Adrenal insufficiency results in low levels of certain hormones, including cortisol. This can impact blood sugar levels and cause hypoglycemia.
Many hormones in the body are responsible for several different bodily functions. As such, when a person has a health condition that reduces the amount of hormones they produce, it can disrupt the regulation of these processes.
For example, adrenal insufficiency can cause hypoglycemia, or low blood sugar levels. Additionally, severe hypoglycemia can be a symptom of an adrenal crisis, which can be a potentially life threatening medical emergency.
Adrenal insufficiency is a condition where the adrenal glands do not produce enough of certain hormones. The adrenal glands are small glands that sit above the kidneys and make hormones that affect many bodily functions. Adrenal insufficiency typically occurs following damage to the adrenal cortex.
Hypoglycemia describes low levels of blood sugar. All cells within the body require energy to function, and they usually receive their energy from glucose in the blood. However, not eating enough or experiencing hormonal problems can cause blood sugar levels to become too low.
Hypoglycemia most often occurs in people living with type 1 diabetes. However, it can also occur due to hormonal problems, such as adrenal insufficiency, as the adrenal glands produce hormones that can help regulate blood sugar levels.
There are different types of adrenal insufficiency:
- Primary adrenal insufficiency: Also known as Addison’s disease, this type occurs when the adrenal glands do not produce enough cortisol or aldosterone.
- Secondary adrenal insufficiency: This type occurs due to problems with the pituitary gland, meaning it does not signal the adrenal glands to produce cortisol.
- Tertiary adrenal insufficiency: This type occurs due to a problem with the hypothalamus. As a result, it does not act on the pituitary gland, which then does not act on the adrenal glands.
Evidence suggests that hypoglycemia occurs most commonly with secondary adrenal insufficiency, and also in children. A 2023 review suggests it may be more common in children as they have higher energy needs for growth and lower stores of glucose in their bodies.
The adrenal glands are responsible for producing many different hormones, including cortisol and aldosterone.
Cortisol
Insulin, a hormone produced by the pancreas, plays an important role in managing blood sugar levels. It allows glucose in the blood to enter cells, providing them with the energy to function.
Usually, the body will regulate and adjust the level of hormones to help maintain homeostasis, where conditions inside the body hold steady. For example, cortisol plays a role in regulating blood sugar levels.
When levels of insulin in the blood are too high, this can cause low blood sugar levels. In response, the body can release cortisol, which makes cells resistant to insulin and also enhances the production of glucose by the liver. As such, cortisol counterbalances the action of insulin.
However, if a person’s adrenal glands are unable to produce sufficient cortisol, this makes it more challenging for the body to raise blood sugar levels when they become too low.
In some cases, hypoglycemia may be an early symptom of adrenal insufficiency. For example, case studies of a
Additionally, a
Symptoms of hypoglycemia can include:
- sweating, chills, and clamminess
- confusion
- dizziness and lightheadedness
- sleepiness
- feeling weak
- nausea
- feeling shaky
- coordination problems
- feeling nervous or anxious
- irritability
- fast heartbeat
- hunger
- color draining from the skin
- blurry vision
- tingling or numbness
- headaches
- nightmares or crying out during sleep
- seizures, in some cases
Symptoms of adrenal insufficiency can include:
- muscle weakness
- fatigue
- weight loss
- decreased appetite
- lightheadedness and dizziness
- nausea
- vomiting
- abdominal pain
- diarrhea
- pain in the muscles and joints
- low blood pressure
- a craving for salt, in some cases
- skin discoloration
- irregular menstrual periods
Some people may not know they have adrenal insufficiency until they experience a sudden worsening of symptoms known as an adrenal crisis. Possible triggers of adrenal insufficiency
If a person experiences low blood sugar levels, they can follow the rule of 15. This describes a
If, after 15 minutes, blood sugars are still low, a person can repeat the steps until their blood glucose levels are within a typical range.
A person at risk of experiencing low sugar levels may wish to prepare a hypoglycemia emergency kit.
People can also use continuous glucose monitors (CGMs) to help manage their sugar levels and prevent hypoglycemia. A CGM is a wearable medical device that monitors blood glucose, allowing a person to quickly and easily check their blood sugar. They will also receive an alert if their blood sugar levels become too low.
Treatment for adrenal insufficiency will
For example, to replace cortisol, a doctor will prescribe a corticosteroid, such as hydrocortisone. A person will usually take this 2 to 3 times a day by mouth. In other cases, they may prescribe prednisone or dexamethasone. If the adrenal glands are not producing aldosterone, a doctor will prescribe fludrocortisone to help balance sodium and fluids in the body.
If a person is experiencing an adrenal crisis, they will receive an immediate intravenous (IV) injection of corticosteroids and large amounts of a salt and sugar solution.
Adrenal insufficiency can result in hypoglycemia. This is because adrenal insufficiency causes low levels of the hormone cortisol. This hormone plays an important role in regulating blood sugar levels, by making cells resistant to insulin when blood sugar levels get too low.
However, if the body is unable to produce sufficient cortisol, it may not be able to regulate blood sugar levels, resulting in hypoglycemia.