Adrenal insufficiency is a medical problem characterized by inadequate secretion of steroid hormones by the adrenal glands. Treatment involves replacing and substituting the hormones that are deficient in the body. Details follow…
The adrenal glands are one of the crucial endocrine glands located on the top portion of each kidney. Their main function is to secrete steroid hormones (specifically cortisol and aldosterone) and release them to the bloodstream, which are then distributed to other parts of the body. Adrenal insufficiency is a health condition in which these glands do not produce adequate amounts of steroid hormones as required by the body. Symptoms may vary from one patient to another, based on which related treatment is provided.
Causes and Symptoms
Both genetic and environmental factors play a major role in causing adrenal insufficiency. Depending upon the underlying cause, it is divided into two types―primary and secondary adrenal insufficiency. In the former type, the adrenal glands are affected directly due to tumors, an autoimmune disease or idiopathic causes. Whereas, in the secondary type, the pituitary gland or the hypothalamus are affected, resulting in abnormal production of hormones that control the adrenal gland function.
When we talk about insufficiency, Addison’s disease is the most serious condition that causes life-threatening symptoms like kidney failure and adrenal crisis or acute adrenal failure (at times of injury or extreme stress). Some of the notable symptoms include:
- Increased fatigue
- Loss of appetite
- Changes in mood and disorientation
- Low sugar level (hypoglycemia)
- Low blood pressure (hypotension)
- Muscle pain
- Weight loss
Diagnosis and Treatment
As these symptoms mimic other health conditions, it is difficult to diagnose it in the early stages. After examining the manifested symptoms and medical history of the patient, the physician may conduct an adrenal insufficiency test, called ACTH stimulation test, to check the level of blood cortisol and urine cortisol. If the test result is not abnormal, a CRH stimulation test is done.
As of now, there is no cure for this condition. This is primarily because the underlying cause of the disease is usually serious and cannot be reversed. Nevertheless, there are effective methods for controlling the symptoms and the associated health complications. Treatment is mainly focused on replacing or substituting the hormones that the adrenal glands do not produce or produce in less amounts.
Patients of secondary adrenal insufficiency experience reduced levels of cortisol, but a normal adolsterone level. For replacing the cortisol hormone, oral medication formulated with hydrocortisone, dexamethasone or prednisone are usually prescribed. The patient has to be administered a specific dosage of this synthetic glucocorticoid, at least once or twice per day. In case of an adrenal crisis emergency, hydrocortisone or other glucocorticoid injections are delivered intravenously.
In case the diagnostic result shows Addison’s disease or very low levels of adolsterone, the physician may prescribe oral medication doses containing fludrocortisone acetate. This aids in maintaining the blood pressure to normal level by regulating the amount of salt excretion. Patients who receive medication for low adolsterone should increase the dietary salt intake, as per the guidelines of the doctor.
Other than the therapeutic treatments for regulating the hormonal level, the physician may recommend medication for combating the symptoms of adrenal insufficiency. It is highly possible that a patient suffering from this condition would need to be administered medication throughout his or her life. But, with regular monitoring and treatment, one can lead a healthy and normal life.
Disclaimer: This HealthHearty article is for informative purposes only, and should not be replaced for the advice of a medical professional.