Adrenal insufficiency

This article is about medically-recognized chronic adrenal insufficiency. For a term used in alternative medicine, see Adrenal fatigue.
Adrenal insufficiency
Other namesadrenocortical insufficiency, hypocorticalism, hypocortisolism, hypoadrenocorticism, hypocorticism, hypoadrenalism
Adrenal gland
SpecialtyEndocrinology

Adrenal insufficiency is a condition in which the adrenal glands do not produce adequate amounts of steroid hormones. The adrenal glands—also referred to as the adrenal cortex—normally secrete glucocorticoids (primarily cortisol), mineralocorticoids (primarily aldosterone), and androgens.[1][2][3][4] These hormones are important in regulating blood pressure, electrolytes, and metabolism as a whole.[2][3] Deficiency of these hormones leads to symptoms ranging from abdominal pain, vomiting, muscle weakness and fatigue, low blood pressure, depression, mood and personality changes (in mild cases) to organ failure and shock (in severe cases).[1][2][3] Adrenal crisis may occur if a person having adrenal insufficiency experiences stresses, such as an accident, injury, surgery, or severe infection; this is a life-threatening medical condition resulting from severe deficiency of cortisol in the body.[2][3] Death may quickly follow.[1]

Adrenal insufficiency can be caused by dysfunction of the adrenal gland itself, whether by destruction (e.g. Addison's disease), failure of development (e.g. adrenal dysgenesis), or enzyme deficiency (e.g. congenital adrenal hyperplasia).[2][3] Adrenal insufficiency can also occur when the pituitary gland or the hypothalamus do not produce adequate amounts of the hormones that assist in regulating adrenal function.[5][6][7] This is called secondary adrenal insufficiency (when caused by lack of production of adrenocorticotropic hormone (ACTH) in the pituitary gland) or tertiary adrenal insufficiency (when caused by lack of corticotropin-releasing hormone (CRH) in the hypothalamus).[2][3][8]

  1. ^ a b c Ashley B. Grossman, MD (2007). "Addison's Disease". Adrenal Gland Disorders.
  2. ^ a b c d e f Nicolaides, Nicolas C.; Chrousos, George P.; Charmandari, Evangelia (2000), Feingold, Kenneth R.; Anawalt, Bradley; Boyce, Alison; Chrousos, George (eds.), "Adrenal Insufficiency", Endotext, South Dartmouth (MA): MDText.com, Inc., PMID 25905309, retrieved 2022-11-02
  3. ^ a b c d e f Huecker, Martin R.; Bhutta, Beenish S.; Dominique, Elvita (2022), "Adrenal Insufficiency", StatPearls, Treasure Island (FL): StatPearls Publishing, PMID 28722862, retrieved 2022-11-02
  4. ^ Bancos, Irina; Hahner, Stefanie; Tomlinson, Jeremy; Arlt, Wiebke (2015-03-01). "Diagnosis and management of adrenal insufficiency". The Lancet Diabetes & Endocrinology. 3 (3): 216–226. doi:10.1016/s2213-8587(14)70142-1. ISSN 2213-8587. PMID 25098712.
  5. ^ Eileen K. Corrigan (2007). "Adrenal Insufficiency (Secondary Addison's or Addison's Disease)". NIH Publication No. 90-3054. Archived from the original on 2008-09-15. Retrieved 2008-08-22.
  6. ^ Brender E, Lynm C, Glass RM (2005). "JAMA patient page. Adrenal insufficiency". JAMA. 294 (19): 2528. doi:10.1001/jama.294.19.2528. PMID 16287965.
  7. ^ "Dorlands Medical Dictionary:adrenal insufficiency".
  8. ^ "Secondary Adrenal Insufficiency - Endocrine and Metabolic Disorders". Merck Manuals Professional Edition.