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Adrenal Crisis

  • Cynthia M. Johnson, MA
Publication Type:


Adrenal Crisis

(Acute Adrenocortical Insufficiency)


Adrenal crisis is a severe lack of a hormone called cortisol. It is made by the adrenal gland and helps the body with blood pressure, metabolism, and the immune system. Levels of another hormone called aldosterone may also be low.

This problem can be deadly.

Adrenal Glands.

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An adrenal crisis can be caused by:

  • Stopping long term use of corticosteroid medicine too quickly
  • Sepsis—a severe illness caused by an infection in the blood
  • Stress from surgery
  • Major sickness, such as a heart attack
  • Harm to the adrenal glands or surgery to remove them
  • Damage to the pituitary gland—it controls the adrenal gland
  • Therapy to replace the thyroid hormone
Pituitary Gland.

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Risk Factors

Things that may raise the risk of adrenal crisis are:


A person with adrenal crisis may have:

  • Weakness or feel very tired
  • Lightheadedness
  • Nausea and vomiting
  • Lost weight or is not hungry
  • Belly pain
  • High or low body temperature
  • Confusion
  • Diarrhea


The doctor will ask about symptoms and health history. A physical exam will be done.

Blood and urine tests may be done to check hormone levels.

Pictures may be taken. This can be done with:


This problem can be deadly. Care is needed right away. A person will need:

  • Fluids to replace what the body has lost
  • Medicines to replace missing hormones


Managing Addison disease can lower the risk of this problem. People with Addison disease should talk to their doctor about what to do when they are sick or stressed. If they are sick or under stress they may need to:

  • Take more medicine that replaces missing hormones
  • Carry emergency medicine




  • Adrenal insufficiency and Addison's disease. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: http://www.niddk.nih.gov/health-information/endocrine-diseases/adrenal-insufficiency-addisons-disease.
  • Adrenal insufficiency in adults. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/adrenal-insufficiency-in-adults.
  • Nowotny, H., Ahmed, S.F., et al. Therapy options for adrenal insufficiency and recommendations for the management of adrenal crisis. Endocrine, 2021; 71 (3): 586-594.


  • James P. Cornell, MD
Last Updated:

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.