Adrenal insufficiency
Adrenal insufficiency is a condition where the body cannot produce enough cortisol, the hormone that helps us deal with stress and inflammation. When cortisol levels are too low, symptoms like fatigue, low blood pressure, and low blood sugar can appear. In more severe cases, it is classified as a rare and intractable disease in Japan. Although there is no cure yet, daily life can be managed through cortisol replacement therapy.
Overview
Steroids are commonly used in medical treatment. They help reduce inflammation and suppress immune response, and are used for many different conditions. However, because of their powerful effects, they must be used carefully, as long-term or excessive use can lead to side effects.
A healthy body allows the adrenal glands to naturally produce cortisol — a steroid hormone that helps manage the body’s response to stress, exercise, illness, or injury. When this system works properly, we don’t need to think about it; the body simply adjusts automatically.
In adrenal insufficiency, that system no longer functions as it should. The body cannot produce enough cortisol to meet daily needs. It is a rare disorder, affecting only a few people per 100,000 in Japan, and is sometimes recognized as a designated intractable disease there. Since there is no curative treatment yet, patients manage their condition by replacing cortisol with medication.
Managing risks
If medication isn’t taken on time or if the body is under stress from illness, injury, or fatigue, it can lead to low blood pressure, low blood sugar, or an electrolyte imbalance. When that happens, vital organs — including the heart, lungs, and digestive system — may stop functioning correctly, which can cause an adrenal crisis and become life-threatening. Prompt supplements and quick treatment can save your life.
In situations where oral medication isn’t possible — such as when a person is unconscious or vomiting — cortisol must be given by injection or IV. That’s why patients are advised to carry an “adrenal emergency card” and a rescue medication kit, so healthcare providers can respond quickly in an emergency.
Cortisol levels are not easily checked with standard blood tests, and if a patient loses consciousness, medical staff might not immediately recognize an adrenal crisis. That’s why the emergency card is a vital lifeline for people living with adrenal insufficiency.
Living with the condition
Cortisol levels naturally vary with activity, stress, and temperature, which makes dosage adjustments complicated. Even minor changes — such as heat, cold, or overexertion — can affect well-being.
Many people with adrenal insufficiency look healthy on the surface, but even a small amount of physical or emotional stress can quickly cause exhaustion. The ability to do things can change a lot from day to day.
Challenges
Low cortisol levels can trigger an adrenal crisis. On the other hand, excessive medication can weaken the immune system and upset the body’s natural rhythm. Finding the right balance — not too much, not too little — is the most challenging part of treatment.
Maintaining health with this condition requires careful daily adjustments. It’s like trying to fill an invisible gas tank — you don’t know how much is left, but you need to fill it just enough without spilling over. That delicate balance is something each patient learns to manage step by step in daily life.