Adrenal insufficiency, including Addison’s disease (primary adrenal insufficiency) is rare but is associated with some tricky symptoms, especially in the early stages. Adrenal insufficiency is a disorder that happens when the adrenal glands don’t work properly. We each have two adrenal glands, sitting atop the kidneys. They are responsible for producing the hormones cortisol and aldosterone, both of which are essential for various bodily processes. Here we look at adrenal insufficiency symptoms and how to manage these.

What are the adrenal insufficiency symptoms?

There are different typess of adrenal insufficiency, with Addison’s disease being the most common. When Addison’s disease first appears, it can unfortunately mimic the symptoms of two common ailments: depression and cold viruses/influenza. It’s more common in women aged 30-50.

Early symptoms of adrenal insufficiency include:

• Fatigue, lethargy and lack of energy – this is chronic and long-lasting, and doesn’t ease with more sleep
• Muscle weakness
• Depression or low mood
• Reduced appetite
• Unintentional weight loss
• Stomach pains or cramps
• Thirst
• Adrenal insufficiency symptoms worsen over time. Later adrenal insufficiency symptoms include:
• Dizziness and lightheadedness; you may faint
• Muscle cramps
• Worsened lack of energy and exhaustion
• Dark spots on your skin, usually most evident on existing scars or areas like the elbows, knees and knuckles.
• Dark lips, inner cheek or gums as well as other mucous membranes.

Other symptoms that some people with adrenal insufficiency experience include:

• Gastric upset including nausea (feeling sick), vomiting and diarrhea.
• Low blood pressure that significantly falls further when you go
  from sitting to standing (you may feel as though you may faint, or
  actually faint, as you stand up).
• Mood changes including irritability and significant depression.
• A craving for certain foods, particularly salty foods, despite increased thirst.
• Pain in your joints and muscles.
• Diabetes symptoms including low blood glucose levels (hypoglycemia).

Even though some of these symptoms may mirror other common conditions, if you are concerned about adrenal insufficiency, or feel unusually unwell for a period of time, you should visit your doctor. They can eliminate adrenal insufficiency, or begin treatment to manage your symptoms and help you feel better.

Furthermore, adrenal insufficiency symptoms aren’t acute. This means they don’t come on suddenly, but rather develop gradually over time. This can make them difficult to spot as defined symptoms. You might easily put them down to lifestyle exhaustion, menopause or feeling unwell for other reasons. This is particularly true because adrenal insufficiency is most common in women of child-bearing age with busy family lives. However, despite your lifestyle, it is not normal to feel continually tired and weak. If you experience this, it’s always worth having a review with your doctor to rule out causes like adrenal insufficiency.

How are adrenal insufficiency symptoms treated?

When it comes to treating adrenal insufficiency and its symptoms, it depends on the cause.

Addison’s disease is the most common cause of adrenal insufficiency and is known as the primary type of adrenal insufficiency. This is an autoimmune condition which results in damage to the adrenal glands. Unfortunately, your immune system attacks the adrenal glands. In this case, you will likely be treated with hydrocortisone tablets. These replace some of the missing cortisol you experience. This, in itself, should improve your symptoms.

There are other rarer causes of adrenal insufficiency. These include Tuberculosis and HIV. Both of these causes of adrenal insufficiency are very rare in developed countries. Other rare causes of adrenal insufficiency include surgical removal of the adrenal glands (they are sometimes removed if you have a kidney removed), cancer, genetic disorders, adrenal bleeding and some uncommon medicines.

Secondary and tertiary insufficiency

Most people who experience adrenal insufficiency have primary adrenal insufficiency (Addison’s disease). However, adrenal insufficiency, and its symptoms, can occur as a secondary or tertiary condition. This cascade of issues can sometimes make it harder to spot.

Adrenal insufficiency symptoms can occur when there are problems with the pituitary gland. This is secondary insufficiency.

A common cause of adrenal insufficiency is suddenly stopping use of corticosteroids if you have been taking them for prolonged time. This is the most common tertiary form of adrenal insufficiency. This is why doctors always recommend slowly stopping the use of these medications. If you experience adrenal insufficiency symptoms due to this, your doctor will usually suggest going back on the corticosteroids at a lower dose and tapering off them more slowly. It may take many months to fully stop taking corticosteroids.

Another type of tertiary adrenal insufficiency occurs when Cushing’s syndrome has been successfully treated. This is not usually permanent but it may take some time for your adrenal gland to become adequately functional again.

How to manage adrenal insufficiency symptoms

Once you have been diagnosed with adrenal insufficiency, your doctor will usually prescribe hydrocortisone tablets. It can take some time to perfect the dose and your symptoms may take some time to subside.

You can manage your adrenal insufficiency symptoms in the meantime in various ways, depending on the symptoms you experience. For example, if you are suffering from fatigue, try to rest as much as possible and reduce pressures in your life. If you experience gastric symptoms, ask your doctor if they recommend an anti-emetic or stomach settling medication.

Also, bear in mind that treatment for adrenal insufficiency, using hydrocortisone tablets, can cause some of the same symptoms. You should follow your doctor’s advice for management, treatment and symptom relief.

If you have been prescribed hydrocortisone tablets for adrenal insufficiency, you can buy hydrocortisone tablets at the International Pharmacy, and we dispatch internationally.

International Pharmacy articles are written for generic information only and do not constitute medical advice. If you are concerned that you are experiencing adrenal insufficiency symptoms, please consult with your GP.