Hypoadrenalism, or adrenal insufficiency, is a medical condition caused by impaired adrenal gland function that can be life-threatening if left untreated. It is diagnosed through a battery of tests and treated with hormone replacement therapy. Symptoms include fatigue, joint discomfort, and nausea, and an Addisonian crisis requires emergency medical care. Hormone replacement therapy is the main treatment approach.
Hypoadrenalism is a medical condition that results from impaired function of the adrenal gland. Also known as adrenal insufficiency, impaired adrenal function can cause insufficient hormone production that can be life-threatening if left untreated. Individuals with hypoadrenalism generally receive hormone replacement therapy to restore hormone balance.
The adrenal glands are part of the body’s endocrine system, which serves to regulate metabolic function. Located on each kidney, the two adrenal glands help regulate the production and distribution of hormones throughout the body. Each possesses two distinct sections, the cortex and medulla, to help with the production of cortisol and adrenaline, respectively. The cortex section is responsible for regulating several functions, including blood pressure, immune system stability, and metabolism.
Primary adrenal insufficiency, or Addison’s disease, occurs when the function of the cortex is impaired. Autoimmune diseases, metastatic cancers, and widespread infections that directly threaten adrenal function can contribute to a decrease in cortisol production triggering the onset of Addison’s symptoms. Hypoadrenalism can also arise from a malfunction of the pituitary gland that contributes to a condition called ACTH deficiency. The acronym ACTH stands for adrenocorticotropic hormone, which is produced by the pituitary gland to initiate hormone production from the adrenal cortex.
Hypoadrenalism can be diagnosed after a thorough consultation with a doctor and the administration of a battery of diagnostic tests to rule out other conditions. Cortisol levels are usually measured and evaluated with blood tests. Blood sodium, potassium, and glucose levels can also be measured intermittently to measure cortisol levels indirectly. Erratic or inadequate cortisol readings are usually indicative of this condition. Imaging tests may also be done to evaluate the condition of the adrenal and pituitary glands.
Individuals with hypoadrenalism will often experience a gradual onset of signs and symptoms. A decrease in sodium levels in the body can cause some people to suddenly crave salt-rich foods and drinks. In addition to becoming easily fatigued, individuals may also experience widespread joint discomfort, mood swings, and persistent nausea. Dizziness and fainting are not uncommon in some people with adrenal insufficiency. As hormone levels become increasingly unstable, symptoms can significantly worsen, potassium levels can rise, and blood pressure can drop.
A sharp drop in blood pressure for a person with impaired adrenal gland function is indicative of a complication known as an Addisonian crisis. Individuals with this life-threatening complication require emergency medical care to stabilize their condition. Extremely low blood sugar and potassium levels require immediate intravenous administration of saline and sugar. Additional fluids and nutrients should also be given to prevent dehydration.
Hormone replacement is the main focus of any treatment approach for this condition. To compensate for unstable corticosteroid levels, hydrocortisone may be given initially in an attempt to stabilize cortisol levels. Additional oral corticosteroid medications, such as prednisone, may also be prescribed. Placement on a synthetic corticosteroid regimen requires regular monitoring due to the risk of potential side effects, including high blood pressure and osteoporosis.
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