I don’t like the term "adrenal crisis," at all, because it is so subjective and non-specific.  As a result, it seems to mean something different to everyone.  To me, it helps to think of the things that happen in the body physically, when one is in a state of "crisis."

 

Basically, an adrenal crisis is when you develop one (or more) of the following three things, as a result of the lack of adrenal hormones: 1) hypoglycemia (low blood sugar) 2) electrolyte abnormalities 3) poor blood circulation. 

 

• When you have CAH, problem # 1---hypoglycemia---is generally caused by the lack of cortisol.  Signs of hypoglycemia are fatigue, lethargy, dizziness, and headache.

 

• Problem #2---electrolyte abnormalities---occurs when your salt and fluid levels get out of whack.  In someone with CAH, this usually occurs when your body becomes dehydrated---or loses more than the usual amount of fluids---due to situations such as fever, vomitting, and/or diarrhea.

 

        In CAH, electrolyte abnormalities usually involve abnormally low sodium levels and/or abnormally high potassium levels.              (Sodium and potassium are both electrolytes, along with calcium, magnesium, bicarbonate, etc.) 

 

        - Low sodium levels in the blood is called "hyponatremia."  Symptoms of hyponatremia are lethargy and mental confusion.  

 

        -  High potassium levels in the blood is called "hyperkalemia." A symptom of hyperkalemia is an irregular heartbeat. 

 

• Problem #3---poor blood circulation---results when the amount of fluid in your bloodstream gets too low---again, usually due to dehydration.  Symptoms of poor blood circulation are low blood pressure, dizziness, a disproportionate increase in heartrate and pulse when you get stand up, flat or collapsing veins.  Because cortisol is also important in maintaining blood vessel tone, low cortisol levels can also result in poor blood circulation. 

 

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Anyway, hope this helps somewhat, and is not too wordy.