- chronic, worsening fatigue
- muscle weakness
- loss of appetite
- weight loss
- low blood pressure that falls further when standing, causing dizziness or fainting
- irritability and depression
- a craving for salty foods due to salt loss
- hypoglycemia, or low blood glucose
How can someone with adrenal insufficiency prepare for an emergency?
People with adrenal insufficiency should always carry identification stating their condition in case of an emergency. A card or medical alert tag should notify emergency health care providers of the need to inject cortisol if the person is found severely injured or unable to answer questions. The card or tag should also include the name and telephone number of the person’s doctor and the name and telephone number of a family member to be notified. The dose of hydrocortisone needed may vary with a person’s age or size. For example, a child younger than 2 years of age can receive 25 milligrams (mg), a child between 2 and 8 years of age can receive 50 mg, and a child older than 8 years should receive the adult dose of 100 mg. When traveling, people with adrenal insufficiency should carry a needle, syringe, and an injectable form of cortisol for emergencies.
What special problems can occur with adrenal insufficiency?
Because cortisol is a “stress hormone,” people with chronic adrenal insufficiency who need any type of surgery requiring general anesthesia must be treated with intravenous glucocorticoids and saline. Intravenous treatment begins before surgery and continues until the patient is fully awake after surgery and able to take medication by mouth. The “stress” dosage is adjusted as the patient recovers until the presurgery maintenance dose is reached.
In addition, people who are not currently taking glucocorticoids but who have taken long-term glucocorticoids in the past year should tell their doctor before surgery. These people may have sufficient ACTH for normal events, but they may need intravenous treatment for the stress of surgery.
During illness, oral dosing of glucocorticoid may be adjusted to mimic the normal response of the adrenal glands to this stress on the body. Significant fever or injury may require triple oral dosing. Once recovery from the stress event is achieved, dosing is then returned to maintenance levels. People with adrenal insufficiency should know how to increase medication during such periods of stress. Immediate medical attention is needed if severe infections, vomiting, or diarrhea occur. These conditions can precipitate an Addisonian crisis.
Hydrocortisone (Oral Route): Side effects – MayoClinic
This is the treatment for Liam’s adrenal insufficiency.
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
- Blurred vision
- Decrease in the amount of urine
- Fast, slow, pounding, or irregular heartbeat or pulse
- Mental depression
- Mood changes
- Noisy, rattling breathing
- Numbness or tingling in the arms or legs
- Pounding in the ears
- Shortness of breath
- Swelling of the fingers, hands, feet, or lower legs
- Trouble thinking, speaking, or walking
- Troubled breathing at rest
- Weight gain
Incidence not known
- Abdominal cramping and/or burning (severe)
- Abdominal pain
- Bloody, black, or tarry stools
- Cough or hoarseness
- Darkening of skin
- Decrease in height
- Decreased vision
- Dry mouth
- Eye pain
- Eye tearing
- Facial hair growth in females
- Fever or chills
- Flushed, dry skin
- Fruit-like breath odor
- Full or round face, neck, or trunk
- Heartburn and/or indigestion (severe and continuous)
- Increased hunger
- Increased thirst
- Increased urination
- Loss of appetite
- Loss of sexual desire or ability
- Lower back or side pain
- Menstrual irregularities
- Muscle pain or tenderness
- Muscle wasting or weakness
- Pain in back, ribs, arms, or legs
- Painful or difficult urination
- Skin rash
- Trouble healing
- Trouble sleeping
- Unexplained weight loss
- Unusual tiredness or weakness
- Vision changes
- Vomiting of material that looks like coffee grounds
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
- Increased appetite
Incidence not known
- Abnormal fat deposits on the face, neck, and trunk
- Dry scalp
- Lightening of normal skin color
- Red face
- Reddish purple lines on the arms, face, legs, trunk, or groin
- Swelling of the stomach area
- Thinning of the scalp hair
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.