Adrenal Insufficiency (Addison’s Disease): Causes, Symptoms & Treatment

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Adrenal InsufficiencyThe human body is an amazing piece of biological machinery. You have so many different organs, glands, and systems working together to allow the body to do everything that it does during an average day.

So, when something goes wrong with one piece, it can be like putting something in between a set of gears in a clock. For example, if your adrenal gland becomes damaged and you start suffering from an adrenal insufficiency.

In this article, we will cover adrenal gland insufficiency also known as Addison’s disease, and let you in on everything that occurs when your adrenal gland stops working properly. By the time you finish reading this article, you will know about the different types of adrenal insufficiency, including secondary adrenal insufficiency. You will learn about symptoms of adrenal insufficiency and adrenal insufficiency treatment. Consider this your complete guide to adrenal gland insufficiency and your body.

Causes of Adrenal Insufficiency

What exactly is adrenal insufficiency or what is Addison’s disease? What causes it?

Adrenal insufficiency results when the adrenal glands stop producing the following hormones:

1. Cortisol

Helps maintain blood pressure and blood vessel function, as well as regulates your metabolism and immune system’s inflammatory response

2. Aldosterone

Helps to balance of sodium and potassium in the blood stream

3. Dehydroepiandrosterone

An important part of making the sex hormones, androgen, and estrogen).

A few different factors can cause adrenal insufficiency:-

1. Infections

Some infections can cause damage to the adrenal glands. Common examples include cytomegalovirus, fungal infections, and tuberculosis.

2. Autoimmune Disorders and Diseases

Autoimmune disorders and diseases can lead to damage of the adrenal glands to the extent that they are not functioning.

3. Medications

Medications like antifungal medications and the anesthetic etomidate can cause the adrenal glands to slow hormone production.

4. Cancer

Cancer that spreads to the adrenal glands can cause issues with hormonal production.

The above are the basic causes of primary adrenal insufficiency, but there are a few other additional causes for secondary adrenal insufficiency.

5. Medications

Medications for asthma and arthritis have been known to cause secondary adrenal insufficiency. In addition to those, someone who suddenly stops taking corticosteroids can trigger secondary adrenal insufficiency.

6. Pituitary Gland Issues

Issues with your pituitary gland including disease and infection can also trigger secondary adrenal insufficiency.

Unfortunately, there are two different types of adrenal insufficiency that come with slightly different issues, but there are enough differences that the two can be separated.

Primary and Secondary Adrenal Insufficiency

When dealing with adrenal insufficiency, it’s very important to know that there are two different types. There is primary adrenal insufficiency and secondary insufficiency. Both are due to two very different things.

Primary adrenal insufficiency is due to issues with the adrenal gland itself. As we noted in the causes, this could be anything from infections and disease to medication use. Secondary adrenal insufficiency, on the other hand, has a very different issue as it’s root cause.

Secondary adrenal insufficiency results when something goes wrong with your pituitary gland. The pituitary gland makes a hormone called adrenocorticotropic hormone (ACTH). ACTH is the hormone that tells the adrenal cortex to produce other hormones. So, if the pituitary gland has an interference with something like an infection, disease, or medication, it may produce less ACTH. As a result, the adrenal gland produces fewer hormones, despite the fact that there is nothing actually wrong with the adrenal gland itself.

It’s important to remember that there are two different causes of adrenal insufficiency when looking for symptoms and preparing to diagnose the issue. While some of the symptoms are the same or similar, there are a few differences.

Symptoms of Adrenal Insufficiency

For the most part, both primary and secondary adrenal insufficiencies share a lot of the same symptoms but do differ in a few different areas.

The symptoms that both primary and secondary adrenal insufficiency share can include:

  • Pain in the muscles and joints
  • Lower electrolyte levels
  • Low blood pressure that can allow for dizziness when you stand up
  • Symptoms of low blood sugar like sweating
  • Irregular menstrual periods in women

Primary adrenal insufficiency also tends to come with two other symptoms. The craving for salt is one. Darkened skin, usually around the neck, the back of the hands and the face.

Secondary adrenal insufficiency does not usually have any skin pigmentation issues and tends to have normal electrolyte levels. It is important to recognize the fact there are differences so you can help your doctor make a correct diagnosis.

Diagnosing Adrenal Insufficiency

Diagnosing adrenal insufficiency, either primary or secondary, has a few steps before the doctor can make a full diagnosis. The first thing a doctor will do is go over your recent medical history. Doing this will isolate the potential causes of the condition, as well as to disqualify other possible issues from which you may be suffering.

Following the discussion of your medical history, there are some tests that the doctor can do to confirm a diagnosis of adrenal insufficiency.

1. Blood Test

Blood tests will show the levels of potassium, cortisol, sodium, and ACTH. Along with the symptoms you may be suffering from, the blood tests should give a clear indication if it is adrenal insufficiency or some other medical issue.

2. Insulin-Induced Hypoglycemia Test

This test is to help clarify whether the adrenal insufficiency is primary or secondary. The test checks your cortisol levels and blood sugar levels after you are injected with insulin. With this test, a healthy person will see their glucose levels fall while the cortisol levels rise.

3. Imaging Tests

CT scans of your abdomen can be used to look for any physical abnormalities on your adrenal glands, as well as looking to see if there is a change of size in the gland.

An MRI scan of your pituitary gland will clarify or confirm if you are suffering from primary or secondary adrenal insufficiency.

4. ACTH Stimulation Test

ACTH stimulation test involves an injection of synthetic ACTH which tells your adrenal glands to create cortisol. Damaged adrenal glands will show a limited or nonexistent output of cortisol.

Once the doctor makes a full diagnosis, he or she can move on to recommending a course of treatment for the adrenal insufficiency and the type from which you are suffering.

Treatment for Adrenal Insufficiency

For the most part, treatment for both primary and secondary adrenal insufficiency comes in the form of hormone replacement therapies. These are the two most common treatments.

1. Oral Corticosteroids

There are a few different oral medications the doctor can prescribe for adrenal insufficiency including prednisone, hydrocortisone (Cortef), or cortisone acetate (which may be used as a replacement for cortisol). Depending on the patient, the doctor may prescribe fludrocortisone as a replacement for aldosterone.

2. Corticosteroid Injections

Unfortunately, adrenal insufficiency can come with the symptom of vomiting and diarrhea, both of which can make it hard to keep oral medications in your system long enough to take full effect. In these cases, the doctor may prescribe corticosteroid injections.

Dosage in these treatments will differ between normal adults, children, and pregnant women. Treatment for pregnant women must especially be done with care.

Beyond these treatments, there are other things that you can do while under the doctor’s supervision that can help you if you are suffering from an adrenal insufficiency. Upping your sodium intake, for example, can help.

There are a few things you should take into account and know well if you are suffering from adrenal insufficiency.

Precautionary Measures to Take with Adrenal Insufficiency

One of the main dangers that you have to worry about in regards to adrenal insufficiencies is that it can cause other issues, one of the most serious of which is an adrenal crisis. Adrenal crisis is when the symptoms of your adrenal insufficiency start getting horribly worse.

You should be on the look out for:

  • Severe pain in the lower back, abdomen, or legs that appears suddenly
  • Dehydration
  • An increase in the severity of diarrhea and vomiting
  • Low blood pressure
  • Sudden blackouts and loss of consciousness

If this begins to happen, you should proceed to a hospital as soon as possible. Adrenal crisis can lead to death if left untreated.

You should also keep adrenal insufficiencies in mind in the case of medical emergency. Surgeries, for example, may require you to have a larger dose of your hormone treatment than normal due to the stress the surgery is putting upon your body. Because of things like this, wearing a medical bracelet is a very good idea so that the doctors treating you can be aware of your condition, even if you are unconscious or unable to communicate with them. Measures like this are simple and may save your life.

Adrenal Insufficiency Can Be Treated!

The symptoms and effects of adrenal insufficiency can be pretty terrible, especially if you go into adrenal crisis. With that said, if caught early and treated properly, the condition often rights itself. The trick is to not hesitate in seeing a doctor.

If you are suffering from adrenal insufficiency symptoms, see a doctor. The best case scenario, you might have the flu. The worst case is you have an adrenal insufficiency issue, and you’ve caught it in time before it has done any form of severe damage.

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