The adrenal glands are endocrine glands located above each kidney. The glands are responsible for producing the hormones aldosterone and cortisol, which have many important functions in the body. Adrenal insufficiency is a condition that occurs when the adrenal glands cannot make adequate amounts of the adrenal hormones.
Types of Insufficiency
There are two types of adrenal insufficiency--primary and secondary. Primary adrenal insufficiency, also referred to as Addison's disease, occurs when the adrenal gland glands are physically damaged and cannot produce hormones properly. According to the National Endocrine and Metabolic Diseases Information Service, 80 percent of cases of primary adrenal insufficiency are caused by autoimmune disorders. Other causes include tuberculosis, infections, cancer, genetic defects and surgical removal of the adrenal gland. Secondary adrenal insufficiency occurs because of a lack of the hormone adrenocorticotropin, which is responsible for triggering the adrenal gland to produce the adrenal hormone cortisol. Secondary adrenal insufficiency may be caused by the cessation of medications, tumors, radiation therapy and surgical removal of the pituitary gland.
Adrenal Hormones
Cortisol, which is often referred to as the stress hormone, belongs to a group of hormones called glucocorticoids. Cortisol helps the body respond to stressful situations by maintaining blood pressure and glucose levels, slowing immune system responses and regulating metabolism. The release of cortisol from the adrenal glands is dependent on triggers from the hypothalamus and pituitary gland. Aldosterone belongs to a group of hormones called mineralocorticoids. The main functions of aldosterone are to maintain blood pressure and regulate fluid and salt balance in the body.
Hyponatremia
Aldosterone helps to regulate fluid and salt balance in the body by aiding the kidneys in sodium retention and potassium excretion. If the adrenal glands are not producing an adequate amount of aldosterone, the kidneys cannot function properly and often excrete excess sodium as a result. This leads to a condition called hyponatremia, which is an abnormally low level of sodium in the blood. Low blood sodium levels cause both blood volume and blood pressure to drop significantly.
Symptoms
According to the Ohio State University Medical Center, symptoms of adrenal insufficiency develop gradually. Possible symptoms include fatigue, weakness, dizziness upon standing, diarrhea, constipation, nausea, vomiting, loss of appetite, stomachache, weight loss and hair loss. The hyponatremia associated with adrenal insufficiency can also cause cravings for salt and salty foods. The National Endocrine and Metabolic Diseases Information Service notes that hyperpigmentation, which is a darkening of the skin, may occur with primary adrenal insufficiency and is most visible on existing scars, skin folds and elbows, knees, knuckles and toes.
Treatment
Treatment for adrenal insufficiency consists of lifelong oral supplementation with synthetic adrenal gland hormones. If blood pressure is extremely low due to significant sodium loss, blood pressure medications may be needed until pressure returns to normal. Blood sugar and acetone levels must also be monitored regularly, according to the Milton S. Hershey Medical Center.
