Adrenal Crisis Causes Death in Some People Who Were Treated With hGH

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Health Alert: Adrenal Crisis Causes Death in Some People Who Were Treated

With hGH

http://www.endocrine.niddk.nih.gov/pubs/creutz/alert.htm

Recently, doctors conducting the follow-up study of individuals treated with

hGH looked at causes of death among recipients and found some disturbing

news. Many more people have died from a treatable condition called adrenal

crisis than from CJD. This risk does not affect every recipient. It can

affect those who lack other hormones in addition to growth hormone. Please

read on to find out if this risk applies to you. Death from adrenal crisis

can be prevented.

Adrenal crisis is a serious condition that can cause death in people who

lack the pituitary hormone ACTH. ACTH is responsible for regulating the

adrenal gland. Often, people are unaware that they lack this hormone and

therefore do not know about their risk of adrenal crisis.

Most people who were treated with hGH did not make enough of their own

growth hormone. Some of them lacked growth hormone because they had birth

defects, tumors or other diseases that cause the pituitary gland to

malfunction or shut down. People with those problems frequently lack other

key hormones made by the pituitary gland, such as ACTH, which directs the

adrenal gland to make cortisol, a hormone necessary for life. Having too

little cortisol can be fatal if not properly treated.

Treatment with hGH does not cause adrenal crisis, but because a number of

people lacking growth hormone also lack ACTH, adrenal crisis has occurred in

some people who were treated with hGH. In earlier updates we have talked

about how adrenal crisis can be prevented, but people continue to die from

adrenal crisis, which is brought on by lack of cortisol. These deaths can be

prevented. Please talk to your doctor about whether you are at risk for

adrenal crisis.

Why should people treated with hGH know about adrenal crisis? Among the

people who received hGH, those who had birth defects, tumors, and other

diseases affecting the brain lacked hGH and often, other hormones made by

the pituitary gland. A shortage of the hormones that regulate the adrenal

glands can cause many health problems. It can also lead to death from

adrenal crisis. This tragedy can be prevented.

What are adrenal hormones? The pituitary gland makes many hormones,

including growth hormone and ACTH, a hormone which signals the adrenal

glands to make cortisol, a hormone needed for life. If the adrenal gland

doesn't make enough cortisol, replacement medications must be taken. The

most common medicines used for cortisol replacement are:

Hydrocortisone

Prednisone

Dexamethasone

What is adrenal crisis? Adrenal hormones are needed for life. The system

that pumps blood through the body cannot work during times of physical

stress, such as illness or injury, if there is a severe lack of cortisol (or

its replacement). People who lack cortisol must take their cortisol

replacement medication on a regular basis, and when they are sick or injured

they must take extra cortisol replacement to prevent adrenal crisis. When

there is not enough cortisol, adrenal crisis can occur and may rapidly lead

to death.

What are the symptoms of lack of 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

When someone with adrenal gland problems has weakness, nausea, or vomiting,

that person needs immediate emergency treatment to prevent adrenal crisis

and possible death.

• Why are adrenal hormones so important? Cortisol (or its replacement)

helps the body respond to stress from infection, injury, or surgery. The

normal adrenal gland responds to serious illness by making up to 10 times

more cortisol than it usually makes. It automatically makes as much as the

body needs. If you are taking a cortisol replacement drug because your body

cannot make these hormones, you must increase the cortisol replacement drugs

during times of illness, injury, or surgery. Some people make enough

cortisol for times when they feel well, but not enough to meet greater needs

when they are ill or injured. Those people might not need cortisol

replacement every day but may need to take cortisol replacement medication

when their body is under stress. Adrenal crisis is extremely serious and can

cause death if not treated promptly. Discuss this problem with your doctor

to help decide whether you 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, the hormones can be given

as an injection. Getting an injection of adrenal hormones can save your life

if you are in adrenal crisis. If you lack the ability to make cortisol

naturally, you should carry a medical ID card and wear a Medic-Alert

bracelet to tell emergency workers that you lack adrenal hormones and need

treatment. This precaution can save your life if you are sick or injured.

• How can I prevent 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. Make sure you have a

hydrocortisone injection with you at all times, and make sure that you and

those around you (in case you're not conscious) know how and when to

administer the injection.

• Carry a medical ID card and wear a bracelet telling emergency workers

that you have adrenal insufficiency and need cortisol. This way, they can

treat you right away if you are injured.

Remember: Some people who lacked growth hormone may also lack cortisol, a

hormone necessary for life. Lack of cortisol can cause adrenal crisis, a

preventable condition that can cause death if treated improperly . Deaths

from adrenal crisis can be prevented if patients and their families

recognize the condition and are careful to treat it right away. Adrenal

crisis is a medical emergency. Know the symptoms and how to adjust your

medication when you are ill. Taking these precautions can save your life.

More links

Health Alert: Adrenal Crisis Causes Death in Some People Who Were Treated

With hGH

http://www.hghstudy.com/health_alert2.html

National Hormone and Pituitary Program: Information for People Treated with

Human Growth Hormone (Comprehensive Report)

http://endocrine.niddk.nih.gov/pubs/creutz/updatecomp.htm