Adrenal insufficiency refers to a condition where the adrenal glands do not produce sufficient amount of cortisol or aldosterone hormone. Adrenal glands are two small glands about the size of an almond located on the top of the two kidneys. Adrenal insufficiency is also referred to as Addison’s disease. Adrenal insufficiency is not a common condition to occur, it is a rare condition. Adrenal insufficiency can affect about 2-4 people in 10,000 people worldwide. This condition was first discovered by a doctor called Dr. Thomas Addison, hence the name. He discovered this condition first in the year 1849.
The two hormones, the cortisol and the aldosterone hormone play an important role in the body. The main functions of cortisol are as follows:
-cortisol hormone basically helps to counter act stress in the body.
-maintaining the normal levels of blood sugar and blood pressure in the body.
-brings about the protein, carbohydrate and fat metabolism in the body.
The main function of aldosterone is the maintenance of the fluid and electrolyte balance in the body. It also helps to main normal blood pressure in the body.
Adrenal insufficiency can be of two types:
A) Primary adrenal insufficiency:
Primary adrenal insufficiency occurs due to a defect seen in the adrenal gland itself.
B) Secondary adrenal insufficiency:
Secondary adrenal insufficiency arises when the primary defect lies in the pituitary gland. The pituitary gland is responsible for the production of the ACTH hormone which then stimulates the adrenal gland for the production of the two hormones. Sometime in conditions such as tumors in the pituitary region or any kind of surgery or any defect in the brain area which affects the pituitary is responsible for the secondary adrenal insufficiency.
In most cases, adrenal insufficiency arises due to an autoimmune response in the body. This causes the body to act against its own adrenal glands in the body. Due to this kind of an autoimmune response the glands fail to function properly.
Adrenal insufficiency may also occur in cases of trauma to the adrenal glands.
-conditions like tuberculosis, fungal infections and even cancer can prevent the adrenal glands to function properly.
-adrenal insufficiency also is seen to occur in some individuals after surgery.
Symptoms of adrenal insufficiency:
-hyper pigmentation of the skin
-extreme weakness accompanied by fatigue
-desire for salty food increases
-lack of appetite
-nausea and vomiting
-gradual weight loss
-frequent fainting attacks which is mainly due to low blood pressure
-the blood sugar levels are below normal
-changes in the bowel movements, either constipation or diarrhea
The diagnosis of adrenal insufficiency starts with taking a proper medical history. To treat adrenal insufficiency it is important to know the causative factor for the condition. Cortisol levels in the blood and urine should be checked for. Blood samples should be collected and studied. Other diagnostic tests such as CT and MRI scans should be taken and studied.
Hormone replacement therapy is usually done to treat adrenal insufficiency. The cause is treated first. Hydrocortisone and fludrocortisones are used in hormone replacement therapy. The dose varies depending on the severity of the condition.
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