The short answer
Immunotherapy works by loosening the brakes on the immune system, and sometimes the immune system turns on healthy glands. NCI says adrenal gland inflammation may cause fatigue, muscle weakness, loss of appetite, weight loss, and abdominal pain. These symptoms are vague and easy to blame on treatment, which is why they need reporting.
NCI says adrenal gland inflammation from immunotherapy may cause fatigue, muscle weakness, loss of appetite, weight loss, and abdominal pain.
The endocrine system is one of the organ systems NCI lists as able to be inflamed by immunotherapy.
Pituitary gland inflammation is the most common endocrine problem NCI describes, and may cause headaches and fatigue.
MedlinePlus describes adrenal insufficiency as the adrenal glands not producing enough hormones.
On this page
Choose how you want to read this
The whole article, with every detail and caution.
This page is for people getting immunotherapy and the people who care for them. It explains how immunotherapy can affect the adrenal glands, which symptoms to watch for, and when to get help.
When to get help
Call 911 or go to the nearest emergency department if someone on immunotherapy has difficulty breathing. Do the same if they become dizzy or lightheaded and cannot stay upright, or have a reduced level of consciousness. MedlinePlus lists these among the signs of adrenal crisis. It says to go to the nearest emergency room or call 911 if prescribed emergency medicine is not available.
- Call 911 or go to the nearest emergency department for sudden confusion or being hard to wake.
Call your care team right away about new or worsening fatigue or muscle weakness. Call about loss of appetite, unexplained weight loss, or abdominal pain while you are receiving immunotherapy. NCI lists exactly these as possible signs of adrenal gland inflammation. Tell whoever answers that you are on immunotherapy.
If you are also on chemotherapy or have low white blood cells, call right away, day or night. Call for chills, sore throat, mouth sores, burning when you urinate, redness at a catheter site, or any sign of infection. A normal temperature is not a reason to wait.
Why immunotherapy can hit a gland
Immunotherapy helps your immune system fight cancer. The trade-off: an active immune system can sometimes attack healthy tissue too.
NCI calls this inflammation. It lists where it can happen. These are the digestive system, the endocrine system, joints and muscles, the respiratory system, skin, blood, eyes, heart, kidneys, liver, and nervous system. The endocrine system means the hormone-producing glands. That includes the adrenal glands and the pituitary gland.
The symptoms can seem ordinary
Here is what NCI says adrenal gland inflammation may cause: "fatigue, muscle weakness, loss of appetite, weight loss, and abdominal pain."
Every item on that list is something a person having cancer treatment might feel anyway. That overlap is why it is easy to miss.
Do not filter your symptoms before you report them. Let the team decide what is ordinary.
The pituitary connection
NCI notes that pituitary inflammation (swelling and irritation of the pituitary gland) is the most common endocrine problem tied to this treatment. It may cause headaches and fatigue.
Either way, report the symptoms and let your care team work out the cause.
What happens when adrenal hormone levels are low
MedlinePlus explains that in adrenal insufficiency, the adrenal glands do not make enough hormones. Its list includes abdominal pain, ongoing diarrhea, and nausea and vomiting. It also lists darkening of the skin, extreme weakness and fatigue, low blood pressure, and salt craving.
The dangerous end of this is adrenal crisis. MedlinePlus describes it as abdominal pain, difficulty breathing, dizziness or lightheadedness, low blood pressure, and reduced level of consciousness. That is an emergency. Call 911 or go to the nearest emergency department. Do not wait to see if it passes.
What you can do
You are not being asked to diagnose yourself. You are being asked to notice a change and say so.
A useful habit is to describe things as differences, not labels. Try: "I am more tired than I was three weeks ago. I have stopped wanting food." That tells a nurse more than "I think I might have an endocrine problem."
Ask your team in advance which symptoms call for a phone call and which call for urgent care. NCI suggests asking this directly.
Common questions
How would I tell this apart from ordinary treatment tiredness?
Often you cannot, and that is the honest answer. NCI's list for adrenal inflammation — fatigue, muscle weakness, loss of appetite, weight loss, abdominal pain — overlaps heavily with how cancer treatment makes people feel anyway. That overlap is the reason to report the symptoms rather than to try to sort them out yourself.
What are the adrenal glands actually for?
MedlinePlus describes adrenal insufficiency as a disorder in which the adrenal glands do not produce enough hormones. Low levels can cause weakness, low blood pressure and feeling faint.
Does this mean immunotherapy has to stop?
That is a decision for your oncology team based on how you are and what the tests show, and it is not something an article can answer. NCI's advice is to ask your care team ahead of time what side effects to call about and which ones need urgent care.
Can this happen after treatment has finished?
NCI does not give a fixed window on this page, and instead lists it as something to ask about — specifically when side effects might start and how long they might last. Bring that question to your team rather than assuming the risk ends on your last infusion day.
Questions to ask your doctor
Being prepared helps you get the most out of your appointments. Save or print these questions.
Tap a question to save it to your list (kept on this device).
Your next step
Turn this topic into questions for your next appointment.
Talk with a trained specialist or navigator
Cancer Explained provides educational guidance, but does not replace trained specialists, social workers, or your medical team.
Talk to a trained cancer information specialist
Free, confidential assistance from NCI Cancer Information Service via phone, chat, or email.
Contact your oncology team
Locate after-hours contact numbers, portal messages, or urgent triage phone lines.
Find a patient navigator
Get one-on-one help with appointments, logistics, translation, and care coordination.
Find a genetic counselor
Discuss inherited mutation risk, family history, and genetic testing options.
Find an oncology social worker
Access emotional counseling, family support groups, and mental health resources.
Find a financial navigator
Locate copay assistance foundations, grant programs, and lodging/travel support.
Find a clinical-trial specialist
Search matching studies and speak with NCI trial information specialists.
Get urgent help
Fever of 100.4°F (38°C) or higher during chemo, severe pain, or trouble breathing: call your cancer care team right away, day or night. Call 911 for an emergency.
Know someone who needs this?
Plenty of people are looking for something like this and do not know where to start. If this would help a friend or someone you love, send it on — we have written an opening line so you do not have to stare at an empty message. You can change every word of it.
Your message is written and sent in your own email or messaging app — we never see who you send it to, and nothing is added to any list.
Plain-language explanation of the published sources cited on this page. AI-assisted, source-checked, not clinician-reviewed.
Sources last checked: 2026-08-11 what this meansLast updated: 2026-09-29Next planned review: 2027-08-11
Review details and limits
Cancer Explained does not originate medical claims. Every page restates guidance already published by the National Cancer Institute, the CDC, the USPSTF and the FDA, in plain language, with the source cited so you can check the original yourself. AI does the translating and organizing; automated checks test claims, citations, clarity and safety before anything publishes, and this is translation and navigation, not clinical judgment. Nothing here is personal medical advice, and no page can account for your particular situation.
Editorial status — Source checked. This page was written with AI assistance and then compared with the sources listed on it, looking for statements those sources do not back up. That check is not a sentence-by-sentence record and can miss errors. It is not a medical review, and it does not confirm the page is complete or right for your situation.
High-risk topic — talk to your care team. This topic can involve urgent, individual medical decisions. This page is general education only: it cannot tell you whether your situation is an emergency or what you personally should do. Follow your oncology team's instructions and contact them for individual guidance.
Human medical review: not completed. Pages here are not signed off by a clinician before they publish. That is not an oversight we are quietly working around: we restate published guidance and cite it, so the authority belongs to the source rather than to us, and every page names where its claims come from — you can verify us instead of trusting us. Where a volunteer clinician has reviewed a page, their name and credentials appear on it; where no name appears, no clinician has checked it. We are glad to have reviewers and are recruiting them, and we do not hold pages back waiting for one. Use this site to understand your situation and to ask better questions of the people treating you.
Words to know
Tap any term to see what it means.
How this page was created
Cancer Explained does not originate medical claims. Every page restates guidance already published by the National Cancer Institute, the CDC, the USPSTF and the FDA, in plain language, with the source cited so you can check the original yourself. AI does the translating and organizing; automated checks test claims, citations, clarity and safety before anything publishes, and this is translation and navigation, not clinical judgment. Nothing here is personal medical advice, and no page can account for your particular situation.
Editorial status: Source checked — This page was written with AI assistance and then compared with the sources listed on it, looking for statements those sources do not back up. That check is not a sentence-by-sentence record and can miss errors. It is not a medical review, and it does not confirm the page is complete or right for your situation.
Human medical review: not completed. Pages here are not signed off by a clinician before they publish. That is not an oversight we are quietly working around: we restate published guidance and cite it, so the authority belongs to the source rather than to us, and every page names where its claims come from — you can verify us instead of trusting us. Where a volunteer clinician has reviewed a page, their name and credentials appear on it; where no name appears, no clinician has checked it. We are glad to have reviewers and are recruiting them, and we do not hold pages back waiting for one. Use this site to understand your situation and to ask better questions of the people treating you.
Read more about our editorial process, our use of AI, and our corrections policy.
Spotted a problem? Report an error — a factual mistake, broken or outdated source, confusing wording, or anything that seems unsafe. Please do not include names, medical record numbers, dates of birth, addresses, or other identifying medical information in your report.
After using this page, do you understand what to do next?
Anonymous — we only record the answer, never who gave it.