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Educational article

Adrenal Crisis: How to Recognize an Emergency in People With Adrenal Insufficiency

Endomédicos

Endomédicos medical profile

Published 5 min read

Educational content. It does not replace an individual medical assessment and should not be used for self-medication.

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A person sitting appears very weak while a companion stays nearby and uses a phone.
Severe weakness or confusion in a person with adrenal insufficiency may require urgent care.

What Is an Adrenal Crisis?

An adrenal crisis is a medical emergency that can occur in a person with adrenal insufficiency when the body cannot respond adequately to increased demands, for example, during an infection or another illness. It can worsen rapidly and requires urgent evaluation. No single symptom confirms an adrenal crisis, but significant deterioration in this context should not wait for an outpatient appointment.

Signs That Require Urgent Care

Seek urgent care if a person with adrenal insufficiency has severe weakness, faints or feels faint, is confused, has difficulty staying alert, has significant abdominal pain, or has persistent vomiting. Severe diarrhea is also concerning, especially if it prevents the person from keeping oral medication down or the person is getting worse. Signs can vary; they do not all need to be present to seek help.

Infections, Vomiting, and Other Triggers

An infection, fever, vomiting, or diarrhea can increase the body’s demands and complicate the usual management of adrenal insufficiency. Tell the emergency care team if there has been an interruption in prescribed treatment, without assuming that every illness is an adrenal crisis. If there is marked deterioration, seek evaluation promptly.

What to Do if Someone Deteriorates Rapidly

If there are severe signs, call the local emergency service or go to an emergency department right away. If the person is confused, faints, or worsens rapidly, do not leave them alone or let them drive; ask for help with transportation. In Colombia, use the appropriate local emergency number. Tell the emergency team that the person has adrenal insufficiency, and do not wait for an outpatient appointment.

Follow the Individual Emergency Plan

People with adrenal insufficiency should follow the emergency plan provided by their treating team. This plan is individualized: do not replace it with general recommendations or make treatment changes on your own. If the person worsens or cannot keep oral medication down, seek urgent care; the healthcare team will decide on the appropriate management.

What to Tell the Emergency Care Team

Tell the team that the person has adrenal insufficiency, what symptoms they have, and when the symptoms began. Mention any infection, vomiting, or diarrhea, and whether the person has been able to keep the prescribed treatment down. Bring the emergency plan or medical information if available, but do not delay leaving to gather documents.

Mistakes to Avoid

Do not stop or change prescribed glucocorticoids on your own. Do not try to manage severe deterioration with improvised adjustments, either. Do not wait for all symptoms to appear: fainting, confusion, severe weakness, or persistent vomiting may require urgent care, especially if the person is getting worse. A single symptom does not confirm an adrenal crisis, but the context and progression matter.

After Urgent Care

After the evaluation, follow the instructions from the team that cared for the person and contact their treating team to review the individual plan and address questions about future illnesses or difficulty keeping medication down. This follow-up does not replace urgent care if deterioration occurs again.

When to seek medical care

If symptoms persist, test results are abnormal, or you have questions about medication, arrange an individual assessment. Do not change treatment or doses without medical guidance.

Frequently asked questions

Does vomiting mean I’m having an adrenal crisis?

Not necessarily; a single episode of vomiting does not confirm an adrenal crisis. If vomiting persists, prevents you from keeping oral medication down, or occurs along with severe weakness, fainting, confusion, or worsening symptoms, seek urgent care and follow your individual plan.

Should I wait for an endocrinology appointment if I keep feeling worse?

Not if there is significant deterioration or severe symptoms. Seek urgent care or call the local emergency service; do not wait for an outpatient appointment.

Can I change my treatment on my own during an infection?

Do not stop or change prescribed glucocorticoids on your own. Follow the individual plan provided by your treating team, and seek urgent care if you cannot keep oral medication down or your condition worsens.

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