Adrenal Crisis

(Acute Adrenocortical Insufficiency)


Adrenal crisis is a severe lack of a hormone called cortisol made by the adrenal gland. This hormone helps the body with blood pressure, metabolism, and the immune system. Aldosterone hormone levels may also be low. This problem can be deadly.

Adrenal Glands

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Causes are:

  • Stopping chronic use of corticosteroid medicine too quickly
  • Sepsis—severe illness caused by an infection in the blood
  • Stress from surgery
  • Major sickness, such as a heart attack
  • Harm to the adrenal glands or surgery to remove them
  • Damage to the pituitary gland (controls the adrenal gland)
  • Therapy to replace the thyroid hormone

Pituitary Gland

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Risk Factors

Things that may raise the risk of this problem are:


Problems may be:

  • Feeling weak
  • Lightheadedness
  • Being very tired
  • Nausea and vomiting
  • Lack of hunger
  • Weight loss
  • Belly pain
  • High or low body temperature
  • Confusion
  • Diarrhea


The doctor will ask about your symptoms and health history. A physical exam will be done.

Blood and urine tests may be done to check hormone levels.

Pictures may be taken. This can be done with:


This problem can be deadly. Care is needed right away. A person will need:

  • Fluids to replace those that the body has lost
  • Medicines to replace missing hormones


Managing Addison disease can lower the risk of this problem. A person should be aware of signs of stress and:

  • Increase medicines that replace missing hormones
  • Carry emergency medicine


American Association of Clinical Endocrinologists
National Institute of Diabetes and Digestive and Kidney Diseases


Canadian Association of Emergency Physicians
Canadian Institute for Health Information


Adrenal insufficiency and Addison's disease. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at:
...(Click grey area to select URL)
Accessed October 27, 2020.
Adrenal insufficiency in adults. EBSCO DynaMed website. Available at: Accessed October 27, 2020.
Charmandari E, Nicolaides NC, et al. Adrenal insufficiency. Lancet. 2014 Jun 21;383(9935):2152-2167.
Last reviewed September 2020 by EBSCO Medical Review Board James P. Cornell, MD