Patients who have adrenal insufficiency have a severe or total deficiency in hormones produced by the adrenal cortex. Adrenal hormones, which include cortisol and aldosterone, are important chemicals the body needs to function correctly. Some of the roles cortisol and aldosterone play include regulating the following:
- Blood pressure
- Metabolism, which is the way the body uses digested food for energy
- Stress response (fight or flight)
An additional adrenal hormone, dehydroepiandrosterone (DHEA), produces androgens and estrogens, which are important sex hormones.
Types of Adrenal Insufficiency
Primary adrenal insufficiency is also known as Addison’s Disease. Addison’s Disease occurs when the adrenal glands are damaged, whether through autoimmune disorders, infection, or medication, and cannot produce cortisol.
Secondary adrenal insufficiency occurs when the pituitary gland fails to produce the hormone that activates the adrenal glands. The pituitary is a small gland in the brain responsible for producing adrenocorticotropin (ACTH); without ACTH the adrenal glands will not produce cortisol, and they may even shrink, further limiting their effectiveness.
Congenital Adrenal Hyperplasia (CAH) is a genetic disorder that affects the adrenal glands, and is a type of secondary adrenal insufficiency. In CAH, the pituitary gland releases excess ACTH because the kidneys aren’t producing enough cortisol. This leads to an overabundance of androgens, or masculinizing steroid hormones, and this affects puberty and growth in children, and causes infertility.
Adrenal insufficiency disorders are usually treatable with medications, but they have serious health consequences, including:
- Chronic fatigue
- Muscle weakness
- Lack of appetite
- Weight loss
- Abdominal pain
- Nausea and vomiting
- Low blood pressure, resulting in lightheadedness when standing up
- Irritability and depression
- Fertility issues
Adrenal insufficiency can worsen suddenly, causing adrenal crisis. Adrenal crisis is a serious, life-threatening condition. An adrenal crisis can be triggered by severe stress, because stress creates a need for cortisol in the body. The symptoms of an adrenal crisis include severe pain, especially in the lower back, abdomen, or legs; severe vomiting and diarrhea; dehydration; low blood pressure; and loss of consciousness. A person in adrenal crisis should seek immediate medical treatment.
Patients with primary or secondary adrenal insufficiency can take oral medications like hydrocortisone, prednisone, or dexamethasone several times a day to replace cortisol and fludrocortisone acetate to replace aldosterone. A patient in adrenal crisis can be treated with Solu-Cortef, administered intramuscularly or intravenously. Learn how to administer these medications with Demo Dose® Simulated prednisone and Solu-Cortf.