When people have adrenal insufficiency they must be sure to pay special attention to times of increased stress on the body such as those undergoing surgery, those suffering from an illness or severe injury, and those who are pregnant. Even taking part in strenuous sports or exercise or working night shifts can affect cortisol levels. Some of these types of stress would require additional treatment to recover including “stress” dosages of corticosteroids, which may be given either intravenously or orally. When the person recovers from the stress situation, they can usually return to their usual amounts of medications.
A medical history of the symptoms mentioned above, especially hyperpigmentation of the skin or gums, is often enough to raise a strong suspicion, prompting the appropriate tests. Quite often, however, the first clue is from the abnormal results of routine tests done in a hospital or doctor’s office. These may include an elevated blood level of potassium, a low blood level of sodium, a shift in the ratio of certain white blood cells, or surprising changes on an EKG or chest x-ray that are caused by high potassium or low blood volume. Other causes for these changes, particularly from medications, must be considered first.