I've just been diagnosed with adrenal insufficiency and am being treated at home. What should I be aware of? (Anh Hong, 51 years old, Lam Dong )
Reply:
Adrenal insufficiency occurs when the hypothalamus-pituitary-adrenal axis is disrupted, interrupting the adrenal cortex's production of steroid hormones. The disease has two forms: primary, caused by autoimmune diseases, infections, tuberculosis, HIV, cancer, or adrenalectomy. In this case, the adrenal glands are attacked and destroyed, leading to an inability to produce cortisol and aldosterone.
Secondary adrenal insufficiency occurs when the pituitary gland does not secrete enough adrenocorticotropin (ACTH), leading to insufficient cortisol production by the adrenal glands. This condition is common in people who have used corticosteroids for a long time and stopped abruptly. Secondary adrenal insufficiency can also occur due to pituitary tumors pressing on normal pituitary cells or due to pituitary surgery or radiation therapy.
Adrenal insufficiency is a chronic condition that requires lifelong monitoring and treatment. You should take medication at home as prescribed by your doctor to avoid complications.
The doctor instructed the patient and their family on how to administer corticosteroid injections and how to recognize emergency situations such as acute adrenal insufficiency so that the patient could be taken to a medical facility for timely treatment.
Adrenal insufficiency is common in people aged 30-50. (Illustration: Freepik)
Diet plays a crucial role in improving health. She noted that she should increase her intake of calcium- and vitamin D-rich foods, as corticosteroid use increases the risk of osteoporosis. If she has low aldosterone levels, she should consult her doctor about supplementing sodium through diet or medication.
Typical symptoms of acute adrenal insufficiency include hypotension, severe dehydration, confusion, and coma. The condition is often associated with acute stressors such as surgery, infection, or trauma. In such cases, the patient needs to be hospitalized for prompt intervention to avoid life-threatening situations.
Chronic adrenal insufficiency commonly presents with symptoms such as nausea, vomiting, abdominal pain, loss of appetite, weight loss, fatigue, muscle pain, and increased skin and mucous membrane pigmentation. If you notice any unusual health symptoms, you should see a doctor for timely examination and treatment.
Dr. Do Tien Vu
Department of Endocrinology and Diabetes, Tam Anh General Hospital, Ho Chi Minh City
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