The two adrenal glands are hormone-producing glands. If the adrenal cortex is underactive (adrenal insufficiency, sometimes also called Addison’s disease), the body lacks vital hormones.
Why do we need adrenal glands?
The adrenal glands release hormones that are particularly important for the body’s stress response – i.e. creating the perfect conditions for flight and attack. For example, they cause an increase in blood pressure, provide nutrients and suppress processes that would hinder flight or fight. One of these hormones is cortisol. It plays a central role in metabolism.
Control centers in the brain
Certain endocrine glands in the brain control how much cortisol is released by the adrenal cortex. These control centers are called the hypothalamus and the pituitary gland. They release the two hormones CRH and ACTH , which in turn regulate the cortisol production of the adrenal cortex.
The cortisol level varies throughout the day. It is highest in the morning, but drops during the day. The body needs a lot of cortisol in stressful situations.
What are the symptoms of adrenal insufficiency?
If the body lacks adrenal hormones, there are disturbances in the water and salt balance: salt (sodium) and water are lost, there is a lack of fluid, blood pressure drops. Sugar metabolism is also disturbed. The body is also less able to react to stress. Often, however, the symptoms are ambiguous at first and do not immediately suggest adrenal insufficiency. Possible symptoms include:
- increasing weakness,
- fatigability with loss of performance Loss of appetite with weight loss
- Vomiting and diarrhea
- increasing pigmentation of the skin even without sunlight (in the case of primary adrenal underfunction)
Possible symptoms in children and adolescents:
- Decline in academic performance
- delayed puberty development,
- growth retardation.
In primary adrenal insufficiency (Addison’s disease), symptoms do not appear until more than 90 percent of the adrenal cortex has been destroyed.
Causes of adrenal insufficiency
If the adrenal cortex (adrenal cortex) produces too few hormones, the cause can either lie in the adrenal gland itself – in which case doctors speak of primary adrenal insufficiency. If the cause is outside the adrenal cortex, it is a secondary adrenal insufficiency.
Primary adrenal insufficiency: A hereditary disorder of cortisol formation – the so-called adrenogenital syndrome (AGS) – is comparatively common. Another possible cause is autoimmune processes. The immune system is directed against the tissue of the adrenal cortex and destroys it. As a result, the adrenal cortex can produce fewer hormones (cortisol, aldosterone and DHEA). This condition is called Addison’s disease (Addison’s disease). However, the adrenal cortex can also be caused by bleeding, tumor metastases or certain infectious diseases (such as tuberculosis).
Secondary adrenal insufficiency: Here, the signal for cortisol release from the control glands in the brain is missing. This can be caused by a malfunction of the hypothalamus and pituitary gland. A common cause is (usually benign) tumors. Long-term therapy with high doses of corticosteroids ("cortisone") also suppresses the release of the control hormones ACTH and CRH. Such treatment is used, for example, in rheumatic diseases. If the patient stops cortisone therapy abruptly, the body cannot adapt quickly enough. This is how cortisol deficiency occurs. This is referred to as tertiary adrenal insufficiency. Therefore, the doctor will usually not abruptly discontinue such a corsion therapy, but will "taper off", i.e. gradually reduce the dose. Secondary and tertiary adrenal insufficiency are significantly more common than the primary forms.
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Nice information.
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