

If you have AI, you should wear a medical alert bracelet or tag and know the warning signs of adrenal crisis.Adrenal nodules are found in approximately 5-8% of all patients. Then they need to go to the hospital immediately for more treatment. People in adrenal crisis need an injection (shot) of glucocorticoids (medicines that replace cortisol) right away. Adrenal crisis occurs mainly in people with primary AI. If left untreated, adrenal crisis can cause death. Physical stress caused by illness, infection, surgery, or an accident can suddenly make symptoms of AI much worse, an emergency illness called an adrenal crisis. Some people don't know they have AI until they have a sudden worsening of symptoms called an adrenal crisis.

Normally, the pituitary gland makes a hormone called ACTH, which tells the adrenal glands to make cortisol. Secondary AI: Problems with the pituitary gland cause secondary AI. Other causes of primary AI include bleeding in the glands, infections, genetic (inherited) diseases, and surgical removal of the adrenal glands. When adrenal glands are damaged, they can't produce hormones. Primary AI: The most common cause of primary AI is autoimmune disease, meaning the body's defense system attacks and destroys the body's own tissues. In AI, the adrenal cortex does not make enough steroid hormones. The outer layer (cortex) of the adrenal glands makes three types of steroid hormones. The adrenal glands, located on top of the kidneys, make hormones that are essential for body functions.

Only an endocrinologist, an expert in hormones, should diagnose AI using standard tests. The adrenal glands do not get “adrenal fatigue” or lose function because of mental or physical stress. Production of aldosterone is normal in secondary AI. It results when the pituitary gland, a small gland near the brain, does not signal the adrenal glands to make cortisol.

Secondary AI is the far more common type of AI. Usually, production of aldosterone and androgens (the two other types of steroid hormones made by the adrenal glands) is also low. Primary adrenal insufficiency (AI), also called Addison's disease, is a rare condition where the adrenal glands do not work properly and cannot make enough cortisol (a “stress” hormone).
