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Adrenal Insufficiency and Addison Disease

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Signs and Symptoms

The signs and symptoms associated with adrenal insufficiency are often vague and nonspecific. They may emerge slowly, first appearing during times of physical stress such as an infection or trauma, then increase in intensity over a period of several months. Signs and symptoms may include a combination of the following:

  • Fatigue or extreme weakness
  • Unexplained weight loss
  • Muscle aches and weakness
  • Dizziness and fainting
  • Changes in blood pressure or heart rate
  • Abdominal pain
  • Nausea, vomiting
  • Diarrhea or constipation
  • Decreased body hair
  • Hyperpigmentation (with Addison disease, dark patches of skin, especially in the folds of the skin, and on the face, neck, and back of the hands)
  • Low blood sugar (hypoglycemia)
  • Salt craving (with Addison disease)
  • Dehydration (with Addison disease)

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 physical stress, such as illness, trauma, surgery, or 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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