User:Mr. Ibrahem/Adrenal insufficiency

Adrenal insufficiency is a condition in which the adrenal glands do not produce enough of the hormone cortisol and potentially aldosterone. Symptoms vary from mild to severe. Mild symptoms may include weakness, tiredness, lightheadedness with standing, and darkening skin. More severe symptoms may include low blood pressure and weight loss. There may also be vomiting, abdominal pain, intolerance to the cold, and salt cravings. Complications may include an adrenal crisis.

The causes of adrenal insufficiency are divided into primary, secondary, and tertiary. Primary causes are due to the adrenal gland and include Addison disease, congenital adrenal hyperplasia, adrenal hemorrhage, and certain medications. Secondary causes involve decreased ACTH from the pituitary and include panhypopituitarism and Sheehan’s syndrome. Tertiary causes involve decreased CRH from the hypothalamus and include brain tumors and long term corticosteroid use. Diagnosis is suspected based on symptoms and confirmed by blood tests.

Treatment is generally with hydrocortisone or prednisone. In primary disease fludrocortisone is also required. Larger doses of hydrocortisone are required during physical stress, such as infections, and people are generally given injectable forms to self administer as soon as they feel sick. Outcomes are often good with treatment.

Primary adrenal insufficiency affects about 5 per 100,000 people. Secondary adrenal insufficiency affects about 22 per 100,000 people. Women are affected about twice as often as men. The condition was first described in 1855 by Thomas Addison.