Adrenal Crisis

Adrenal Crisis Death in People Who Got hGH

Adrenal crisis is a preventable cause of death in people who have been treated with hGH. Many of these people do not know about their risk of adrenal crisis, though it has caused more deaths than CJD.

Most people who received hGH lack growth hormone. They may also lack other key hormones made by the pituitary gland. Having too little of these hormones can be fatal if not properly treated. Earlier updates have talked about how adrenal crisis can be prevented, but deaths have still occurred. Please talk to your doctor about whether you are at risk for adrenal crisis.

• Why should people treated with hGH know about adrenal crisis? Many people who received hGH had tumors, birth defects, and other diseases affecting the brain. These problems led to a shortage of hGH and, often, of other hormones made by the pituitary gland. A shortage of hormones that regulate the adrenal glands can cause many health problems. This shortage can also lead to death from adrenal crisis.



• What is adrenal crisis? Adrenal hormones are needed for life. The system that pumps blood throughout the body cannot work if there is a severe lack of cortisol or its replacement. Death can be very fast if there is too little adrenal hormone to help the body respond to illness, injury or other stress. People taking cortisol replacements must increase their hydrocortisone, prednisone, or dexamethasone when they are sick or injured to prevent adrenal crisis.



• What are adrenal hormones? The same gland that makes growth hormone signals the adrenal glands to make cortisol, a hormone needed for life. If your adrenal gland doesn't make enough cortisol, you need to take medicines to replace it. The usual replacement medicines are:
  • Hydrocortisone.
  • Prednisone.
  • Dexamethasone.
• What are the symptoms of insufficient adrenal hormones? If you don't have enough cortisol or its replacement, you may have some of these problems:
  • feeling weak
  • feeling tired all the time
  • feeling sick to your stomach
  • vomiting
  • no appetite
  • weight loss

• Why are adrenal hormones so important? Cortisol or adrenal replacement medicines help the body respond to stress from infections, injury, or surgery. The normal adrenal gland responds to serious illness by making up to 10 times more cortisol than normal. It automatically makes as much as the body needs. If you take an adrenal replacement drug because your body cannot make these hormones, you must increase the drug when you are sick. Some people make enough cortisol for times when they feel well, but not enough to meet greater needs when they are ill or injured. Adrenal crisis is extremely serious and can cause death if not treated promptly. You should discuss this problem with your doctor to help decide whether you may need more medication or other treatment to protect your health.



• How is adrenal crisis treated? People with adrenal crisis need immediate treatment. Any delay can cause death. When people with adrenal crisis are vomiting or unconscious and cannot take medicine, it can be given as an injection. Getting an injection of adrenal hormones can save the life of someone with adrenal crisis. Wearing a tag or ID to tell emergency workers you lack adrenal hormones and need treatment can save your life if you are injured.



• How can I avoid adrenal crisis?
  • If you are always tired, feel weak, and have lost weight, ask your doctor if you might have a shortage of adrenal hormones.
  
  
  
  • If you take hydrocortisone, prednisone, or dexamethasone, learn how to increase the dose when you become ill.
  
  
  
  • If you are very ill, especially if you are vomiting and cannot take pills, seek emergency medical care immediately.
  
  
  
  • Carry a medical ID card or bracelet telling emergency workers that you need adrenal hormones so they can treat you right away if you are injured.

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