Oh, have you ever felt unimaginably tired, with a stomachache, and a feeling of helplessness? Maybe some parts of your body look a little dark? These are not really simple things, they could be symptoms of an emergency called an adrenal crisis . Let's talk about this in a little more detail today, because this can also affect life.
Why is this called an adrenal crisis? What happens in this?
Simply put, an adrenal crisis is a serious condition that occurs when your adrenal glands are not producing enough of the hormone cortisol . This is actually the most severe form of adrenal insufficiency , a condition similar to Addison's disease . If you suspect you have this condition, it's best to see a doctor right away.
Now look, these adrenal glands are located above our kidneys. They are like two small triangles. These are the ones that produce many important hormones, including cortisol . Hormones are like chemical messengers that coordinate every function in our body. They travel through the blood and carry messages to all parts of our organs, skin, and muscles, saying, "Do this here, do this here, do this here at this time."
The hormone cortisol affects almost every organ and tissue in our body. Here are some of the main things it does:
- It controls how our body responds to stress.
- It helps control our metabolism.
- Reduces inflammation in the body.
- Regulates blood pressure.
- Controls blood sugar levels.
- It also helps regulate our sleep-wake cycle.
This is also called Addisonian crisis , or acute adrenal crisis .
Why is this adrenal crisis such an emergency?
This is very dangerous, because when an adrenal crisis occurs, our body may not get enough blood flow. We call this a shock . This shock condition can become severe very quickly and damage our internal organs. If not treated properly, about 20% of people who get this condition may die. Also, seizures and coma may occur. That is why this is called an emergency.
Who is most affected by this condition? How common is it?
Adrenal crisis can occur at any age, but it is most common in people between the ages of 30 and 50.
This is not uncommon. Studies show that about 42% of people with adrenal insufficiency will develop an adrenal crisis . In the United States, the incidence of adrenal insufficiency is about 1 in 100,000. Some studies suggest that about 25% of people who develop an adrenal crisis die. That's why it's important to be aware of this.
What are the symptoms of an adrenal crisis?
The main symptoms that appear in this condition are:
- Stomach ache, or pain in the lower abdomen.
- Feeling of constant, excessive fatigue.
- The food is tasteless.
- Darkening of some areas of the skin (hyperpigmentation) .
- Feeling weak in the body.
- Becoming thin for no reason.
In addition to this, there may be other warning signs:
- Dehydration.
- Diarrhea.
- Dizziness, lightheadedness, lightheadedness, fainting, or loss of consciousness (coma).
- Getting a fever.
- Headache.
- Joint pain.
- Low blood sugar levels (low blood glucose).
- Low blood pressure.
- Vomiting and nausea.
- Rapid breathing.
- Rapid heart rate.
If you have one or more of these symptoms, don't take it lightly.
What are the causes of an adrenal crisis?
This can be caused by a variety of stressors. Here are some of the main reasons:
- Not properly treating a condition called adrenal insufficiency, such as Addison's disease .
- Adrenal gland damage. That is, things like adrenal gland disease and surgery.
- Dehydration.
- A condition called hypopituitarism (decreased function of the pituitary gland).
- Infections. Imagine if you had a bad cold or other infection.
- Sudden discontinuation of glucocorticoid medications (such as prednisone ) after prolonged use.
- Severe mental or emotional stress. Imagine if you had a big problem, sadness, or serious pressure.
How is an adrenal crisis diagnosed?
It can be a little difficult to diagnose, as its symptoms are similar to those of other common illnesses. However, there are a few tests that can help doctors diagnose it accurately:
- Adrenocorticotropic hormone (ACTH) blood test
- Blood sugar tests (blood sugar tests)
- Cortisol test ( test that checks cortisol levels)
- pH blood test ( a test that measures the acidity of the blood)
- Potassium blood test ( a test that checks the level of potassium in the blood)
- Sodium blood test ( a test that checks the level of sodium in the blood)
These tests are what allow a doctor to tell you exactly whether you are having an adrenal crisis or not.
How is this treated?
If you suspect you are having an adrenal crisis , your doctor will start treating you right away . This usually involves giving you a hydrocortisone injection (either hydrocortisone phosphate or hydrocortisone sodium succinate ) and saline solution into a vein in your arm or hand using a small needle and tube. This is called an intravenous (IV) injection . The hydrocortisone injection works by replacing the cortisol hormone that your body has lost.
Important: Starting this treatment as soon as possible is the best way to save a life.
If, even if it's just a coincidence, your condition is caused by a bacterial infection, your doctor may give you antibiotics .
Also, other symptoms that occur with this adrenal crisis are treated. For example, if there is dehydration or an electrolyte imbalance (an imbalance of salts in the body), water, sports drinks, or coconut water can be given. If blood sugar is low (hypoglycemia) , foods containing carbohydrates can be given.
If you have never had an adrenal crisis before, your doctor will also do tests such as ACTH stimulation tests to find the cause.
Are there any side effects of the hydrocortisone injection?
Yes, like all medications, there are some minor side effects. However, compared to the severity of an adrenal crisis, these are generally tolerable. Some people may experience:
- Allergic reaction.
- Black or bloody stools.
- Fever.
- Sore throat.
- Cough.
- Mood swings.
- Pain in the hip area, back, ribs, arms, shoulders, or legs.
If something like this happens, you should tell the doctor .
Is this hydrocortisone injection suitable for pregnant women?
Yes, if you are pregnant and have an adrenal crisis , it is safe to get a hydrocortisone injection. This medicine, called hydrocortisone, does not cross the placenta to the baby.
Just think, if you don't get this treated, it's a risk to your life as well as the baby's. Therefore, it's important to get treatment as prescribed by the doctors.
How quickly will I recover after treatment?
It can take 24 hours or more for you to feel better after receiving treatment for an adrenal crisis . It takes a little patience.
How to prevent an adrenal crisis?
If you have adrenal insufficiency , it's important to be aware of the stressors that can trigger an adrenal crisis . Remember the things we talked about earlier, like stress, dehydration, infections, or not taking your prescribed glucocorticoid medication properly?
Surgery and pregnancy can also worsen adrenal insufficiency . Therefore, you should tell your doctor that you have this condition before having surgery. If you are planning to have a baby, talk to your doctor about that as well.
Another very important thing is to always carry a medical ID card, necklace, or bracelet with you that states your medical condition. It should clearly state what medication you need and what dosage you need. This information will help those treating you in an emergency to provide you with the right treatment at the right time.
Check your weight regularly and check your blood pressure. If you are losing weight or your blood pressure is too high or too low, tell your doctor .
Your doctor may give you a cortisol injection to take in an emergency. He or she will tell you when to take it and how to take it. Keep this medicine and instructions for use with you at all times. If you are too weak to take it in an emergency, teach a family member or close friend how to take it.
It's a good idea to make a plan with your doctor about what to do if you can't take hydrocortisone pills because of nausea or vomiting.
What happens if you have an adrenal crisis? What to expect?
If you suspect you are having an adrenal crisis , seek immediate medical attention. Taking too much glucocorticoids for a short period of time won't do much harm. However, if you don't get treatment quickly, it can be fatal. So don't take this lightly.
Often, people who have had an adrenal crisis will have to take hydrocortisone pills for the rest of their lives. It's wise to always have some extra medication on hand, just in case you get sick and need more.
When should I see a doctor?
If you have symptoms of an adrenal crisis , see a doctor immediately .
If you have a major stressor – whether it's an injury, illness, or severe depression – see a doctor. You may need to adjust your medication dosage.
What questions should you ask the doctor?
When you go to see a doctor, it's a good idea to ask questions like these:
- How exactly do you tell if I'm having an adrenal crisis ?
- If I don't have an adrenal crisis , what other condition could I have?
- What stressful situation caused my adrenal crisis ?
- How long will it take for me to recover?
- What kind of medicine do you recommend?
- How should I store this medicine properly?
- Are there any side effects to this medicine?
Ask these questions to gain a better understanding of your situation.
What is the difference between Thyroid Storm and Adrenal Crisis?
Although both of these are emergencies, there is a difference between the two.
Thyroid storm is the most severe form of a condition called thyrotoxicosis . Thyrotoxicosis is when your body produces too much thyroid hormone. The thyroid gland in our neck produces the hormones triiodothyronine (T3) and thyroxine (T4) . These hormones control things like our body temperature, heart rate, and metabolism.
However, adrenal crisis , as we have discussed, is a life-threatening condition that occurs when the adrenal glands do not produce enough cortisol .
Finally, things to remember
So, if you have adrenal insufficiency or are experiencing symptoms of an adrenal crisis , talk to a doctor immediately. Prompt treatment can save your life.
If you have an adrenal crisis , you will likely need to take medication for the rest of your life. Work with your doctor to identify any triggers that may be causing your condition and try to avoid them as much as possible. Your life is precious to you, so take care of it.
` Adrenal crisis, cortisol, Addison's disease, hormones, adrenal glands, emergency treatment, symptoms
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