Secondary Adrenal Insufficiency: A Case Report

A 65-year-old male with symptoms of nausea, vomiting, hypotension, hypoglycemia, abdominal pain, fatigue, weight loss, sweating, hair loss, shortness of breath, and bilateral breast pain was diagnosed with secondary adrenal insufficiency. Despite high stress, his cortisol levels were immeasurably low, and he had a history of hypothyroidism and unexplained fatigue. After treatment with cortisol, his condition significantly improved within one month. This case highlights the importance of considering adrenal insufficiency in patients with unexplained fatigue, weight loss, and muscle weakness, as it can lead to an adrenal crisis if not promptly identified. Laboratory findings supported the diagnosis, showing hyponatremia, normal urine sodium and osmolality, low morning serum cortisol, and borderline low ACTH, indicating a secondary cause of adrenal insufficiency.