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Adrenal insufficiency is a disorder in which the adrenal glands do not produce sufficient amounts of essential hormones, particularly cortisol and sometimes aldosterone. Cortisol helps regulate blood pressure, blood glucose, metabolism, and the body’s response to stress, while aldosterone helps maintain fluid and electrolyte balance.

The condition may be primary, known as Addison’s disease, when the adrenal glands themselves are damaged. It can also be secondary or tertiary when reduced stimulation from the pituitary gland or hypothalamus limits hormone production. Common causes include autoimmune disease, prolonged corticosteroid use followed by sudden withdrawal, infections, adrenal disorders, and certain pituitary conditions.

Symptoms often develop gradually and may include persistent tiredness, muscle weakness, reduced appetite, weight loss, nausea, abdominal discomfort, dizziness, and low blood pressure. People with primary adrenal insufficiency may also develop increased skin pigmentation and salt cravings. Symptoms can become severe during illness, injury, or other physical stress.

Diagnosis generally involves blood tests measuring cortisol and adrenocorticotropic hormone, along with an ACTH stimulation test when appropriate. Treatment usually requires hormone replacement with prescribed corticosteroids. Some individuals also need mineralocorticoid replacement.

A potentially life-threatening adrenal crisis can cause severe weakness, vomiting, dehydration, low blood pressure, confusion, and shock. Prompt emergency treatment with intravenous fluids and corticosteroids is essential. Lifelong monitoring and appropriate dose adjustments help prevent complications.