Adrenal Insufficiency: Causes, Symptoms and Treatments

The adrenal glands help the body deal with stress and illness by producing the steroids, cortisol and aldosterone. When you have adrenal insufficiency (also called hypocortisolism), your adrenals cannot make enough of these steroids. This leads to altered electrolyte levels, mainly potassium and sodium. Many people with this disorder lose a lot of sodium in their urine and crave salty foods. One known condition is Addison's disease, which is a congenital form of adrenal hyperplasia and insufficiency.

What Causes It?

The adrenal glands are two tiny endocrine organs on the top of the kidneys. When they don't release enough hormones, it results in insufficiency. Causes vary depending on the type, either primary or secondary.

Primary Adrenal Insufficiency

Also known as Addison's disease, the adrenal glands are unable to produce adequate amounts of cortisol. There may also be low levels of aldosterone. There are approximately 110 to 144 people out of 1 million with Addison’s disease.

Secondary Adrenal Insufficiency

This form is not actually caused by malfunctioning adrenal glands. The cause is actually in the pituitary gland. The pituitary gland lies at the base of the brain and produces adrenocorticotropin (ACTH). ACTH triggers the adrenal glands to make and release cortisol. If the adrenal glands are not stimulated, they begin to shrink.

Secondary insufficiency is actually more common than primary.  

What Are the Symptoms of Adrenal Insufficiency?

The symptoms aren’t very specific in the early stages and often ignored. Symptoms include:

If you have any of the above symptoms, see your doctor. They will perform a thorough physical and have your blood levels of cortisol checked. There is also imaging tests of the pituitary and adrenal glands to look for any irregularities.

How Is It Treated?

Note: An adrenal crisis is a medical emergency. If you or someone you know has adrenal insufficiency and has nausea, vomiting, and weakness, get to a hospital right away. An adrenal crisis can be fatal if not treated. The treatment for an adrenal crisis is a cortisol injection right away. People with known Addison's disease may have an injection pen on them for use in emergencies.

The best way to complement your doctor’s recommended treatment is to make healthy lifestyle changes that support healthy adrenal gland function. These lifestyle changes include:

Prognosis for Adrenal Insufficiency

If you follow your doctor’s recommendation for treatment, the prognosis is very good. If Addison’s disease is left untreated, the outcome could be fatal. One complication to look out for is that intestinal perforation or sepsis can occur if the body has too high a cortisol level.

In adrenal crisis, death can occur from low blood pressure or arrhythmia due to the potassium levels being too high. Immediate steroid hormone replacement is needed in an emergency room setting. 

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