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Adrenal Insufficiency and Addison Disease

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Signs and Symptoms

The symptoms associated with adrenal insufficiency are often vague and nonspecific. They may emerge slowly, first appearing during times of stress, then increasing in intensity over a period of several months. Symptoms may include:

  • Abdominal pain
  • Decreased body hair
  • Dehydration, with Addison disease
  • Diarrhea or constipation
  • Dizziness and fainting
  • Fatigue or extreme weakness
  • Hyperpigmentation, with Addison disease - dark patches of skin, especially in the folds of the skin; sometime black freckles on the forehead and face and/or discoloration around areas such as the nipples, lips, and rectum
  • Joint and muscle aches
  • Changes in blood pressure or heart rate
  • Hypoglycemia
  • Muscle weakness
  • Salt craving, with Addison disease
  • Vomiting
  • Weight loss

Since the signs and symptoms of adrenal insufficiency are gradual and non-specific, people may ignore them until they suddenly worsen into a severe condition called an adrenal crisis. About 25% of the time, adrenal insufficiency is diagnosed during an adrenal crisis (also called an Addisonian crisis). This crisis may be caused by a period of increased stress, trauma, surgery, or a severe infection. If left untreated, it can be fatal. In an adrenal crisis, the signs and symptoms may include:

  • Abdominal pain
  • Difficulty breathing
  • Kidney failure
  • Loss of consciousness
  • Low blood pressure
  • Severe pain in the lower back, abdomen or legs
  • Severe vomiting and diarrhea, leading to dehydration
  • Shock

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