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Secondary Adrenal Insufficiency: Care Instructions

Your Care Instructions

Your adrenal glands sit on top of your kidneys. They make hormones that affect almost every organ in your body.

Secondary adrenal insufficiency means that your adrenal glands don't make enough of a hormone called cortisol. Cortisol helps maintain blood pressure. It helps break down sugar and fat for energy. It also helps manage stress.

The problem starts with the pituitary gland. It's located at the base of your brain. Normally it sends a signal to the adrenal glands to make more cortisol. The signal is a hormone that the pituitary gland makes, called ACTH. When the pituitary gland doesn't make enough ACTH, the adrenal glands won't make enough cortisol.

This can happen if the pituitary gland is damaged by things like a tumour or surgery.

Treatment involves replacing the hormones that your body needs. You might get some of these hormones in the hospital. Some people will take hormones at home for the rest of their lives. Hormones may be pills or injections (shots).

If possible, your doctor will treat the condition that damaged the pituitary gland.

Some people may need urgent care because they have what is called an adrenal crisis. It can be caused by severe infection or stress. Symptoms may include:

  • Severe nausea, vomiting, and diarrhea.
  • Abdominal (belly) pain.
  • Losing too much fluid or not taking in enough fluid (called dehydration).
  • Confusion.
  • Low blood pressure and fainting.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse call line if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

How can you care for yourself at home?

  • Take your medicines exactly as prescribed. Call your doctor or nurse call line if you think you are having a problem with your medicine.
  • Wear medical alert jewellery. This lets others know that you have adrenal insufficiency.
  • Have a shot of emergency medicine with you at all times. Know when and how to give yourself the shot. Have instructions written out. Teach someone else how to give you the shot in case you can't give it to yourself.
  • Keep track of your blood pressure. Let your doctor know if it's high or too low. Also let your doctor know if you have swelling or you feel light-headed. You may need to adjust your dose of medicine.
  • Work with your doctor to create a plan for what to do when you're sick or when your body is under stress. You may need to change your dose of medicine during this time.

When should you call for help?

Call 911 anytime you think you may need emergency care. For example, call if:

  • You passed out (lost consciousness).
  • You have symptoms of an adrenal crisis. These may include:
    • Severe nausea, vomiting, and diarrhea.
    • Low blood pressure and fainting.
    • Abdominal (belly) pain.
    • Losing too much fluid or not taking in enough fluid (called dehydration).
    • Confusion.

Call your doctor or nurse call line now or seek immediate medical care if:

  • You have trouble taking medicines by mouth.
  • You have a fever.

Watch closely for changes in your health, and be sure to contact your doctor or nurse call line if:

  • You do not get better as expected.

Where can you learn more?

Go to https://www.healthwise.net/patientEd

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