The adrenal glands produce several hormones that influence the body's water and salt balance and the metabolism of sugar, proteins and fat. Adrenal insufficiency is a condition wherein the adrenal glands fail to produce sufficient levels of the hormones needed to control these important body functions. Inflammation, infection, tumors and some medications may cause adrenal insufficiency, also known as Addison's disease. Adrenal insufficiency symptoms affect multiple body systems, reflecting the wide-ranging actions of the adrenal hormones in the body.
Fatigue and Muscular Weakness
Adrenal insufficiency leads to decreased blood levels of the hormone cortisol, sometimes called the stress hormone. Cortisol has many actions in the brain and body that influence alertness and the overall rate of metabolism. Adrenal insufficiency causes a net decrease in body metabolism leading to chronic fatigue and muscle weakness, as noted by "The Merck Manual for Healthcare Professionals."
Dizziness and Fainting
Decreased production of the hormone aldosterone accompanies adrenal insufficiency. This hormone normally acts on the kidneys to help retain needed body water and salt. An aldosterone deficiency causes dehydration and low blood pressure. Drs. E. Charmandari and G. Chrousos note in the online endocrinology book, "Endotext," that dizziness and fainting may occur due to the low blood pressure associated with adrenal insufficiency.
Increased Skin Pigmentation
The pituitary gland normally controls the activity of the adrenal glands by secreting adrenocorticotropic hormone or ACTH. When the diseased adrenal glands fail to produce sufficient adrenal hormones, the pituitary releases increasingly excessive levels of ACTH in an attempt to stimulate the adrenals. A side effect of high levels of circulating ACTH is increased skin pigmentation. "The Merck Manual for Healthcare Professionals" notes that adrenal insufficiency often causes an overall bronzed appearance to the skin. New freckling may occur, especially on sun-exposed areas of the body.
Loss of Body Hair and Menstrual Disorders
In women, the adrenal glands are a primary source of androgen hormones. The androgens are testosterone-like sex hormones needed for normal function of the reproductive system. Low levels of androgens due to adrenal insufficiency may cause loss of pubic hair and hair under the arms in women. As noted by Drs. E. Charmandari and G. Chrousos in their academic chapter on adrenal insufficiency published electronically in "Endotext," the deficit of androgens also frequently causes menstrual abnormalities including irregular periods or loss of normal menstruation.
Loss of Appetite and Weight Loss
The National Institute for Diabetes and Digestive and Kidney Diseases advises that the chemical imbalances caused by adrenal insufficiency commonly leads to loss of appetite and unintended weight loss. Nausea, vomiting, abdominal pain and diarrhea or constipation may also occur, further aggravating the weight loss associated with adrenal insufficiency.
References
- National Institute of Diabetes and Digestive and Kidney Diseases: Adrenal Insufficiency and Addison's Disease
- Merck Manual for Healthcare Professionals: Addison's Disease
- Merck Manual for Healthcare Professionals: Secondary Adrenal Insufficiency
- Endotext: Adrenal Insufficiency
- Penn State Milton S. Hershey Medical Center: Adrenal Insufficiency
