Adrenal insufficiency, an endocrine disorder, arises when the adrenal glands fail to produce adequate amounts of certain hormones. These glands, situated just above the kidneys, regulate various hormonal functions. There are two main types of adrenal insufficiency:
Primary adrenal insufficiency, known as Addison’s disease, results from damage to the adrenal glands, impairing the production of cortisol and often aldosterone. Addison’s disease affects approximately one to four individuals per 100,000 across all age groups and genders.
Secondary adrenal insufficiency occurs when the pituitary gland, located in the brain, fails to produce sufficient adrenocorticotropin (ACTH), a hormone essential for stimulating cortisol production. Inadequate ACTH output leads to decreased cortisol production and potential adrenal gland shrinkage. Secondary adrenal insufficiency is more prevalent than Addison’s disease.
The adrenal hormones, cortisol, and aldosterone play crucial roles in bodily functions:
Cortisol, a glucocorticoid hormone, influences nearly every organ and tissue, primarily aiding in stress response. Its functions include regulating blood pressure and cardiovascular function, moderating the immune system’s inflammatory response, controlling blood glucose levels for energy, and managing the metabolism of proteins, carbohydrates, and fats. Cortisol production is finely tuned by the hypothalamus and pituitary gland through a feedback loop involving corticotropin-releasing hormone (CRH) and ACTH.
Aldosterone, a mineralocorticoid hormone, contributes to blood pressure regulation and electrolyte balance by assisting the kidneys in retaining sodium and excreting potassium. Inadequate aldosterone production disrupts water and salt balance, resulting in decreased blood volume and pressure.