PATIENT EDUCATION
Adrenal Disorders
The adrenal glands produce cortisol, aldosterone and adrenal androgens, and the adrenal medulla produces catecholamines. Disorders may cause too little hormone, too much hormone or be discovered incidentally on imaging.
Select a topic below to view more information.
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Severe Fatigue, Weight Loss or Low Blood Pressure
What you'll notice or feel
- Persistent weakness and fatigue.
- Loss of appetite or unintentional weight loss.
- Dizziness or low blood pressure.
- Nausea, abdominal symptoms or salt craving may occur.
Common causes
- Adrenal insufficiency means the body is not producing enough cortisol.
- Autoimmune Addison disease is one cause.
- Pituitary disease or suppression after long-term steroid treatment can also cause cortisol deficiency.
What it could be
- Primary or secondary adrenal insufficiency.
- Another medical cause if adrenal testing is normal.
Initial self-care
- Do not stop long-term steroid medicines suddenly.
- If you already have diagnosed adrenal insufficiency, follow your sick-day steroid plan.
- Carry steroid identification/emergency information.
When to see a doctor urgently
- Vomiting, severe weakness, low blood pressure, confusion or collapse in known or suspected adrenal insufficiency can be adrenal crisis and requires emergency treatment.
When to see a doctor
- Symptoms are persistent and unexplained.
- You are reducing long-term steroid treatment.
- There is low sodium or other biochemical concern.
Weight Gain, Bruising or Muscle Weakness
What you'll notice or feel
- Weight gain mainly around the trunk.
- Easy bruising or wide purple stretch marks.
- Weakness climbing stairs or rising from a chair.
- High blood pressure, diabetes or osteoporosis may develop.
Common causes
- Long-term high-dose glucocorticoid treatment is a common cause of Cushing syndrome.
- Rarely, the body produces excess cortisol from pituitary, adrenal or other tumours.
What it could be
- Cushing syndrome if the characteristic pattern and biochemical tests support it.
- More common metabolic conditions if cortisol testing is normal.
Initial self-care
- Do not abruptly stop prescribed steroids.
- Bring details of tablets, inhalers, injections and creams containing steroids.
- Avoid unregulated “cortisol blocker” supplements.
When to see a doctor urgently
- Severe infection, very high blood pressure, chest pain or sudden neurological symptoms.
When to see a doctor
- Typical features are progressive.
- You have repeated steroid exposure and concerns about side effects.
- An adrenal or pituitary lesion is known.
Adrenal Incidentaloma
What you'll notice or feel
- An adrenal nodule or mass is found on CT/MRI done for another reason.
- Usually no symptoms.
- You may be told it looks benign but needs hormonal assessment.
Common causes
- Benign adrenal adenomas are common incidental findings.
- Some lesions produce cortisol, aldosterone or catecholamines without obvious symptoms.
- A minority have imaging features that need closer evaluation.
What it could be
- A non-functioning benign adrenal adenoma.
- A functioning adrenal lesion.
- Less commonly, a tumour requiring surgical evaluation.
Initial self-care
- Keep the original imaging report and, if possible, images.
- Do not assume “incidental” means “ignore”.
- Medication and blood-pressure history are important for hormone testing.
When to see a doctor urgently
- Severe episodic headache, palpitations with very high blood pressure, chest pain or collapse.
When to see a doctor
- An adrenal lesion has been newly reported.
- Follow-up recommended by radiology is overdue.
- There is resistant hypertension or low potassium.
Episodes of Headache, Palpitations or Sweating
What you'll notice or feel
- Sudden attacks of pounding headache.
- Palpitations, sweating or tremor.
- Blood pressure may rise markedly during attacks.
- Anxiety-like symptoms may occur.
Common causes
- Many common conditions can cause these symptoms.
- Rarely, a catecholamine-producing adrenal tumour such as pheochromocytoma.
What it could be
- A need to exclude pheochromocytoma when the clinical context or adrenal imaging suggests it.
- A cardiac, anxiety or thyroid cause if testing is negative.
Initial self-care
- Record blood pressure and pulse during an episode if safe.
- Avoid self-starting stimulants or decongestants if blood pressure is severely elevated.
- Seek specialist advice if an adrenal mass is present.
When to see a doctor urgently
- Chest pain, neurological symptoms, severe hypertension, fainting or collapse.
When to see a doctor
- Episodes are recurrent and dramatic.
- There is an adrenal mass.
- Hypertension is difficult to control.
Steroid Withdrawal or Sick-day Concerns
What you'll notice or feel
- Weakness, dizziness, nausea or body aches while reducing steroids.
- Concern about what to do during fever, vomiting or surgery.
- Long-term steroid use from tablets, injections or other preparations.
Common causes
- Chronic glucocorticoid exposure can suppress the body’s own cortisol production.
- Recovery of the adrenal axis can take time.
What it could be
- Glucocorticoid-induced adrenal suppression.
- Symptoms unrelated to adrenal function if testing is reassuring.
Initial self-care
- Never stop long-term steroids abruptly unless specifically instructed.
- Follow a clinician-supervised taper.
- People with confirmed adrenal insufficiency need written sick-day rules.
- Seek early help if vomiting prevents oral steroid use.
When to see a doctor urgently
- Vomiting with inability to keep steroid medication down, severe weakness, low blood pressure, confusion or collapse.
When to see a doctor
- You have been on substantial steroid treatment for weeks or longer and want to stop.
- Symptoms appear during tapering.
- Surgery or major illness is planned.
YOUR CONSULTATION
What to Expect at Your Visit
- Detailed review of steroid exposure, blood pressure, weight change, potassium/sodium results and adrenal imaging.
- Hormone tests are selected according to the suspected problem; indiscriminate cortisol testing can be misleading.
- Adrenal incidentalomas are assessed for both imaging risk and hormone secretion.
- Suspected adrenal insufficiency may require morning cortisol and dynamic testing.
- Cortisol excess is usually confirmed with more than one appropriate screening test.
- Management can involve hormone replacement, treatment of an underlying cause or multidisciplinary surgical review.
* IMPORTANT: A Note Before You Go
Adrenal hormone testing is highly context-dependent. Timing, medications and acute illness can alter results, so specialist interpretation is often important.
This page provides general educational information and cannot replace an individual medical assessment. If symptoms are persistent, worsening or concerning, arrange appropriate medical review.
NEED AN ASSESSMENT?
Arrange an Endocrinology Consultation
For non-emergency assessment or follow-up, appointments are booked through the hospital’s central appointment desk on 0422 432 4433. For severe or rapidly worsening symptoms, seek urgent medical care rather than waiting for a routine appointment.