What is adrenal gland?

The adrenal glands sit at the top of the kidneys, one on each side of the body, and have an inner core (known as the medulla) surrounded by an outer shell (known as the cortex). The inner medulla produces adrenaline, the “fight or flight” stress hormone. While the absence of the adrenal medulla does not cause disease, the cortex is more critical. It produces the steroid hormones that are essential for life: cortisol and aldosterone.

Cortisol mobilises nutrients, enables the body to fight inflammation, stimulates the liver to produce blood sugar and also helps control the amount of water in the body. Aldosterone regulates salt and water levels which affect blood volume and blood pressure. The adrenal cortex also produces sex hormones known as adrenal androgens; the most important of these is a hormone called DHEA (dehydroepiandrosterone).

What is Adrenal insufficiency or Crisis?

Adrenal insufficiency or crisis is a life-threatening condition that happens when your adrenal glands don’t produce enough cortisol and aldosterone hormones. These hormones help your body respond to stress, regulate blood pressure, and maintain energy levels.


What are the Symptoms?

– Severe fatigue or weakness

– Nausea and vomiting

– Abdominal pain

– Low blood pressure

– Dizziness or fainting

– Confusion or loss of consciousness

What Causes Adrenal Crisis?

– Not taking medication as prescribed

– Infection or illness

– Injury or trauma

– Surgery or anaesthesia

– Stopping steroid medication suddenly

How to Prevent Adrenal Crisis

– Take your medication exactly as prescribed

– Carry a steroid emergency card or wear a medical alert bracelet

– Always keep an emergency injection kit with you if you are adrenal insufficient.

– Inform your doctor about any changes in your medication or health

– Get regular check-ups and blood tests

– Avoid stopping steroid medication suddenly

What to Do in Case of Adrenal Crisis?

– Call emergency services or go to the hospital immediately

– Administer an emergency injection of hydrocortisone (if trained)

– Lie down and elevate your feet

– Stay calm and stay hydrated

Remember, adrenal crisis is a medical emergency. Don’t hesitate to seek help if you experience any symptoms!

Please note that this is a simplified version and you should consult a healthcare professional for more detailed information and personalized advice.

Contributed by: Dr Tauseef Ahmad

Consultant Endocrinologist, Ziauddin Medical University, Karachi,

Executive member, Pakistan Endocrine Society