Addisonian Crisis: Symptoms, Diagnosing & Treatments

Addisonian Crisis, Symptoms of Addisonian Crisis, Treatments for Addisonian Crisis


What Is Addisonian Crisis?

When we’re stressed out, our adrenal glands produce a hormone called cortisol. Cortisol helps our bodies respond effectively to stress. It also plays a role in bone health, immune response, and the metabolism of food.

People who have Addison’s disease don’t make enough cortisol or aldosterone. Low levels of cortisol may cause weakness, fatgue and low blood pressure. Aldosterone regulates sodium and potassium levels. When levels of cortisol fall rapidly, you develop Addisonian crisis. Addisonian crisis, also called acute adrenal insufficiency, is a serious emergency condition.

Symptoms of Addisonian Disease

Addison’s disease symptoms usually develop slowly, often over several months, and may include:

  • Muscle weakness and fatigue
  • Weight loss and decreased appetite
  • Darkening of your skin (hyperpigmentation)
  • Low blood pressure, even fainting
  • Salt craving
  • Low blood sugar (hypoglycemia)
  • Nausea, diarrhea or vomiting
  • Muscle or joint pains
  • Irritability
  • Depression
  • Body hair loss or sexual dysfunction in women

Diagnosing Addisonian Disease

Your doctor may use various blood tests to determine if your adrenal hormone levels are normal. These might include:

  • an ACTH or Cosyntropin (Cortrosyn) Stimulation Test, where a doctor will assess your cortisol levels relative to an ACTH injection
  • a fasting blood sugar test
  • a serum potassium or serum sodium test
  • a simple cortisol test

Treatments for Addisonian Disease

All treatment for Addison’s disease involves hormone replacement therapy to correct the levels of steroid hormones your body isn’t producing. Some options for treatment include:

  • Oral corticosteroids. Your doctor may prescribe fludrocortisone to replace aldosterone. Hydrocortisone (Cortef), prednisone or cortisone acetate may be used to replace cortisol.
  • Corticosteroid injections. If you’re ill with vomiting and can’t retain oral medications, injections may be needed.
  • Androgen replacement therapy. To treat androgen deficiency in women, dehydroepiandrosterone can be prescribed. Some studies suggest that this therapy may improve overall sense of well-being, libido and sexual satisfaction.

An ample amount of sodium is recommended, especially during heavy exercise, when the weather is hot, or if you have gastrointestinal upsets, such as diarrhea. Your doctor will also suggest a temporary increase in your dosage if you’re facing a stressful situation, such as an operation, an infection or a minor illness.