Causes

The most common causes for developing a crisis in people already diagnosed with and treated for adrenal insufficiency are:

• infections, particularly gastroenteritis (“stomach flu” with diarrhoea and vomiting), pneumonia / lower respiratory tract infections and urinary tract infections
• surgery
• strenuous exercise
• emotional stress
• dehydration
• accidents

NOTE: The development of an adrenal crisis usually takes several hours but can occur much more quickly or take even days to develop.

Symptoms

The most common symptoms are:

• Severe drop in blood pressure causing dizziness, lightheadedness and possibly loss of consciousness
• Nausea and vomiting
• Confusion and lethargy
• Muscle weakness, joint pains, cramps, headaches

Note: This list is not complete and symptoms can differ from patient to patient. They are usually an exacerbation of the symptoms you experienced before being diagnosed.

Do not wait “to get better”!

1. Follow the stress dosing guidelines

>> Guidelines for Stress Dosing & Sick Day Management

2. If your condition rapidly declines (for instance if you cannot keep down your tablets due to vomiting), do not wait – immediately give yourself an emergency injection.

>> Video demonstration
>> Simplified illustrated injection guide (if you are alone, unwell or shaky)
>> Detailed illustrated guide: How to Give an Emergency Injection

If unsure whether or not to inject, it is better to err on the side of caution rather than risk adrenal crisis. One injection won’t harm you and may well save your life.

3. Call an ambulance or present to nearest emergency department.