Adrenal Insufficiency and Addison’s Disease

What is Adrenal Insufficiency/Addison’s Disease?

• Rare, potentially deadly but treatable

• Divided into primary and secondary

  • Primary: called Addison’s Disease - damage to adrenal cortex → not able to make enough cortisol and aldosterone

  • Secondary: de-function pituitary gland (in brain) not signalling the adrenal glands to make cortisol - can also be from long term steroid intake

What are the roles of Cortisol and Aldosterone

• Help regulate BP

• Help immune system

• Balance effect of insulin

• Assist body responding to stress

• Regulates salts in blood

What are some signs and symptoms of adrenal insufficiency/addison’s disease?

• Hyperpigmentation/vitiligo

• Low BP (coritsol not being produced enough)

• Weight loss

• Weakness

• GI symptoms

• Syncope

• Convulsions

• Hypoglycaemia

• Hyponatremia

What are some possible triggers of acute addisons/adrenal insufficiency exacerbation?

• Infection

• Hypogylaemia

• Stress

• Traumatic injuries

• Surgery

• Burns

• Pregnancy

• Medical emergencies (e.g. MI)

• Sudden stop to steroid treatment

How should you manage Adrenal Insufficiency/Addison’s Disease?

• Assess and manage ABCs symptomaitcally

• IV access and hydrocortisone if indicated (paramedic)

• Manage hypoglycaemia where required

• ECG

• Rapid transport to nearest ED