In acute adrenal failure occurring de novo (e.g. as with a septicaemia), the patient will not be pigmented and the symptoms will usually be weakness, malaise, nausea (often with vomiting), and non-specific or vague epigastic abdominal pain associated with constipation or diarrhoea. A cardinal physical sign is postural hypotension.
In chronic adrenal insufficiency, many of the same features are present, but the presentation is much more vague.
