13-07-2025
How Malaysia's heat affects people with adrenal insufficiency
Malaysia's tropical climate, marked by scorching heat, relentless humidity and sudden downpours, is more than just uncomfortable.
For individuals living with adrenal insufficiency, these environmental extremes can severely impact their health, intensifying risks like dehydration and heat stress that strain the body's ability to function normally.
Sunway Medical Centre Consultant Endocrinologist and Diabetes and Internal Medicine Specialist Dr Lim Chong Wei explains on how Malaysia's weather patterns can complicate adrenal disorders and debunks common myths about this often-overlooked condition.
Often referred to as the body's hormonal control centres, the adrenal glands sit atop each kidney and are responsible for producing key hormones.
As Dr Lim explains, these hormones regulate vital functions such as blood pressure and the body's stress response which are essential to overall health.
'The adrenal glands produce essential hormones like cortisol, noradrenaline and adrenaline, which play a vital role in maintaining blood pressure within a healthy range. When the body lacks sufficient cortisol, an individual's blood pressure may drop," he said in a statement.
Adrenal insufficiency, he says, arises when these glands fail to produce enough of these critical hormones.
"The condition commonly affects people between the ages of 30 and 50, and it is usually associated with autoimmune conditions like type one diabetes, coeliac and thyroid disorder," he added.
However, he noted that other environmental factors like tuberculosis (TB), human immunodeficiency virus (HIV) and fungal infection may contribute to this condition in any age group.
Malaysia's hot and humid weather doesn't just cause discomfort, it also makes diagnosing adrenal insufficiency more difficult.
Many symptoms, such as exhaustion and poor focus, can easily be mistaken for common side effects of heat or stress.
Dr Lim notes that this overlap complicates early detection.
"Environmental stressors, including dehydration and poor concentration, often mask the symptoms of adrenal insufficiency.
"Compounding this challenge, the symptoms of adrenal insufficiency are non-specific and include weight loss, nausea, vomiting, abdominal discomfort, fatigue and confusion, making it difficult to distinguish between general fatigue and a more serious underlying adrenal issue," he said.
He stressed that persistent symptoms should not be ignored, urging individuals to consult medical professionals for proper assessment and testing. Malaysia's hot and humid weather doesn't just cause discomfort, it also makes diagnosing adrenal insufficiency more difficult. Photo illustrated by Sinar Daily.
How do individuals diagnose Adrenal Disorders?
According to Dr Lim, adrenal disorders can be difficult to pinpoint without specific testing because their symptoms overlap with those of other health issues.
One of the key diagnostic tools used is the Short Synacthen Test. Dr Lim further explained on how this test works to confirm adrenal function.
"This test involves administering synthetic ACTH to stimulate the adrenal glands. The adrenal glands fail to produce adequate cortisol in response to this stimulation for those with adrenal insufficiency," he said.
While adrenal disorders aren't curable, Dr Lim said they can be managed, especially with a focus on hydration, which becomes even more important in a hot and humid environment like Malaysia.
"Ideally, everyone should carry a bottle of water with them and ensure they stay hydrated, especially in hot and humid conditions,' he recommended.
He also warns about the seriousness of untreated adrenal insufficiency, which can lead to an adrenal crisis, a potentially fatal emergency.
'Without treatment, adrenal insufficiency can lead to life-threatening adrenal crises, where the body's inability to produce sufficient hormones results in fatal outcomes.
"It will then become a medical emergency, and patients would require urgent hydrocortisone. Patients may be in a comatose state, and without treatment, up to 20 per cent of people in shock may die from an adrenal crisis," he said.
Clearing the air on misconceptions
Myths surrounding adrenal disorders can prevent people from seeking or following through with the right treatment.
One widespread misconception is that adrenal function can return after a diagnosis of primary adrenal failure.
"Primary adrenal failure is irreversible, and the adrenal glands do not regain their ability to produce hormones.
"However, in cases of secondary adrenal insufficiency, there is a small chance about one in six that adrenal function may recover, which can take up to five years," he noted.
According to Dr Lim, another dangerous myth is treating hydrocortisone as just another over-the-counter supplement.
'Hydrocortisone is not a simple supplement. It is a life-saving medication that replaces the hormones the body can no longer produce, essential for regulating blood pressure and responding to stress. Patients should never discontinue its use without consulting their healthcare provider," he said.
