What is Adrenal Crisis Management?

16th April 2023

Adrenal Crisis Management Information 

An Acute Adrenal Crisis is a life-threatening condition caused by a lack of cortisol production from the kidneys. It is most common in people with Addison’s Disease and is a sudden worsening of the usual symptoms associated with it. 


What is Addison’s Disease?

First, let’s explain Addison’s Disease. Also known as Primary Adrenal Insufficiency or Hypoadrenalism, it is a rare disorder of the adrenal glands that affects roughly 100 out of every million people in developed countries. There are around 9000 cases confirmed in the UK, with a few hundred more being diagnosed each year. 

The adrenal glands, found on top of the kidneys, produce cortisol and aldosterone. These are two essential hormones that are needed to keep our energy levels consistent throughout the day. 

Addison’s Disease can affect people of any age but is most common between the ages of 30 and 50 and is more common in women than men. 


What are the Symptoms of Addison’s Disease? 

The main early symptoms of Addison’s Disease are: 

  • Low energy levels/ lack of motivation 
  • Muscle weakness
  • Lack of appetite – leading to unintended weight loss
  • Increased thirst
  • Low mood

These are similar symptoms to cold, flu and depression, which are all very common. This is why it is so important to see your GP if these symptoms persist longer than a usual bout of illness. 

Other, more serious symptoms include: 

  • Cramps
  • Dizziness/Delirium 
  • Exhaustion 
  • Fainting

These symptoms are a clearer sign of Addison’s Disease and shouldn’t be ignored. They are also signs of an Adrenal Crisis


What Causes Addison’s Disease? 

Any condition that damages the adrenal glands can cause Addison’s Disease. The most common is a problem with the immune system, which causes the glands to become blocked as the immune system attempts to attack them. The reason for this is still unknown, but it is the reason for between 70-90% of cases. 

Tuberculosis (TB) can also cause Addison’s Disease, but this is very rare in the UK, and happens more in underdeveloped countries where TB is less treatable. 


Can you treat Addison’s Disease?

Like many diseases, Addison’s Disease is treatable, so people with it can live a relatively normal life if they stay healthy and don’t over-exert themselves. 

Medicine can be taken that replaces the missing hormones, meaning that apart from occasional low energy levels, you can live a normal, active life by taking the replacements regularly. 

Bouts of fatigue will still occur if you have Addison’s Disease, but provided you are cautious and don’t push themselves, it shouldn’t affect you too much. 

Addison’s Disease may also have associated health conditions such as diabetes or hypothyroidism. Consult your GP or doctor if you have any unusual symptoms. 


What is an Adrenal Crisis? 

Every year, 8% of people with Addison’s Disease experience an Adrenal Crisis.

It is a sudden worsening of the symptoms associated with Addison’s Disease, as a result of a drastic drop in the amount of hormones being produced by the kidneys. 

If someone experiences an Adrenal Crisis, they need emergency treatment and admission to hospital as soon as possible. 


What are the Symptoms of an Adrenal Crisis? 

If you know that someone has Addison’s Disease, it is important to know how to spot an Adrenal Crisis so you can act fast. Also, if you have Addison’s Disease, you should be ready to act if any of the following happen to you. 

Here are the symptoms to look for: 

  • Light-headedness or Dizziness 
  • Sudden Extreme Weakness 
  • Vomiting and Severe Nausea 
  • Feeling Very Cold and Shivering
  • Back, Limb or Abdominal Pain
  • Confusion and Loss of Consciousness 

Remember, if you haven’t been diagnosed with Addison’s Disease, you can still have an Adrenal Crisis. It may be rare, and these symptoms aren’t unique to an Adrenal Crisis, but knowing how to spot one is still important. 


What can Cause an Adrenal Crisis? 

Addison’s Disease is the main cause of an Adrenal Crisis, but anything that damages the Kidneys’ adrenal glands can also cause one.

A pituitary gland injury can be the result of damaged kidneys, severe dehydration or if Primary Adrenal Insufficiency isn’t treated properly. 

Even if you regularly treat your Addison’s Disease with hormone injections, there is still a risk of Adrenal Crisis. This is a rare condition that is still being studied, so more causes may still exist. 


How to Treat an Adrenal Crisis? 

If you, or someone close to you, has an Adrenal Crisis, you need to act fast. Unlike a usual bout of fatigue that is typical Addison’s Disease, this is a severe attack that is fatal if not treated quickly. 


What to do if You have an Adrenal Crisis 

If you are having an Adrenal Crisis, you may have a small window to act. 

First, call an ambulance. 

When you have been diagnosed with Addison’s Disease, you will have been given medicine to control your hormone levels. This is most commonly hydrocortisone, prednisolone, or dexamethasone.

If you are able, inject yourself with your medicine to supplement the lack of cortisol. If you have a caregiver present, they should do it for you. 

If you are too dizzy or weak to do either of these steps, and don’t have a caregiver present, try to get help from someone close by who can give you the injection. 


What to do if Someone Else has an Adrenal Crisis

If you see someone having an Adrenal Crisis, follow these steps:

Call an ambulance.

The person having an Adrenal Crisis will need to be hospitalised, so getting an ambulance to their location is essential. If you are confident that it is an Adrenal Crisis, inform them when you make the call so they can prepare the ambulance crew. 

Give an injection. 

If you know the person is receiving treatment for Addison’s Disease, give them an injection of their medicine to reduce the loss of cortisol. The injection needs to be into the thigh muscle. 

Once you’ve completed both of these steps, make sure the person is in the recovery position and wait for the ambulance. 

An intramuscular injection is a delegated nursing task. If you work in a regulated provision, such as a School or Care Home, ensure that your workforce is supported and trained in this life-saving task. 


Training for Adrenal Crisis Management

Guardian Angels Training offer in-depth courses that teach you how to act and save lives when someone is ill or injured. An Adrenal Crisis is uncommon, so knowing how to spot one early and act fast is essential.

To learn more our company or about our courses, please get in touch.