Adrenal deficiency, also known as adrenal insufficiency, is a medical condition characterized by low levels of hormones normally produced by the adrenal glands. These include cortisol, aldosterone, and androgens, all critical in the functioning of a healthy body. In some people, a condition known as adrenal crisis can develop. Patients in adrenal crisis are facing a life threatening medical emergency that requires prompt medical treatment in a hospital environment. These patients are usually sick enough that emergency services are called even if people are not sure why the patient is feeling so ill.
There are two broad categories of adrenal deficiency: primary and secondary. A primary adrenal deficiency is a problem with the adrenal gland itself, such as a tumor, Addison's disease, or trauma to the gland. Secondary adrenal deficiency is caused by damage to the hypothalamus or pituitary, the glands that release hormones to regulate adrenal function. When these glands don't produce enough of the needed hormones, the adrenal glands cannot function as they normally would.
Symptoms of adrenal deficiency can include nausea, dizziness, low blood pressure, and darkening of the skin, among others. When blood tests are run on the patient, the blood will have low levels of adrenal hormones; in a secondary deficiency, levels of hormones from the hypothalamus or pituitary will be low also. The patient may also develop additional symptoms, depending on the exact cause of the deficiency and the patient's general level of health. Lack of androgens, for example, can lead to serious symptoms in both men and women.
Patients in adrenal crisis are treated with immediate replacement of adrenal hormones and other supportive therapies to stabilize the patient. Then, a doctor can work on determining why the patient went into crisis. For other patients with adrenal deficiencies identified before they reach a crisis point, diagnostic testing is used to find the cause so that a treatment plan can be developed.
Treatment may be as basic as replacing adrenal hormones when there is no apparent reason for the adrenal gland not to be functioning. Patients with tumors may require surgery and other measures to address the tumor. Determining the cause is important as simply supplementing with the needed hormones may not resolve the issue. Diagnostic testing can include blood work and medical imaging studies to get a complete picture of what is happening inside the patient's body, along with interviews to narrow down the point when symptoms first developed.
