Adrenal insufficiency - Symptoms & Causes

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

Types of Adrenal Insufficiency

There are three types of adrenal insufficiency. They are described below.

Detection & Diagnosis

Down below some of the common methods are discussed using which you can detect the adrenal insufficiency in your body.

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

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.

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.

1. Both Assertion & Reason are true and the reason is the correct explanation of the assertion.

2. Both Assertion & Reason are true but the reason is not the correct explanation of the assertion.

3. Assertion is true statement but Reason is false

4. 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

1. Low blood sugar

2. Increased urinary Na+

3. a bronze-like pigmentation of the skin

4. 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

1. Conn’s Syndrome

2. Cushing’s Syndrome

3. Addison’s disease

4. 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:

• MCQs on Adrenal Cortex

• Difference between Thyroid and Parathyroid

• Disorders of Pituitary Gland

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.

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