Hydrocortisone emergency in pituitary patients: adrenal/addisonian crisis

The Pituitary Foundation is a national charity, which started 18 years ago and covers the United Kingdom and Republic of Ireland. Our services include offering support and information to those people who have pituitary conditions and their families. We provide services to those with acromegaly, Cushing's disease, prolactinoma, diabetes insipidus, craniopharyngioma plus other rarer pituitary conditions. Many pituitary patients, no matter which particular condition they have, take hydrocortisone as a replacement hormone. The Pituitary Foundation raises much awareness and education around hydrocortisone, for patients and clinicians, as this vital stress hormone can require prompt adjustment and monitoring in cases of emergency.

Hydrocortisone is a steroid hormone produced by the adrenal gland. A good majority of people with pituitary conditions have to take replacement hydrocortisone daily as they don't produce this naturally. The condition is referred to as a secondary adrenal insufficiency.

If any person became ill or were to suffer severe shock, the body would naturally increase the output of cortisol from the adrenals. However, people who need to take replacement hydrocortisone have to increase their ‘chemical' dose to help mimic the cortisol surge they don't naturally have.