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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. 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 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.


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.


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.

Steroid medicine

balances 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 are used to measure hormone levels and to check for health problems SAI may be causing.
  • Urine tests are used to check the amount of adrenal hormones in your urine.
  • Chemical stimulation tests are used to check for an increase in hormone levels. Your blood is tested 2 times. First it is tested to measure the hormone levels. Then you are given a shot of chemicals to cause your pituitary and adrenal glands to make hormones. Your blood is tested a second time to see if the hormone levels increased.
  • CT scan or MRI pictures of your brain and adrenal glands may be used to see why you have SAI. They can show cancers, infection, or any abnormal bleeding. You may be given contrast liquid to help your brain and adrenal glands show up better in the pictures. Tell the healthcare provider if you have ever had an allergic reaction to contrast liquid. Do not enter the MRI room with anything metal. Metal can cause serious injury. Tell the provider if you have any metal in or on your body.


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 cause 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.

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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 (Inpatient Care)

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Further information

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