Adrenal insufficiency - Symptoms & Causes
Adrenal insufficiency, also called Addison’s disease, occurs when adrenal glands fail to produce enough cortisol and aldosterone. It affects metabolism, blood pressure, and salt-water balance. This topic is crucial for Class 11–12 Biology and NEET with 5–7% exam weightage.
This Story also Contains
- What is Adrenal Insufficiency?
- Causes of Adrenal Insufficiency
- Types of Adrenal Insufficiency
- Detection & Diagnosis
- Symptoms of Adrenal Insufficiency
- Treatment & Management
- Mnemonics & Exam Tips
- Exam Relevance & Weightage
- Adrenal Insufficiency NEET MCQs
- FAQs on Adrenal Insufficiency
- Recommended Video on Adrenal Insufficiency
Adrenal gland is divided into two distinct regions. The outer adrenal cortex and the middle, adrenal medulla. Zona fasciculata, the middle region of the adrenal cortex secretes cortisol and when it does not secrete the required amount of the hormone it leads to adrenal insufficiency. Cortisol helps to regulate metabolism and cardiovascular function, and aldosterone. Other names for this are Addison’s disease or hypocortisolism. The function of the adrenal glands is to produce the hormones responsible for survival, when the hormones are not released in the required amount, it leads to imbalance in chemical coordination and integration and hence causing adrenal insufficiency.
What is Adrenal Insufficiency?
Adrenal insufficiency is a disease that occurs in the adrenal gland when the amount of cortisol is very less or absent. In patients with adrenal insufficiency who do not secrete enough aldosterone (Addison’s disease), there is increased excretion of sodium and water, reduction in extracellular fluid volume, and a tendency toward low blood pressure. In the complete absence of aldosterone, the volume depletion may be severe unless the person is allowed to eat large amounts of salt and drink large amounts of water to balance the increased urine formation.
Causes of Adrenal Insufficiency
Type | Reason | Explanation |
Primary causes | Autoimmune Disorders |
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Infections |
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Secondary causes | Long-term use of medications |
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Pituitary gland issues |
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Tertiary cause | Hypothalamus problems |
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Other risking factors | Genetical history of auto union disorders |
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Surgery or radiation near the brain |
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Use of steroids |
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Commonly Asked Questions
Yes, long-term use of glucocorticoids (like prednisone) can suppress the body's natural cortisol production, leading to secondary adrenal insufficiency when the medication is stopped abruptly.
Primary adrenal insufficiency (Addison's disease) is often caused by autoimmune destruction of the adrenal glands. People with one autoimmune disorder are at higher risk of developing others, so Addison's disease can be associated with other autoimmune conditions.
Dizziness upon standing (orthostatic hypotension) occurs due to low blood volume and blood pressure, caused by insufficient aldosterone. This hormone helps maintain blood volume and pressure by regulating sodium retention.
Adrenal insufficiency can sometimes lead to mild anemia. This is partly due to the role of cortisol in red blood cell production and the overall impact of the condition on the body's metabolic processes.
Types of Adrenal Insufficiency
There are three types of adrenal insufficiency. They are described below.
Type | Reason | Explanation |
Primary adrenal insufficiency | Damage in the adrenal glands |
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Secondary adrenal insufficiency | The issue with the pituitary gland |
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Tertiary Adrenal insufficiency | The problem in the hypothalamus |
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Commonly Asked Questions
There are two main types: primary adrenal insufficiency (Addison's disease), where the adrenal glands themselves are damaged, and secondary adrenal insufficiency, where the pituitary gland fails to produce enough ACTH to stimulate the adrenals.
In secondary adrenal insufficiency, the problem originates in the pituitary gland, which doesn't produce enough ACTH to stimulate the adrenals. This differs from primary insufficiency where the adrenal glands themselves are damaged.
In primary adrenal insufficiency, low aldosterone levels lead to excessive sodium excretion in urine (salt-wasting). This can cause dehydration, low blood pressure, and electrolyte imbalances if not treated.
While not a direct symptom, severe adrenal insufficiency or an adrenal crisis can potentially cause visual disturbances due to effects on blood pressure and brain function. In secondary adrenal insufficiency, pituitary issues might also affect vision.
Cortisol influences various liver functions, including glucose and lipid metabolism. In adrenal insufficiency, these processes may be altered, potentially affecting blood sugar regulation and lipid profiles.
Detection & Diagnosis
Down below some of the common methods are discussed using which you can detect the adrenal insufficiency in your body.
Testing method | Purpose |
Blood Tests |
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ACTH stimulation Test |
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Imaging test |
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Other diagnostic tools |
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Symptoms of Adrenal Insufficiency
The common symptoms of this disease include:
Weakness
Fatigue
Dizziness
Vomiting
Weight loss
Lack of appetite
Muscle aches
Fluid loss
Diarrhea
Low blood pressure
Low glucose levels
Irregular menstrual cycle
Abdominal pain
Commonly Asked Questions
Cortisol deficiency can lead to fatigue, weakness, weight loss, low blood sugar, nausea, and decreased stress tolerance. Cortisol helps regulate metabolism, blood pressure, and the body's response to stress.
Early symptoms often include fatigue, weakness, loss of appetite, weight loss, and abdominal pain. These symptoms can be vague and develop gradually, making early diagnosis challenging.
In primary adrenal insufficiency (Addison's disease), increased production of melanocyte-stimulating hormone can cause hyperpigmentation, particularly in sun-exposed areas, scars, and skin folds.
Salt craving is common in adrenal insufficiency due to low aldosterone levels. Aldosterone helps retain sodium, so when it's low, the body loses more sodium, leading to a craving for salty foods to replenish sodium levels.
Aldosterone regulates sodium and potassium balance in the body. In adrenal insufficiency, low aldosterone can lead to increased sodium excretion and potassium retention, causing dehydration, low blood pressure, and electrolyte imbalances.
Treatment & Management
There are effective treatment methods for adrenal and sufficiency which is very important for restoring the hormonal balance in the body. One of the options is therapy which can be compensation for deficient hormones that the adrenal gland is unable to produce. Some of the general treatment methods for adrenal insufficiency are discussed below:
Hormone Replacement Therapy: There are daily medications that help to replace missing cortisol and aldosterone.
Checking Hormone Level: There are regular blood tests that help to track down the hormone level and then there is lifelong hormone management for chronic adrenal insufficiency.
Lifestyle and Diet: One of the general management adrenals balances a high sodium diet for those individuals who have Aldosterone insufficiency.
Mnemonics & Exam Tips
It becomes hard to remember everything in a single click. We have dispatched some of the bricks below which you can use to keep important points of adrenal insufficiency in mind.
ADDISON: Autoimmune attack
Autoimmune
Damage cortisol
Damage to adrenal glands
Insufficient aldosterone
Symptoms ( fatigue, weakness)
Ongoing treatment
Need for monitoring
ACTH = Adrenal Call to Action
Three A’s
Autoimmune
Addison's
Activity
Exam Relevance & Weightage
During the preparation for several exams, students may come across different types of questions from the topic Adrenal Insufficiency. They are discussed below.
Exam type | Types of questions asked | Weightage |
| 5% | |
| 7% | |
Paramedical |
| 4% |
Adrenal Insufficiency NEET MCQs
Q1. Assertion: In Addison's disease, the adrenal glands make too little cortisol and, often, too little of another hormone, aldosterone.
Reason: Addison's disease, also called adrenal insufficiency, is an uncommon illness that occurs when the body doesn't make enough of certain hormones.
Both Assertion & Reason are true and the reason is the correct explanation of the assertion.
Both Assertion & Reason are true but the reason is not the correct explanation of the assertion.
Assertion is true statement but Reason is false
Both Assertion and Reason are false statements
Correct answer: 1) Both Assertion & Reason are true and the reason is the correct explanation of the assertion
Explanation:
Addison's disease, also called adrenal insufficiency, is an uncommon illness that occurs when the body doesn't make enough of certain hormones. In Addison's disease, the adrenal glands make too little cortisol and, often, too little of another hormone, aldosterone. Addison's disease, also called adrenal insufficiency, is an uncommon illness that occurs when the body doesn't make enough of certain hormones. In Addison's disease, the adrenal glands make too little cortisol and, often, too little of another hormone, aldosterone.
Hence, the correct answer is option 1) Both Assertion & Reason are true and the reason is the correct explanation of the assertion.
Q2. Symptoms of Addison’s disease include
Low blood sugar
Increased urinary Na+
a bronze-like pigmentation of the skin
All of the above
Correct answer: 4) All of the above
Explanation:
Addison’s disease is caused by the deficiency of mineralocorticoids and glucocorticoids. It is also caused by the destruction of the adrenal cortex in diseases such as tuberculosis. Its symptoms include low blood sugar, low plasma Na+, high K+ plasma, increased urinary Na+, nausea, vomiting, diarrhoea and a bronze-like pigmentation of the skin. Severe dehydration is also common.
Hence, the correct answer is the option 4) All of the above.
Q3. The deficiency of mineralocorticoids and glucocorticoids causes
Conn’s Syndrome
Cushing’s Syndrome
Addison’s disease
Gynaecomastia
Correct answer: 3) Addison’s disease
Explanation:
Addison's disease is a condition caused by a lack of both glucocorticoids and mineralocorticoids.
The adrenal glands in Addison's disease do not generate enough of these hormones:
Aldosterone and other mineralocorticoids aid in blood pressure maintenance and sodium and potassium balance regulation.
Cortisol and other glucocorticoids play a role in immunological response, metabolism, and stress adaptation.
Addison's disease symptoms include: Weariness, Loss of weight, Low blood pressure, Desire for salt, Skin hyperpigmentation Hypoglycemia, or low blood sugar
If Addison's disease is not well treated, it can result in an Addisonian crisis, which is a potentially fatal illness that needs to be treated right away.
Hence, the correct answer is option 3) Addison’s disease.
Also Read:
FAQs on Adrenal Insufficiency
What do you mean by adrenal insufficiency?
Adrenal insufficiency is a condition in which the adrenal glands fail to produce sufficient amounts of essential hormones, mainly cortisol and, in some cases, aldosterone. Cortisol is vital for regulating metabolism, immune function, and stress response, while aldosterone helps maintain salt and water balance. A lack of these hormones leads to symptoms like chronic fatigue, low blood pressure, muscle weakness, weight loss, and hormonal imbalance.
What are the causes of adrenal insufficiency?
Adrenal insufficiency can arise from multiple factors. The disorder may have primary or secondary origins. The most common cause is an autoimmune destruction of the adrenal cortex, as observed in Addison’s disease. Other causes include infections like tuberculosis, cancer to adrenal glands, or genetic enzyme defects that affect hormone synthesis. Long-term use of steroid medications can suppress adrenal function and damage to the pituitary or hypothalamus disrupts ACTH production, causing secondary adrenal insufficiency.
How is adrenal insufficiency detected?
Diagnosis involves blood tests. Blood tests measure cortisol levels and electrolytes, showing low sodium and high potassium. An ACTH stimulation test helps check whether the adrenal glands respond adequately to ACTH. Imaging tests like CT or MRI scans may be used to detect structural damage or tumors. Monitoring blood glucose levels is also important, as hypoglycemia is a common feature. Early diagnosis is crucial to prevent life-threatening adrenal crisis.
What are the treatment options?
Treatment of adrenal insufficiency mainly involves hormone replacement therapy. Regular medical monitoring ensures the correct balance of electrolytes and blood pressure. Along with medicines, a healthy diet, adequate salt intake, and stress management are recommended. With proper treatment, patients can lead normal, healthy lives.
Recommended Video on Adrenal Insufficiency
Frequently Asked Questions (FAQs)
Adrenal insufficiency can cause gastrointestinal symptoms like nausea, vomiting, abdominal pain, and decreased appetite. These symptoms are partly due to cortisol's role in maintaining the gut lining and regulating stomach acid production.
Yes, adrenal insufficiency can lead to mood changes, irritability, depression, and anxiety. Cortisol plays a role in regulating mood and cognitive function, so its deficiency can impact mental health.
Yes, muscle weakness is common in adrenal insufficiency. Cortisol helps maintain muscle mass and strength. Its deficiency can lead to muscle breakdown and weakness, particularly in the legs and arms.
Cortisol helps regulate body temperature. In adrenal insufficiency, people may have difficulty maintaining normal body temperature, leading to increased sensitivity to cold or heat.
While not directly impacting lung function, adrenal insufficiency can cause breathlessness due to weakness and fatigue. In severe cases or during an adrenal crisis, it can lead to respiratory distress.
Yes, adrenal insufficiency can lead to cognitive symptoms such as difficulty concentrating, memory problems, and mental fog. These are partly due to cortisol's role in cognitive function and the overall impact of the condition on the body.
Adrenal insufficiency can lead to menstrual irregularities or amenorrhea (absence of menstruation) in women. This is due to the impact of cortisol and adrenal androgens on the reproductive system and overall hormonal balance.
While not a primary symptom, changes in body odor can occur in adrenal insufficiency due to alterations in sweat production and composition, as well as potential changes in skin bacteria related to electrolyte imbalances.
Cortisol plays a role in calcium metabolism and bone health. In adrenal insufficiency, there may be subtle changes in calcium balance, potentially affecting bone density over time if left untreated.
Cortisol has anti-inflammatory properties and influences pain perception. In adrenal insufficiency, some people may experience increased sensitivity to pain or worsening of chronic pain conditions due to the lack of cortisol's modulating effects.
