Preventing an adrenal crisis

We all understand the importance of knowing what to do in an adrenal crisis, how and when to inject, when to seek medical support, etc.
But equally important is crisis prevention.

An adrenal crisis can be brought on by a sudden traumatic event or it can be a culmination of factors that result in a crisis.

Patient self-management is a vital tool to avoid “stacking” stressors one on top of another leading to a crisis.
Learning self-care can be confusing, especially for new patients, so we’ve put together some tips to help you design your own program based on your specific needs.

1. Recognize low cortisol symptoms.
You may experience some or all of these symptoms. Keeping a daily journal to track dosage, time, blood pressure and symptoms is helpful.
– Headache
– Body ache
– Nausea
– Fatigue
– Sweats and or chills
– Racing heart
– High or low blood pressure
– Dizziness on standing
– Depression/weepiness
– Confusion
– Anxiety

2. Listen to your body. Everyone is different.
Only you can recognize the pattern of progression from early symptoms to crisis. Journaling helps you see the pattern so you can take more cortisol before it gets worse. Discuss your individual needs with your doctor and create a plan to prevent low cortisol from reaching the crisis point. This 2013 study from the National Institutes of Health recognizes the need for more education on this subject and may be a useful starting point for discussions with your medical provider.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3805018/

3. Create emotional rest periods for yourself.
Stress is the third leading cause of adrenal crisis. While we can’t control everyday stress in our lives, we can control how we cope with it. Planning regular emotional rest periods helps. These can be anything you enjoy that gives you a “time out” Talking with a friend, sitting in the park, soaking in the tub, reading a book, watching a movie, and meditating are all good tools to incorporate into your daily routine. It’s ok to put yourself first and let those around you know this is an important part of managing your illness.
This link gives tips on how to calm your mind:
http://www.mindful.org/how-to-settle-the-mind/
This link is for the study on causes of adrenal crisis: http://press.endocrine.org/doi/10.1210/jc.2014-3191

4. Pace yourself physically.
Physical activity uses up cortisol. Only you know your limits. It takes time to learn when to stop moving and rest, but it can be one of the most important tools in your arsenal when it comes to preventing a crisis. Updosing to keep going will only work for so long and a crisis can come on suddenly when you unintentionally “stack” one stressor on another.

5. Address your body’s needs for good nutrition. Stay hydrated.
Know your individual electrolyte needs and supplement appropriately
Eat frequent small meals to maintain blood sugar.

6. Have a crisis plan in place for emergencies.
This link is for our crisis page at Adrenal Insufficiency United. It has links for emergency letters and many other resources.

We hope this information will help patients understand the various factors that may contribute to an adrenal crisis. We can’t control everything, but with good self-management hopefully we can reduce the number of crisis and improve the quality of our lives.