According to the National Institutes of Health, adrenal hormone deficiency occurs when the adrenal glands do not produce enough hormones to supply the body's needs. Adrenal hormone deficiency is known as primary adrenal insufficiency when it is caused by the adrenal glands themselves not producing enough hormones. When the pituitary gland is failing to produce enough hormone to stimulate the adrenal gland, this is called secondary adrenal insufficiency.
Function of Adrenal Hormones
As the Mayo Clinic explains, the outer layer of the adrenal gland, or cortex, produces a group of hormones called corticosteroids, which include glucocorticoids, mineralocorticoids, and androgens. Glucocorticoids, include cortisol, which assists the body in responding to stress and helps to maintain blood pressure response, slows the inflammatory response, maintains glucose levels in the bloodstream and helps to regulate metabolism. Mineralocorticoids, include aldosterone, which helps the kidneys regulate salt, water and potassium. Androgens are male sex hormones produced by both women and men. In men, androgens affect sexual development and muscle mass. In women, they affect a sense of well-being.
Symptoms of Adrenal Hormone Deficiency
Symptoms of adrenal hormone deficiency are often insidious. These can include fatigue, loss of appetite and weight loss. Patients also may notice nausea, diarrhea, low blood pressure with standing, depression, craving for salty foods, low blood sugars and absent or irregular menstrual periods in women. Darkening of the skin can occur in adrenal hormone deficiency that occurs secondary to the adrenal gland itself failing to produce enough hormones.
Symptoms of Acute Adrenal Hormone Deficiency
Since adrenal hormones help the body respond to stress, an acute stressful event can cause an "adrenal crisis." According to the University of Maryland Medical Center, this occurs when cortisol is not produced at a high enough quantity during a stressful event. The body is unable to respond to the event and the patient can experience low blood pressure, severe abdominal pain, low blood sugars and loss of consciousness. This event can be life threatening and is commonly precipitated by an event such as surgery, trauma or infection in the setting of untreated adrenal hormone deficiency.
Causes of Adrenal Hormone Deficiency
In 80 percent of cases, gradual destruction of the outer cortex of the adrenal gland occurs during an autoimmune process. According to the NIH, symptoms of adrenal hormone deficiency occur when 90 percent of the cortex is destroyed. Other causes related to the adrenal gland include infections, cancer, bleeding into the adrenal glands, and surgical removal of the glands. Adrenal hormone deficiency can also occur when there is an abnormality with stimulation of the adrenal glands. The most common cause of this is the sudden cessation of an oral glucocorticoid, such as prednisone, which a patient was taking.
Treatment for Adrenal Hormone Deficiency
Treatment for adrenal hormone deficiency involves replacing the hormones with medications that act in the same manner. Cortisol can be replaced by prednisone or dexamethasone. Aldosterone can be replaced by an oral mineralocorticoid such as fludrocortisone. If a patient suffers from acute adrenal crisis, large amounts of intravenous prednisone or dexamethasone are typically used. Patients may require extra medication if they develop an illness, are undergoing surgery or become pregnant and these situations should always be discussed with a doctor.
