Drug-induced adrenal insufficiency

This condition is treated with glucocorticoids. Higher doses are needed in stressful situations (such as during infections, or before and after surgery).

Symptoms of adrenal insufficiency usually improve quickly after treatment with glucocorticoids. The long-term outlook varies based on how dependent you are on these drugs, and any complications that occur.

If you no longer need glucocorticoid treatment for the original condition, the drugs can be very slowly tapered (dosage decreased gradually, over time), under a physician's supervision.

Tapering off the medication may take many months. Some withdrawal symptoms are possible.

Complications include:

• Dependence on steroids
• Need for glucocorticoid treatment during stressful situations -- possibly for up to a year after tapering off them

Complications from steroid use include:

• Diabetes
• High blood pressure
• Osteoporosis

A serious complication is adrenal crisis, which requires immediate treatment with glucocorticoids. Symptoms include dizziness, nausea and vomiting, extreme fatigue, and low blood pressure. This usually follows a stress on the body, such as dehydration, infection, or another illness or injury. Adrenal crisis can generally be prevented by increasing (doubling or tripling) the steroid dose during illness or other physical stress.

Call your health care provider if you are taking glucocorticoid drugs and experience any of the symptoms of adrenal insufficiency. If the symptoms are severe, go to an emergency room or call 911 (or your local emergency number).

People with adrenal insufficiency should wear a Medic-Alert tag to alert health care professionals to this condition in case of emergency.

Images

Endocrine glands

Review Date: 08/09/2008
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and Deborah Wexler, MD, Assistant Professor of Medicine, Harvard Medical School, Endocrinologist, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org)