The most common signs and symptoms include muscle weakness and fatigue; muscle, joint or abdominal pains; and decreased appetite and weight loss.
In addition, signs and symptoms can include lightheadedness, feeling wiped out by an ordinary illness, depression, nausea, vomiting or diarrhea. Cravings for salt and darkening of skin, especially on the face and hands, or on moles, scars or skin folds, are seen only with primary adrenal insufficiency.
Symptoms of adrenal insufficiency can develop suddenly and rapidly into an adrenal crisis. This can occur in someone who has been diagnosed with adrenal insufficiency or in someone who has yet to be diagnosed. Often, an adrenal crisis is triggered by health-related stress, such as an illness, surgical procedure or serious injury. These are also the times that higher cortisol production usually would occur in someone without adrenal insufficiency.
As symptoms of adrenal crisis escalate, most people feel terrible — perhaps with severe abdominal pain, nausea, vomiting and lightheadedness — and realize that emergency care is required. Some people may pass out, requiring help from others. An adrenal crisis can result in death if not promptly treated.
Adrenal insufficiency can be confirmed or ruled out with blood tests. Although there’s no cure, primary adrenal insufficiency can be managed effectively by taking cortisol and aldosterone replacement hormones, with the goal of stabilizing hormone levels and relieving signs and symptoms.