• body produces insufficient amounts of certain hormones produced by your adrenal glands
  • Also called adrenal insufficiency



  • fatigue (lack of energy or motivation)
  • lethargy (abnormal drowsiness or tiredness)
  • muscle weakness
  • low mood (mild depression) or irritability
  • loss of appetite and unintentional weight loss
  • the need to urinate frequently
  • increased thirst
  • craving for salty foods
  • Weight loss and decreased appetite
  • Darkening of your skin (hyperpigmentation)
  • Low blood pressure, even fainting
  • Irritability
  • Depression
  • Body hair loss or sexual dysfunction



  • causes of primary adrenal insufficiency include:
    • Prolonged administration of glucocorticoids (e.g. prednisone)
    • tuberculosis
    • Cancer and abnormal growths (tumors)
    • Certain blood thinners used to control clotting in the blood
  • Secondary adrenal insufficiency occurs when:
    • pituitary gland can’t produce adrenocorticotropic hormone (ACTH)
  • immune system problems
  • genetics
  • surgical removal of both adrenal glands (adrenalectomy)
  • haemorrhage
  • adrenoleukodystrophy (ALD)


Risk factors

  • have cancer
  • take coagulants (blood thinners)
  • have chronic infections like tuberculosis
  • had surgery to remove any part of your adrenal gland
  • have an autoimmune disease, like type 1 diabetes or Graves’ disease


Diagnostic Tests

  • blood to be tested for the following:
  • a low level of the hormone aldosterone
  • a high level of adrenocorticotrophic hormone (ACTH)
  • a low level of glucose (sugar used for energy)
  • positive adrenal antibodies (antibodies designed to attack the adrenal gland)
  • synacthen stimulation test, Insulin-induced hypoglycemia test
  • thyroid function test
  • scans
  • Insulin-induced hypoglycemia test



  • Oral corticosteroids
  • Corticosteroid injections
  • intravenous injections



  • Hydrocortisone
  • Saline solution
  • Sugar (dextrose)


Lifestyle Management

  • Carry a medical alert card and bracelet at all times.
  • Keep extra medication handy
  • remember to collect your repeat prescriptions