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Secondary Adrenal Insufficiency


Secondary adrenal insufficiency (SAI)

is a condition that develops when your adrenal glands do not make enough adrenal hormones. The adrenal glands are controlled by the pituitary gland in the brain. SAI develops when the pituitary gland does not make enough of a chemical called ACTH to control adrenal hormone production. Adrenal hormones such as cortisol help your body handle stress, keep blood pressure normal, and balance salt and fluids. They also control how your body uses sugars, fats, and proteins. Any procedure, condition, or disease that involves your pituitary gland may cause SAI. An adrenal crisis may happen if your adrenal hormone level becomes too low. This condition is life-threatening and needs immediate treatment.

Seek care immediately if:

  • You always feel dizzy when you stand.
  • You have severe pain in your stomach, waist, or back.
  • You have very dry skin, a dry mouth and tongue, or feel very thirsty.
  • Your symptoms become worse, even after you take your medicines.

Call your doctor if:

  • You have a fever.
  • You have nausea, diarrhea, or abdominal pain, or you are vomiting.
  • You sweat or urinate more than usual.
  • You stopped taking your medicine.
  • You have questions or concerns about your condition or care.

Signs and symptoms

may develop slowly over months or years:

  • Dizziness, weakness, and tiredness
  • Nausea, vomiting, decreased appetite, and weight loss
  • Depression or trouble thinking clearly
  • Muscle, joint, and back pain
  • Loss of hair or white patches of skin
  • Darkening of certain skin areas such as sun-exposed areas, nipples, genital area, and the inside of your mouth
  • Desire for certain foods, such as licorice and salty foods


Steroid medicine is given to balance the level of steroid hormones your adrenals naturally make. You may need to take this medicine for the rest of your life. You may need to change the amount you take when you are ill or have increased stress. Your healthcare provider will order medicine that can be given as a shot if you have an adrenal crisis. Ask your healthcare provider to show you and a friend or family member how to do this. Do not stop taking this medicine before you talk to your healthcare provider. You can trigger an adrenal crisis if you stop taking steroids suddenly.

What you need to know about an adrenal crisis:

An adrenal crisis happens when your cortisol and aldosterone levels suddenly drop. This may lead to low blood pressure, dehydration, and low blood sugar. An adrenal crisis is life-threatening and needs immediate treatment in a hospital. You will be given steroids and glucose (sugar). You may be given sodium (salt) and medicine to increase your blood pressure. You may also need IV fluids to treat dehydration. An adrenal crisis can happen if you suddenly stop taking your medicine. It can also happen when your body is under more stress than usual. This may happen during surgery, an illness, or trauma.

Medical alert identification:

Wear medical alert jewelry or carry a card that says you have adrenal disease. You may get one from your local drugstore or ask your healthcare provider where to get this.

Medical Alert Jewelry

Follow up with your doctor or endocrinologist as directed:

You may need to have blood tests and your bone density checked often. Your endocrinologist may have you check your blood pressure and blood sugar level on a regular basis. He will tell you when and how often to do this. Write down your questions so you remember to ask them during your visits.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Learn more about Secondary Adrenal Insufficiency (Ambulatory Care)

Associated drugs

IBM Watson Micromedex

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.