7 Surprising Facts About Adrenal Insufficiency

Medically Reviewed By William C. Lloyd III, MD, FACS
Written By Elizabeth Hanes, RN on April 28, 2020
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    Adrenal Insufficiency Facts and Myths
    The adrenal glands produce hormones, including cortisol, that play a vital role in the body’s ability to regulate blood pressure and respond to stress. In some people, however, the adrenal glands don’t produce enough hormones – a condition called adrenal insufficiency (AI). Adrenal insufficiency can be caused by many things, but “adrenal fatigue” isn’t one of them. Learn the adrenal insufficiency facts you need to know, including the three types of adrenal insufficiency, AI symptoms, and when to consult a doctor to evaluate your adrenal gland health.
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    1. There are three types of adrenal insufficiency.
    Of the three types of adrenal insufficiency, the most commonly known is Addison’s disease—medically called “primary adrenal insufficiency” or “primary AI.” Addison’s disease is usually caused by an autoimmune malfunction. Another type of AI, secondary adrenal insufficiency is actually more common than Addison’s disease and is caused by a problem with the pituitary gland in the brain. A third type of AI, tertiary adrenal insufficiency, results from an issue in the feedback loop between the pituitary gland and the adrenals.
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    2. All types of adrenal insufficiency are rare.
    The incidence of primary AI (Addison’s disease) is estimated at just six new cases per million people per year. Primary AI appears to affect slightly more women than men and usually is diagnosed between the ages of 30 and 50. Secondary AI also affects more women than men and often is diagnosed when a woman is in her 60s. Approximately 300 new cases of secondary AI per one million population occur each year. Tertiary AI mainly affects people treated with long-term glucocorticoids (steroids) and is very rare.
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    3. Adrenal insufficiency isn’t always caused by a problem with the adrenal glands.
    Only primary AI results from a problem with the adrenal glands themselves. The most common cause of primary AI is destruction of the outer tissue of the adrenal glands by the body’s immune system. Secondary and tertiary AI, however, are caused by issues with the pituitary gland in the brain, which is responsible for signaling the adrenal glands to produce hormones. Cancer, damage of the pituitary gland due to traumatic brain injury, and other things can disrupt the pituitary’s communication with the adrenal glands and cause adrenal insufficiency.
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    4. The adrenal glands do not get “fatigued.”
    Adrenal insufficiency is not caused by “adrenal fatigue.” Adrenal fatigue is not a true medical diagnosis. The adrenal glands do not become worn out or fatigued due to stress or other conditions. Adrenal insufficiency is only caused by conditions that directly damage adrenal gland tissues or disrupt communication between the pituitary gland and the adrenals. Cancer, skull fractures, traumatic brain injuries, and many other conditions can negatively affect the delicate signaling systems required to make the adrenal glands produce adequate hormone levels, but the adrenal glands do not simply “wear out” due to overwork.
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    5. The symptoms of adrenal insufficiency can be vague.
    Adrenal insufficiency rarely comes on suddenly—though it can, in an event called an “adrenal crisis.” More commonly, AI symptoms occur gradually and may seem vague. See a doctor for any combination of these symptoms:

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    6. Adrenal crisis is a medical emergency.
    People being treated for adrenal insufficiency need to know the signs of an adrenal crisis. This event can occur during periods of acute stress, when the supplementary hormones you take to treat AI are insufficient to support the body’s needs. Call 911 for an adrenal crisis with symptoms that include:

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    7. Hormone replacement is the primary treatment for adrenal insufficiency.
    If you are diagnosed with primary or secondary AI, your doctor will develop a personalized treatment plan that likely includes taking supplemental hormones (glucocorticoids and/or mineralocorticoids) for the rest of your life. These oral therapies will maintain your corticoids and other hormones at the appropriate levels. You may need to increase your dosage at times of acute stress, such as illness or surgery, and your doctor will advise you on how to do that.
7 Surprising Facts About Adrenal Insufficiency

About The Author

As “the nurse who knows content,” Elizabeth Hanes, RN, works with national and regional healthcare systems, brands, agencies and publishers to produce all types of consumer-facing content. Formerly a perioperative and cosmetic surgery nurse, Elizabeth today uses her nursing knowledge to inform her writing on a wide variety of medical, health and wellness topics.
  1. Addison Disease. U.S. Library of Medicine, MedlinePlus. https://medlineplus.gov/addisondisease.html
  2. Adrenal Insufficiency (for Parents). Nemours Foundation. https://kidshealth.org/en/parents/adrenal-insufficiency.html
  3. Adrenal Insufficiency. Hormone Health Network, Endocrine Society. https://www.hormone.org/diseases-and-conditions/adrenal-insufficiency
  4. Addison’s Disease. American Academy of Family Physicians. https://familydoctor.org/condition/addisons-disease
  5. Adrenal Insufficiency. National Adrenal Diseases Foundation. http://www.nadf.us/tools/Braithwaite/Chrousos_2014_Lancet_Adrenal_Insufficiency.pdf
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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2020 Apr 10
THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.