preventing adrenal

Overview

The adrenal glands are two small triangular organs that sit on top of your kidneys. They produce important hormones that control how your body handles stress, keeps blood pressure steady, balances salt and water, and supports your immune system. Preventing adrenal problems means taking steps to keep your adrenal glands healthy and, if you already have an adrenal disorder, preventing serious episodes like an adrenal crisis.

Adrenal disease is uncommon. The most common form, Addison's disease, affects about 1 in 10,000 people. However, many people take steroid medicines for asthma, arthritis, or other conditions, which can affect how the adrenal glands work.

Adrenal problems can affect anyone, but they are more likely in people with autoimmune diseases, people who take long-term steroid medicines, and those with a family history of adrenal disorders.

Symptoms

Common symptoms

• Persistent and unusual tiredness
• Muscle weakness
• Weight loss or weight gain
• Low blood pressure, causing dizziness when standing up
• Salt craving
• Nausea, abdominal pain, or loss of appetite
• Darkening of the skin, especially on elbows and knuckles

Symptoms in children

• Slow growth and poor weight gain
• Vomiting or dehydration
• Tiredness that interferes with play or school

Symptoms in older adults

• Confusion or memory problems
• Low blood pressure and balance issues
• General weakness that is often blamed on aging

Causes

Main causes

• Autoimmune disease, where the body's immune system attacks the adrenal glands
• Infections, such as tuberculosis, that damage the glands
• Bleeding into the adrenal glands (rare)
• Surgery to remove the adrenal glands
• Long-term steroid medicine can suppress your adrenal glands, so the body stops making enough cortisol on its own

Risk factors

• Taking oral or inhaled steroids for more than a few weeks
• Having an autoimmune condition like type 1 diabetes or thyroid disease
• Having a family member with Addison's disease
• Undergoing major surgery or serious illness while on steroids

When to see a doctor

See a doctor urgently if:

• Severe vomiting, diarrhoea, or shaking that stops you from taking your medicine
• Sudden fainting or very low blood pressure
• Confusion or unusual behaviour

Book a routine appointment if:

• You have steady, unexplained tiredness or weight loss
• You feel dizzy when you stand up
• You crave salt more than usual

Diagnosis

Your doctor will ask about your symptoms and medical history, and then order blood tests to measure hormone levels. You may be referred to a specialist in hormones called an endocrinologist.

Tests that may be done

• Blood tests to measure cortisol and other hormone levels
• A short stimulation test to see how your adrenal glands respond
• Checking blood sugar, sodium, and potassium levels
• In some cases, a CT scan of your abdomen

What to expect at your appointment

If your tests suggest adrenal insufficiency, your doctor may recommend an overnight stay in the hospital for more detailed tests. Don't worry — your team will explain every step and make you comfortable.

Treatment

Treatment depends on the type of adrenal problem. For adrenal insufficiency, you will receive hormone replacement medicine that replaces what your body isn't making. Most people feel much better once treatment begins. You will need to take this medicine for life.

Self-care at home

• Always take your medicine exactly as prescribed.
• Keep a good supply of your medicine at home and when travelling.
• Wear a medical alert bracelet or carry a card listing your condition.
• Follow your doctor's instructions for how to change your medicine dose during illness or surgery.

Medical treatments

Your specialist may prescribe oral steroid replacement medicines to mimic the natural hormones your body needs. Some people also need a medicine to help the kidneys hold on to salt and water. In serious illness or injury, extra doses may be given, and you might be taught to give an injectable form of your medicine in emergencies.

When is surgery considered?

If your adrenal glands produce too much hormone, such as in Cushing's disease, you may need an operation to remove a tumour or all of the affected gland. Your healthcare team will discuss the risks and benefits with you.

Living with this condition

Living with an adrenal condition means following a steady daily routine, taking your medicines, and being alert to how you feel. With proper care, you can work, travel, and enjoy life just like anyone else.

Lifestyle tips

• Sleep seven to nine hours a night and rest if you feel drained.
• Learn simple stress-reduction techniques like deep breathing or walking.
• Avoid extreme physical activity unless your doctor has said it's safe.
• Tell every healthcare professional about your adrenal condition.

Diet and exercise

A healthy balanced diet and regular gentle exercise help keep you well. Some people with low aldosterone need extra salt, especially in hot weather or after exercise. Talk to your physician about what's right for you.

Mental health and emotional wellbeing

Adjusting to a lifelong condition can be emotionally challenging. It's normal to feel frustrated or anxious sometimes. If you feel overwhelmed, talk to your doctor or a counsellor. If you ever have thoughts of harming yourself, call your local emergency number or a mental health crisis line right away.

Prevention

You can't prevent most adrenal disorders, but you can prevent dangerous episodes like an adrenal crisis. Learn to recognize early warning signs, keep your medicines up to date, and have a clear plan with your doctor for when you're ill.

Vaccines

Stay up to date with recommended vaccines, especially the flu and pneumonia vaccines. Infections can trigger adrenal crisis in people with adrenal insufficiency. Ask your doctor which vaccines are right for you.

Screening programmes

If you have an autoimmune disease or have taken steroids for a long time, your doctor may check your adrenal function occasionally. For everyone else, routine screening isn't needed.

Complications

If left untreated

• Adrenal crisis, a life-threatening condition that needs emergency treatment
• Very low blood pressure and shock
• Dangerously low sodium or high potassium levels in the blood
• Severe muscle weakness and inability to do normal tasks

Long-term outlook

With early diagnosis and proper treatment, most people with adrenal disorders enjoy a full, active life. The key is good communication with your healthcare team, careful taking of your medicine, and knowing what to do when life gets stressful or you become unwell.

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