Adrenal Crisis

Overview

Cortisol helps the body cope with stress, illness and injury. In adrenal crisis, levels fall dangerously low, causing very low blood pressure and shock. It needs immediate treatment.

Symptoms

• Severe weakness and confusion
• Severe pain in the abdomen, lower back or legs
• Vomiting and diarrhoea
• Very low blood pressure, dizziness or fainting
• Fever

Causes and risk factors

It usually occurs in people with adrenal insufficiency (Addison's disease) or pituitary problems during an illness, injury or surgery, or when long-term steroid tablets are stopped suddenly.

Diagnosis

Blood tests show low cortisol and abnormal sodium and potassium levels. Treatment should not be delayed while waiting for results.

Treatment

Emergency treatment is a hydrocortisone injection and fluids through a drip. People at risk should carry a steroid card and an emergency injection kit and learn sick-day rules for increasing their steroid dose.

When to see a doctor

Call for emergency help immediately if someone with adrenal insufficiency or on long-term steroids becomes very weak, confused, faint or starts vomiting.