ADDISON’S DISEASE

Adrenal insufficiency is diagnosed when the adrenal glands, located just above the kidneys fail to produce enough of particular hormones necessary for the body to function properly. Addison’s disease is one type of adrenal insufficiency.

Adrenal insufficiency occurs when the adrenal glands cannot make enough of the hormones cortisol or aldosterone. Depending on the cause of decreased hormone production, adrenal insufficiency can either be diagnosed as primary adrenal insufficiency, secondary adrenal insufficiency, or tertiary adrenal insufficiency. A primary, secondary, or tertiary designation directly relates to where the breakdown originates in the body that ultimately causes insufficient adrenal activity.

Primary adrenal insufficiency occurs when the adrenal glands themselves become damaged in some way. This impairs their ability to produce the proper amount of hormones necessary to keep the body working efficiently. The lack of cortisol affects regulation of certain important actions including infection fighting, weight control and heart function. Cortisol is needed for skin and bone health as well. Deficiencies in aldosterone can cause low blood pressure, dizziness, heart palpitations and high pulse rate. High potassium and low sodium are also hallmarks of low aldosterone production.

Primary adrenal insufficiency is known as Addison’s disease.

Secondary adrenal insufficiency has its origin in the pituitary gland located at the base of the brain. The pituitary gland normally produces a hormone known as adrenocorticotropic (ACTH). Its job is to stimulate the adrenal glands into producing cortisol. If the pituitary gland fails to produce enough ACTH, the correct amount of cortisol cannot be produced by the adrenal glands. If adrenal insufficiency is caused for this reason, the adrenal glands may shrink and stop producing cortisol altogether.

Tertiary adrenal insufficiency originates in the hypothalamus, located close to the pituitary gland in the brain. One of its functions is to produce corticotropin-releasing hormone (CRH). This hormone stimulates the pituitary gland into making ACTH. Without ACTH communication is lost between the pituitary and the adrenals and cortisol production is insufficient.