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Adrenal insufficiency is a condition in which the adrenal glands do not produce adequate amounts of steroid hormones.The adrenal glands—also referred to as the adrenal cortex—normally secrete glucocorticoids (primarily cortisol), mineralocorticoids (primarily aldosterone), and androgens.
Addison's disease, or primary adrenal insufficiency, is an uncommon chronic illness characterized by insufficient production of cortisol and aldosterone by the adrenal glands. [17] Chronic primary adrenal insufficiency is typically characterized by an extended period of malaise , fatigue , anorexia , weight loss , joint and back pain, and skin ...
With appropriate treatment, the overall outcome is generally favorable, [10] and most people are able to lead a reasonably normal life. [11] Without treatment, an adrenal crisis can result in death. [1] Addison's disease affects about 9 to 14 per 100,000 people in the developed world. [1] [3] It occurs most frequently in middle-aged females. [1]
Conversely, chronically elevated ACTH levels occur in primary adrenal insufficiency (e.g. Addison's disease) when adrenal gland production of cortisol is chronically deficient. In Cushing's disease, a pituitary tumor leads to excessive production of ACTH, which stimulates the adrenal cortex to produce high levels of cortisol.
The variation in cortisol levels according to disease type and severity, as well as variation within the same patient, hampers the establishment of a clear threshold below which CIRCI occurs. [6] Moreover, in patients whose adrenal glands are already maximally stimulated, a stimulation test would not be informative. [ 6 ]
Cortisol is a steroid hormone in the glucocorticoid class of hormones and a stress hormone. When used as medication, it is known as hydrocortisone. It is produced in many animals, mainly by the zona fasciculata of the adrenal cortex in an adrenal gland. [1] In other tissues, it is produced in lower quantities. [2]
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