adrenal self care basics

Overview

Your adrenal glands are two small, triangular-shaped glands that sit on top of your kidneys. They release hormones, such as cortisol and adrenaline, that help control your blood pressure, blood sugar, energy levels, and your body's response to stress. Adrenal self-care means building daily habits that support these hormone systems and overall wellbeing. It is not a treatment for a medical condition, but a way to help keep your body steady and resilient.

True adrenal gland disorders are not common. However, feeling tired or stressed is very common, and most cases of low energy are not caused by adrenal problems. The idea of “adrenal fatigue” is not a recognized medical diagnosis.

Anyone can experience stress and fatigue, but genuine adrenal gland conditions can affect people of any age. They are more likely in people with autoimmune diseases, people who take long-term steroid medicines, or those who have had certain infections or surgery on the adrenal glands.

Symptoms

Common symptoms

• Persistent tiredness or weakness
• Dizziness when standing up
• Unexplained weight loss or poor appetite
• Craving salty foods
• Low blood pressure
• Nausea or mild stomach discomfort
• Darkening of the skin, especially in creases or scars (in some adrenal conditions)

Symptoms in children

• Tiredness or low energy
• Poor weight gain or slow growth
• Stomach pain or nausea
• Low blood sugar episodes
• Irritability or low mood

Symptoms in older adults

• Confusion or mental fogginess
• Falls due to dizziness or low blood pressure
• Feeling unusually weak or unsteady
• Loss of appetite and rapid weight loss

Causes

Main causes

• Autoimmune disease — the body's immune system mistakenly attacks the adrenal glands
• Infections that damage the adrenal glands
• Surgery to remove the adrenal glands (for example, for a tumour)
• Long-term steroid therapy that is stopped too quickly (this can suppress the adrenal glands' own hormone production)

Risk factors

• Having an autoimmune condition such as type 1 diabetes or thyroid disease
• Taking corticosteroids (steroid medicines) for a long time
• Family history of adrenal disorders
• Tuberculosis or other severe infections (more common in some parts of the world)

When to see a doctor

See a doctor urgently if:

• If you take steroid medicine and you are vomiting and cannot keep your tablets down, seek urgent medical care
• If you have fainted, severe confusion, or very low blood pressure, call your local emergency number
• If you have severe abdominal or back pain with nausea and dizziness, get emergency help

Book a routine appointment if:

• If you have had ongoing tiredness, weakness, dizziness, or weight loss for more than a few weeks
• If you are losing your appetite or craving salt much more than usual
• If you notice your skin gradually darkening for no clear reason

Diagnosis

A doctor will ask about your symptoms and medical history, and may check your blood pressure lying down and standing. They may refer you to a hormone specialist (endocrinologist) for further tests. Diagnosis of adrenal problems is based on blood and sometimes urine tests that measure hormone levels.

Tests that may be done

• Blood test for cortisol — taken in the morning
• Blood test for sodium, potassium, and other electrolytes
• ACTH stimulation test — a hormone blood test that checks how your adrenal glands respond
• CT scan or ultrasound of the adrenal glands (in some cases)
• Urine test to measure cortisol over 24 hours (in some cases)

What to expect at your appointment

The tests are usually simple blood tests or a short outpatient procedure. You may be asked to come in early in the morning. If tests show that your adrenal hormone levels are low, you may be offered treatment and regular follow-up with a specialist to help you manage your condition well.

Treatment

Treatment for genuine adrenal disorders mainly involves replacing the hormones your body is missing. This is usually with steroid medicines taken by mouth, and in some cases an emergency injection. Self-care habits are important alongside medical treatment, but they do not replace it. If your adrenal glands are overactive (producing too many hormones), treatment may include medication, lifestyle changes, or sometimes surgery.

Self-care at home

• Eat regular meals and snacks to keep blood sugar steady throughout the day
• Drink enough fluids to stay hydrated, especially in hot weather or after exercise
• Add extra salt to your meals if your doctor has advised you to (for example, for low aldosterone)
• Get 7–9 hours of sleep each night and try to keep a consistent sleep schedule
• Practise gentle stress-reducing activities like walking, deep breathing, or mindfulness
• Avoid heavy alcohol use and recreational drugs, which can strain your stress system
• If you take steroid medicine, always have a medical alert card or bracelet and an emergency plan agreed with your doctor

Medical treatments

Medical treatment depends on the specific adrenal problem. For underactive adrenal glands, doctors prescribe replacement hormone therapy in pills (or sometimes injections) to replace cortisol and/or aldosterone. This is usually taken once or twice a day, and doses may need to increase during illness, injury, or major stress — this is called “stress dosing.” Overactive adrenal glands may be treated with medicines that reduce hormone production, plus sometimes radiation or surgery. Always discuss your treatment plan with your specialist and take medicines exactly as prescribed.

When is surgery considered?

Surgery may be considered if a growth on the adrenal gland is causing hormone excess, or if a gland needs to be removed for medical reasons. After surgery, your hormone needs may change and you might need replacement therapy for a while or for life. Your surgeon and endocrine team will explain what to expect.

Living with this condition

Keeping a steady rhythm to your day helps your body's stress system stay calm. Eat at regular times, rest when you need to, and take your medicines at the same times each day if they have been prescribed. Learn to notice early warning signs of low hormone levels, such as unusual tiredness, dizziness, or nausea, and contact your health team early.

Lifestyle tips

• Make sleep a priority — go to bed and wake around the same time daily
• Take gentle exercise like walking, swimming, or stretching — listen to your body and rest when tired
• Set aside time for relaxation or activities you enjoy, even just 10 minutes a day
• Avoid skipped meals and prolonged fasting, especially if you have adrenal insufficiency
• Carry your medical alert information and let close friends or family know about your condition

Diet and exercise

Try to eat a balanced diet with plenty of vegetables, fruit, wholegrains, and protein. If your doctor says you need extra salt, include salty snacks like crackers or soups. Exercise is safe and helpful for most people, but start slowly and increase gradually. If you have low blood pressure, drink fluids before you stand up and avoid sudden changes in position.

Mental health and emotional wellbeing

Living with chronic fatigue or a long-term hormone condition can affect your mood and mental health. It is normal to feel frustrated or anxious at times. Talking to a mental health professional, counsellor, or a support group can help. If you ever feel unable to cope or have thoughts of harming yourself, reach out to a crisis helpline or your local emergency services.

Prevention

Autoimmune adrenal disease cannot always be prevented. However, you can reduce the risk of an adrenal crisis by never stopping steroid medicines suddenly, and by asking your doctor if you need extra “stress dose” steroids during illness, injury, or surgery. Avoiding long-term misuse of steroid medicines is also important.

Vaccines

Staying up to date with routine vaccinations, like flu and COVID-19, is important because infections can be more serious if you have adrenal insufficiency. Talk to your healthcare team about which vaccines are recommended for you.

Screening programmes

If you have a close family member with an adrenal condition, or you have an autoimmune disease and symptoms of adrenal insufficiency, your doctor may suggest blood tests to check your hormone levels. There is no routine screening for the general public.

Complications

If left untreated

• Adrenal crisis — a life-threatening drop in blood pressure, sodium, and sugar
• Severe dehydration and electrolyte imbalance
• Weight loss and muscle weakness
• Reduced ability to handle infection or injury
• Mood changes or depression

Long-term outlook

With the right diagnosis and treatment, most people with adrenal disorders lead full and active lives. The key is to follow your medical plan, learn your own warning signs, and keep a good communication channel with your care team. Self-care supports your treatment — it is a way to help your body and mind stay as steady and strong as possible.

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