Skip to Content

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. An adrenal crisis may happen if your adrenal hormone level becomes too low. This condition is life-threatening and needs immediate treatment.


Informed consent

is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.


is a small tube placed in your vein that is used to give you medicine or liquids.

Intravenous therapy:

This is a special liquid given to replace the fluid that your body has lost. It will help keep the fluid and salt balance in your body normal.


  • Steroid medicine: Steroids are 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 how much medicine you take when you are ill or have increased stress. You will need to keep extra medicine with you in case you have an adrenal crisis. 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 without talking to your healthcare provider. You can trigger an adrenal crisis if you stop taking steroids suddenly.


  • Blood tests: You may need blood taken for tests. These tests tell your healthcare provider how high or low the hormone levels are in your blood. Other blood tests may be done to give your healthcare providers more information about your health. The blood can be taken from a blood vessel in your hand, arm, or the bend in your elbow. You may need to have blood drawn more than once.
  • Chemical stimulation tests: Your blood will be tested first and then you will be given a shot of special chemicals. The chemicals will cause your pituitary or adrenal glands to make hormones. After several minutes, your hormone levels in your blood are tested again. Ask your healthcare provider for more information about this test.
  • Imaging tests: These tests may be done to see why you have SAI. They can show cancers, infection, or any abnormal bleeding. Certain tests use a special dye to help pictures show up better. People who are allergic to iodine or shellfish (lobster, crab, or shrimp) may be allergic to some dyes. Tell your healthcare provider if you are allergic to shellfish, or have other allergies or medical conditions.
    • Computed tomography scan: This is also called a CT scan. A special x-ray machine uses a computer to take pictures of your brain. It may also be used to look at tissues, bones, muscles, and blood vessels. Before taking the pictures, you may be given dye through an intravenous (IV) tube in your vein.
    • Magnetic resonance imaging: This test is also called a MRI. During the MRI, pictures of your brain and adrenal glands may be taken. You will need to lie still during the test. Never enter the MRI room with an oxygen tank, watch, or any other metal objects. This can cause serious injury.
  • Urine test: This may include measuring the amount of hormones in your urine.

Vital signs:

Healthcare providers will check your blood pressure, heart rate, breathing rate, and temperature. They will also ask about your pain. Vital signs give information about your current health.


You may be weighed each day. Healthcare providers compare your weight from day to day to record how much body fluid you have. You can become dehydrated if you lose too much. You can have shortness of breath or swelling in your legs if you retain too much.


  • You may have an allergic reaction to the medicines used to treat your SAI. The medicines may cause you to gain weight or bruise easily. They may cause you to have a fast heartbeat and muscle weakness. Treatment can make your bones brittle and break more easily.
  • You may become weak, tired, and confused if you do not take your medicine. SAI that is not treated can lead to a life-threatening condition called adrenal crisis. Adrenal crisis can make you lose too much fluid, drop your blood pressure, and put you into a coma.


You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your healthcare providers to decide what care you want to receive. You always have the right to refuse treatment.

Ā© Copyright IBM Corporation 2018 Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotesĀ® are the copyrighted property of A.D.A.M., Inc. or IBM Watson Health

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.

Further information

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

Learn more about Secondary Adrenal Insufficiency (Inpatient Care)

Associated drugs

IBM Watson Micromedex