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What are symptoms of low cortisol?

Symptoms Extreme fatigue. Weight loss and loss of appetite. Areas of darkened skin. Low blood pressure, even fainting. Salt craving. Low blood sugar, also called hypoglycemia. Nausea, diarrhea or vomiting. Abdominal pain. More items... •

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Overview

Addison's disease, also called adrenal insufficiency, is an uncommon illness that occurs when the body doesn't make enough of certain hormones. In Addison's disease, the adrenal glands make too little cortisol and, often, too little of another hormone, aldosterone. Addison's disease can affect anyone and can be life-threatening. Treatment involves taking hormones to replace those that are missing.

Symptoms

Addison's disease symptoms usually happen slowly, often over months. The disease can move so slowly that people who have it may ignore the symptoms at first. Then a stress, such as illness or injury, makes symptoms worse.

Symptoms may include:

Extreme fatigue

Weight loss and loss of appetite

Areas of darkened skin

Low blood pressure, even fainting

Salt craving

Low blood sugar, also called hypoglycemia

Nausea, diarrhea or vomiting

Abdominal pain

Muscle and joint pain

Irritability

Depression

Body hair loss or sexual issues in some people

Acute adrenal failure, known as addisonian crisis

Sometimes the symptoms of Addison's disease appear suddenly. Acute adrenal failure can lead to life-threatening shock. Seek emergency treatment for the following:

Severe weakness

Confusion

Pain in the lower back or legs

Severe abdominal pain, vomiting and diarrhea, leading to dehydration

Reduced consciousness or delirium

Low blood pressure

When to see a doctor

Darkened areas of skin

Extreme loss of body water, also known as dehydration

Severe fatigue

Weight loss that doesn't happen on purpose

Nausea, vomiting or belly pain

Lightheadedness or fainting

Salt cravings

Muscle or joint pains

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Causes

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Adrenal glands Open pop-up dialog box Close Adrenal glands Adrenal glands Located on top of each kidney, the adrenal glands make hormones that help regulate metabolism, the immune system, blood pressure and other important functions. Although small, these glands control much of what happens in the body. Addison's disease is caused by damage to the adrenal glands. The adrenal glands sit just above the kidneys. As part of the endocrine system, they make hormones that affect almost every organ and tissue in the body. Damage to these glands results in too little of the hormone cortisol and, often, the hormone aldosterone. The adrenal glands are made up of two sections. The interior, called the medulla, makes adrenaline-like hormones. The outer layer, called the cortex, makes a group of hormones called corticosteroids. Corticosteroids include: Glucocorticoids. These hormones, including cortisol, affect the body's ability to turn food into energy. They also play a role in the immune system's inflammatory response and help the body respond to stress. These hormones, including cortisol, affect the body's ability to turn food into energy. They also play a role in the immune system's inflammatory response and help the body respond to stress. Mineralocorticoids. These hormones, including aldosterone, balance the body's sodium and potassium to keep blood pressure in a healthy range. These hormones, including aldosterone, balance the body's sodium and potassium to keep blood pressure in a healthy range. Androgens. In all people, the adrenal glands make small amounts of these sex hormones. They cause male sexual development. And they affect muscle mass, sex drive, known as libido, and a sense of well-being in all people.

Primary adrenal insufficiency

Sometimes, the outer layer of the adrenal glands, known as the cortex, is damaged. Then it can't make enough hormones, a condition called primary adrenal insufficiency. This is usually the result of an autoimmune disease, in which the body attacks itself. People with Addison's disease are more likely than are other people to have another autoimmune disease as well.

Other causes of adrenal gland failure may include:

Tuberculosis

Other infections of the adrenal glands

Spread of cancer to the adrenal glands

Bleeding into the adrenal glands

Secondary adrenal insufficiency

The pituitary gland makes a hormone called adrenocorticotropic hormone (ACTH). ACTH in turn causes the adrenal cortex to make its hormones. Having pituitary tumors that aren't cancer, inflammation and pituitary surgery can cause the pituitary gland to make too little ACTH . Too little ACTH can cause the adrenal glands to make too little glucocorticoids and androgens. This is called secondary adrenal insufficiency.

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Most symptoms of secondary adrenal insufficiency are similar to those of primary adrenal insufficiency. However, people with secondary adrenal insufficiency don't have darkened skin and are less likely to have severe dehydration or low blood pressure. They're more likely to have low blood sugar. A temporary cause of secondary adrenal insufficiency occurs when people who take corticosteroids, such as prednisone, to treat conditions such as asthma or arthritis, stop taking the medicine suddenly rather than tapering off.

Complications

Addisonian crisis. If you have untreated Addison's disease, you may develop an addisonian crisis as a result of stress on the body, such as injury, infection or illness. Typically, the adrenal glands make two or three times the usual amount of cortisol in response to physical stress. With adrenal insufficiency, not being able to increase the amount of cortisol made as a result of stress can lead to an addisonian crisis. An addisonian crisis is a life-threatening situation that results in low blood pressure, low blood levels of sugar and high blood levels of potassium. It requires immediate medical care.

Other autoimmune diseases. People with Addison's disease often have related autoimmune diseases.

Prevention

Talk to your health care provider if you always feel tired or weak or are losing weight without trying. Ask about an adrenal shortage. If you have been diagnosed with Addison's disease, ask your provider what to do when you're sick. You may need to learn how to increase your dose of corticosteroids. If you become very sick, especially if you are vomiting and you can't take your medicine, go to an emergency room. Some people with Addison's disease worry about serious side effects from hydrocortisone or prednisone. However, people with Addison's disease aren't as likely to get the side effects of high-dose glucocorticoids. That's because the dose prescribed replaces the amount that's missing. If you take cortisone, be sure to follow up with your provider regularly to make sure your dose is not too high.

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