Symptom | Frequency (%) |
Weakness, tiredness, fatigue | 100 |
Anorexia | 100 |
Gastrointestinal symptoms | 92 |
Nausea | 86 |
Vomiting | 75 |
Constipation | 33 |
Abdominal pain | 31 |
Diarrhea | 16 |
Salt craving | 16 |
Postural dizziness | 12 |
Muscle or joint pains | 6 to 13 |
Sign | |
Weight loss | 100 |
Hyperpigmentation | 94 |
Hypotension (systolic BP <110 mmHg) | 88 to 94 |
Vitiligo | 10 to 20 |
Auricular calcification | 5 |
Laboratory abnormality | |
Electrolyte disturbances | 92 |
Hyponatremia | 88 |
Hyperkalemia | 64 |
Hypercalcemia | 6 |
Azotemia | 55 |
Anemia | 40 |
Eosinophilia | 17 |
BP: blood pressure.
*Patients with central adrenal insufficiency due to chronic, supraphysiologic glucocorticoid exposure do not develop symptoms of adrenal insufficiency until the glucocorticoid dose is reduced or treatment is discontinued. In this setting, some physical features and symptoms may suggest hypercortisolism (eg, central obesity, skin atrophy). However, gastrointestinal, muscle, and joint symptoms are usually consistent with adrenal insufficiency.