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.
The adrenal gland produces hormones that affects growth, development and stress, and also helps to regulate kidney function. There are two parts of the adrenal glands, the adrenal cortex and the adrenal medulla. The adrenal cortex produces mineralocorticoids , which regulate salt and water balance within the body, glucocorticoids (including cortisol ) which have a wide number of roles within the body, and androgens , hormones with testosterone-like function.  The adrenal medulla produces epinephrine (adrenaline) and norepinephrine (noradrenaline).  Disorders of the adrenal gland may affect the production of one or more of these hormones.
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The clinical pathways are based upon publicly available medical evidence and/or a consensus of medical practitioners at The Children’s Hospital of Philadelphia (“CHOP”) and are current at the time of publication. These clinical pathways are intended to be a guide for practitioners and may need to be adapted for each specific patient based on the practitioner’s professional judgment, consideration of any unique circumstances, the needs of each patient and their family, and/or the availability of various resources at the health care institution where the patient is located.
Accordingly, these clinical pathways are not intended to constitute medical advice or treatment, or to create a doctor-patient relationship between/among The Children’s Hospital of Philadelphia (“CHOP”), its physicians and the individual patients in question. CHOP does not represent or warrant that the clinical pathways are in every respect accurate or complete, or that one or more of them apply to a particular patient or medical condition. CHOP is not responsible for any errors or omissions in the clinical pathways, or for any outcomes a patient might experience where a clinician consulted one or more such pathways in connection with providing care for that patient.