Hypoadrenalism
Hypoadrenalism Causes
Hypoadrenalism often results from a deficiency of cortisol, a type of steroid hormone. If left untreated, cortisol deficiency may prove fatal. Primary hypoadrenalism, known popularly as Addison's disease, is caused by the failure of the adrenal glands themselves. The origins of this disorder are autoimmune in nature, which means that the immune system of affected patients produce antibodies that attack healthy tissues rather than the invading virus or bacteria. In primary hypoadrenalism, the antibodies damage and scar the adrenal cortex. Secondary hypoadrenalism, also called ACTH deficiency, results from diseases of the pituitary glands, leading to adrenal problems as a secondary effect.
Hypoadrenalism Definition
Hypoadrenalism is a condition whereaby the adrenal glands are underactive, with suppressed ability to produce a range of hormones. The adrenal glands, located above each kidney, are responsible for hormone production. The inactivity of these glands is called hypoadrenalism.
Hypoadrenalism Diagnosis
Clinical telltale signs of primary hypoadrenalism are skin pigmentations of afflicted patients. Sometimes, pigmentation also occurs in the inner wall of the cheeks. In fact, pigmentation occurs on any scars inflicted at the onset of the disease. If Addison's disease is suspected, blood tests will be performed. Patients with severe cortisol deficiency will exhibit decreased sodium levels and elevated potassium levels. Occasionally, blood sugar is low. In addition, a blood count will reveal elevated eosinophils (a white blood cell type) and abnormally large macrocytes (red cells). This abnormality is due to the presence of pernicious anaemia. Further blood tests must be conducted to screen for any associated autoimmune dysfunctions, including testing for thyroid function, vitamin B12, folate, iron and antibodies.
Hypoadrenalism Symptoms and Signs
Addison's disease, or primary hypoadrenalism, initially presents with subtle signs. Affected individuals may complain of faintness and dizziness, experience weakness and fatigue, and lose weight. Some patients also note vague stomach ache and gut pain as symptoms. Also common in primary hypoadrenalism is increased pigmentation of the skin due to elevated ACTH levels. On occasion, patients may experience mental problems such as depression. In some cases, joint and muscle pain may occur. Bleeding into the adrenal glands also happens in rare cases, leading to acute back pain.
Hypoadrenalism Treatment
Upon diagnosis, hydrocortisone replacement for cortisol must be started immediately. Often, after initial treatment, patients will be referred to a specialist endocrine unit. Specialists may then recommend replacement therapy for cortisol. The most popular to date is hydrocortisone, which is very similar to normal cortisol. The focus of hypoadrenalism treatment is to keep cortisol levels high in the morning, and lower in the afternoon and evening. These levels simulate the normal fluctuation of cortisol in the body during the day.