to stress.
- Aldosterone: This hormone helps control the amount of salt and fluid in the body.
Adrenal crisis happens when the adrenal glands do not release enough cortisol, or cortisol and aldosterone. If you do not have enough of these hormones, your body can go into shock. This is when your blood pressure drops to a dangerously low level. An adrenal crisis is a medical emergency.
What are the symptoms of an adrenal crisis?
Adrenal crises usually come on suddenly. The symptoms can include:
- Vomiting
- Belly pain
- Weakness
- Fever
- Confusion
- Feeling dizzy or passing out
What causes an adrenal crisis?
Adrenal crises usually happen in people who already have a medical condition that affects the adrenal glands. For example, it can happen in people who have Addison’s disease (also called “adrenal insufficiency”) or congenital adrenal hyperplasia (also called “CAH”).
People who have these adrenal problems must take hormones to replace the hormones they don’t have enough of. But if they get sick, get into an accident, or have surgery, the hormones they normally take are not always enough. That’s why people with adrenal problems sometimes have to take extra medicine when they are sick or when they know they are going to have surgery.
Adrenal crises can also happen in people who take medicines called steroids at high doses for a long time and suddenly stop taking them. Plus, it can happen in people who have bleeding in their adrenal glands because of an infection, a severe injury, or because they are taking blood thinners.
Should I see a doctor?
Yes, if you have symptoms of an adrenal crisis, call for an ambulance. This is especially important if you already know that you have a medical condition that affects your adrenal glands (such as Addison’s disease).
Will I need tests?
Yes. If your doctor or nurse suspects you have an adrenal crisis, they will order blood tests to check your blood sugar and hormone levels.
How is adrenal crisis treated?
Treatment is done at the hospital and involves getting two things through a thin tube that goes into a vein (called an IV):
- Fluids with salt and sugar to replace what has been lost
- Hormone medicines to replace the hormones that are missing
Once doctors have treated the crisis, they will try to find out what caused it in the first place. For example, they will check for infection or for signs of adrenal gland problems.
Can an adrenal crisis be prevented?
Yes. If you have a medical condition that keeps your adrenal glands from making enough hormones, your doctor will give you hormone medicines to replace what is missing. These medicines can reduce the chances that you will have an adrenal crisis again.
People usually need to take these medicines every day for the rest of their lives. Your doctor or nurse will tell you how to take them and what your dose should be. They will also explain how to change your dose when needed. For example, if you get sick with a cold or another minor illness, you can usually increase your dose for 3 days. It is important to let your doctor or nurse know if you have any side effects, develop any new symptoms, or have a cold or other illness that gets worse while you are taking a higher dose.
Your doctor might also prescribe emergency medicine that you should keep with you at all times in case you have an adrenal crisis again. This medicine comes in the form of a shot. If you think you are having an adrenal crisis, use this medicine and then call for an ambulance.
Your doctor might recommend that you also use this emergency medicine if you:
- Get very sick with a high fever.
- Have a major injury, for example, if you break a bone or lose a lot of blood.
- Pass out
- Vomit up your daily medicine.
If you have a condition that can cause an adrenal crisis, it’s a good idea to wear a medical alert bracelet and carry an emergency medical card. This way, other people will know about your condition in case of an emergency.
