Acute adrenal crisis is a potentially fatal health condition caused by an insufficient amount of cortisol running around your body. Cortisol is a highly essential hormone that is naturally produced by your adrenal glands or supplemented because of some cause for its deficiency.
But for removal or a birth defect, most have two adrenal glands on top of each kidneys. Under healthy conditions they produce an adequate amount of cortisol.
Cortisol affects many systems in your body and a couple of its key roles encompass:
The production of cortisol is regulated by your pituitary gland.
Because of a health issue, typically involving your adrenal or pituitary gland, you may not secrete enough cortisol. When this endocrine deficiency occurs, a cortisol replacement drug is taken to make up for your shortage.
Acute adrenal crisis develops when your body’s demand for cortisol far outweighs its availability. A couple of the classic symptoms indicating you may be entering the state of substantial cortisol deficiency are suddenly severe abdominal pain, vomiting and weakness.
Some other symptoms of your adrenal crisis might include:
- high fever
- salt craving
- appetite loss
- shaking chills
- body hair loss
- chronic fatigue
- severe diarrhea
- sluggish movement
- electrolyte imbalance
- skin rash, skin lesions
- orthostatic hypotension
- unintentional weight loss
- dizziness, light-headedness
- hyperthermia, cold intolerance
- excessive sweating ~ face, palms
- hypoglycemia caused by insulin sensitivity
- sudden, severe flank pain, lower back pain, leg pain
- hyperpigmentation ~ skin darkening even in areas not exposed to sun
You may suffer several of these symptoms well in advance of your actual crisis, especially if you’re not aware that you have some cause for adrenal deficiency.
Emergency treatment for severe abdominal pain, vomiting and weakness caused by adrenal crisis is an immediate injection of hydrocortisone. And you will likely receive intravenous fluids for low blood pressure. If a bacterial infection caused your crisis, then an antibiotic may be given as well.
With prompt treatment your outlook for recovery from severe pain in your abdomen, vomiting and weakness caused crisis is good.
Frequently the cause of adrenal crisis is steroid withdrawal and physiological stress with a pre-existing adrenal deficiency condition, like:
Some examples of health related stresses under which adrenal crisis may result are:
- severe pain
- severe burns
- septic shock
- myocardial infarction
- psychoses, depression
- complicated pregnancy
- dehydration ~ diabetes insipidus
- injury to adrenal or pituitary gland
- glandular infiltration by tuberculosis
- infection ~ H. influenza, staph, strep pneumonia, fungus
- stop treatment with prednisone or hydrocortisone too quickly
- starting thyroid hormone replacement for hypothyroidism with unrecognized adrenal deficiency
If you’re on medication for treating adrenal deficiency, increasing your glucocorticoid dosage during physical stress reduces your risk for an acute adrenal crisis episode. Or at a minimum, know how to give yourself an emergency injection of hydrocortisone.
Milder physical stresses may not require that you make a dose adjustment, such as:
- low fever
- sore throat
- otitis media
- everyday viral infection
- minor upper respiratory tract infection
Hydrocortisone is similar to natural cortisol hormone and is usually the drug of choice for deficient cortisol secretion causing severe abdominal pain, vomiting and weakness. However, drugs such as prednisone and dexamethasone may be used because they last longer. But they’re more difficult to adjust for a precise healthy dosage.