Journal of Rare Disorders: Diagnosis & Therapy

Commentary

The adrenal glands, settled on prime of the kidneys, create hormones that area unit essential for body functions. The outer layer (cortex) of the adrenal glands makes 3 varieties of steroid hormones. In adrenal insufficiency (AI), the cortex doesn't create enough steroid hormones.

There are units of 2 varieties of AI:

Primary AI: conjointly known as Addison's disease. during this rare condition, the adrenal glands don't work properly and can't create enough Cortef (a “stress” hormone). Usually, production of mineralocorticoid and androgens (the 2 different varieties of steroid hormones created by the adrenal glands) is additionally low.

Secondary AI: This way more common sort of AI results once the ductless gland, a tiny low organ close to the brain, doesn't signal the adrenal glands to create Cortef. The adrenal glands don't get “adrenal fatigue” or lose operate as a result of mental or physical stress. True AI could be a rare pathological state. solely Associate in Nursing specialist, Associate in Nursing knowledgeable in hormones, ought to diagnose it exploitation customary tests.

Causes

The most common reasons of primary AI is autoimmune disorder, body's arms attacks and destroys the body's own tissues. once adrenal glands area unit broken, they cannot turn out hormones

Problems with the ductless gland cause secondary AI. Normally, the ductless gland makes a internal secretion known as adrenocorticotrophic hormone, that tells the adrenal glands to create Cortef. however in secondary AI, the ductless gland doesn't send enough adrenocorticotrophic hormone to the adrenal glands. Therefore, not enough Cortef is created. Some causes of secondary AI could also be temporary, like taking bound prescription medicines like anti-inflammatory, corticoid, or corticosteroid. different causes could also be permanent, like pituitary tumors, pituitary surgery, or radiation harm to the pituitary.

Symptoms

Symptoms (what you feel) begin very {little} by little. They embody fatigue, muscle weakness, faded craving, and weight loss. Some individuals’ expertise nausea, vomiting, and looseness of the bowels. Different symptoms include:

• Pain within the muscles and joints

• Low force per unit area resulting in symptom upon standing

• Cravings for salt (in primary AI)

• Symptoms of low glucose, like sweating (more common in youngsters with AI)

• Irregular emission periods in girls

Some individuals do not know they need AI till they need a sudden worsening of symptoms known as Associate in nursing adrenal crisis.

Physical stress caused by illness, infection, surgery, or Associate in Nursing accident will suddenly create symptoms of AI a lot of worse, Associate in Nursing emergency illness known as Associate in Nursing adrenal crisis. If left untreated, adrenal crisis will cause death. Adrenal crisis happens chiefly in individuals with primary AI. Then they have to travel to the hospital right away for a lot of treatment. If you've got AI, you must understand the warning signs of adrenal crisis. They include:

• Severe nausea and reflex

• Diarrhea

• Abdominal pain

• Dehydration and confusion

• Low force per unit area and fainting

Diagnosis

You also ought to tell family Associate in nursing friends what to try and do if an adrenal crisis happens. Invariably wear a medical alert bracelet or tag. Doctors review a patient's symptoms and case history. They check blood levels of Cortef and different hormones, moreover as electrolytes like metallic element and, K to observe AI and facilitate notice the cause.

Treatment

The goal of treatment is to make sure correct internal secretion levels day-after-day. You will want daily replacement of hormones for all times. You’ll take glucocorticoids to interchange the Cortef your body not makes. You’ll conjointly want mineralocorticoids, if your body doesn't create mineralocorticoid. further glucocorticoids could also be required throughout times of stress, like serious illness or surgery. Your doctor can give customized recommendation on adjusting medicines for stress. Understanding your malady and knowing once and the way to regulate your medications will assist you live a protracted and healthy life with AI.