Adrenal insufficiency

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Adrenal insufficiency is caused by a deficiency of the hormone cortisol produced by the adrenal cortex. It is also called the stress hormone. Cortisol plays a role in the body’s response to stress and also regulates blood pressure and blood glucose levels. Patients with adrenal glands should not be taken lightly as the effects of a cortisol deficiency can be harmful.

The adrenal glands are located above the kidneys and play an important role in our body. In addition to cortisol, they produce aldosterone and dehydroepiandrostenedione. They are under the control of the pituitary gland. The pituitary gland produces ACTH, which is an adrenocorticotropic hormone that stimulates the secretion of cortisol by the adrenal glands.

Primary adrenal insufficiency

The primary hormone deficiency results from damage to the adrenal glands and is called Addison’s disease. It may be autoimmune. Damage to the adrenal glands can also occur as a result of malformations, cancer, inflammation, and as a result of long-term use of certain medications.

The most common symptom is very low blood pressure, which is associated with a tendency to faint and exercise intolerance. Weight loss is also very common, as is muscle and joint pain. There may be a characteristic darkening of the skin, mainly of the hands.

Secondary adrenal insufficiency

Deficiency of the pituitary hormone ACTH leads to secondary adrenal insufficiency. This may be due to damage or blockage of the pituitary gland, or due to autoimmune causes. The symptoms are very similar to primary adrenal insufficiency, but are less severe and the skin is very pale (even discolored on the hands). In addition to the above-mentioned causes, bacterial, viral and fungal infections, as well as some neoplasms or even haemochromatosis, can also lead to adrenal cortex diseases.

Symptoms

Symptoms usually only appear when about 90% of the adrenal cortex is destroyed. In people who are not exposed to greater mental and physical stress, the course may be mildly symptomatic or even asymptomatic. Under load, a so-called adrenal crisis can occur, which can lead to coma.

The main symptoms of adrenal insufficiency include:

  • weakness,
  • lack of appetite
  • weight loss
  • skin changes – darkening in the case of primary hypothyroidism and pale skin in the case of secondary hypothyroidism,
  • low pressure,
  • reduced glucose levels – hypoglycaemia,
  • stomach pain and nausea
  • desire to eat salty foods.

If you notice this type of symptoms, we invite you to our endocrinology clinic at the Medical Clinic Podhale Art in Zakopane for consultations with our endocrinologists.

Tests

For the diagnosis of adrenal insufficiency, the ACTH stimulation test is used, which measures the concentration of cortisol in the blood before and after the administration of ACTH. In primary hypothyroidism, the baseline concentration is reduced or normal, but does not increase after ACTH administration. On the other hand, in the case of secondary hypothyroidism, administration of ACTH results in an increase in blood cortisol levels.

Your doctor may also order MRI and CT scans to help detect cancer metastases. Immunological tests detect anti-adrenal antibodies, and an X-ray and ultrasound of the abdominal cavity can detect adrenal calcifications.

Treatment

Treatment of adrenal insufficiency depends on the form of adrenal insufficiency. In the primary form, glucocorticosteroids, mineralocorticosteroids or androgens are used, while in the secondary form, glucorticosteroids are the drug of choice. Additional treatment depends on the cause of the disease.

We cordially invite you to the endocrinology clinic at the Medical Clinic Podhale Art in Zakopane for endocrinology consultations and extended diagnostics.

Endocrinology consultations Zakopane – Specialist outpatient clinics Medical Clinic Podhale Art, Chramcówki 7, tel: +48 570 401 401

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