What is Adrenal Hypofunction & How is it Treated?

Adrenal hypofunction is a condition in which the adrenal glands are unable to perform well or function less than what they normally should. The causes of adrenal hypofunction are many and include a variety of factors including autoimmune disease. The symptoms of adrenal hypofunction need to be understood well to be able to diagnose and manage the condition. Treatment of adrenal hypofunction is mainly based on its causes and symptoms.

However, effective treatments are available for this condition and can treat it well once a diagnosis of adrenal hypofunction or adrenal insufficiency is confirmed.

Adrenal glands are the essential glands responsible for secreting essential hormones required for proper bodily functioning. People with adrenal deficiency or adrenal hypofunction are unable to secrete the required two vital hormones known as aldosterone and cortisol. The adrenal glands which are underactive or in the stage of hypofunction can’t produce and release sufficient amount of these two vital hormones. Symptoms of adrenal hypofunction revolve around the deficiency of these hormones.

The hormones, cortisol and aldosterone are very essential for proper bodily functioning. The role of these two hormones is

• To maintain immune system
• To regulate blood pressure and blood glucose level
• To maintain salt and electrolytes balance in the body
• To ensure heart muscles tone and healthy bones
• To increase body’s response to stress.

As both hormones help to maintain blood vessels and heart in cardiovascular system deficiency of these hormones can lead to cardiovascular problems. These are the commonest symptoms of adrenal hypofunction. The hormones also regulate immune system’s inflammatory response, blood pressure and also perform a variety of other activities inside your body. If there is a disruption in the hormonal functioning inside your body then it leads to adrenal hypofunction which results in some common symptoms.

Some of the common symptoms of adrenal hypofunction include:

• Low blood sugar level
• Low blood pressure
• Craving for salty foods
• Excessive sweating
• Unnecessary weight loss
• Fatigue that becomes worse with passing days
• Loss of appetite
• Muscle weakness
• Irregular or no menstruation in females
• Headaches.

Some symptoms of adrenal hypofunction may be serious and may require immediate medical attention.

Adrenal hypofunction can be of two types and is caused by a variety of factors. Every individual is victimized in a different way and hence treatments are also different for different conditions.

There are two different types of adrenal hypofunction found in individuals namely:

• Primary Adrenal Hypofunction – This is also referred as Addison’s disease and it is a very rare condition in human. In this, the adrenal glands become weak and underactive, resulting in insufficient production of cortisol, the stress hormone. It also reduces the production of other essential hormones like androgens and aldosterone.
• Secondary Adrenal Hypofunction – This is the most commonly found adrenal hypofunction. In this the pituitary gland, which is a small gland close to human brain, stops responding and sending signals to adrenal glands and hence the production of cortisol reduces.

There are many factors that cause adrenal hypofunction in human. Problem with the pituitary gland is a common cause of secondary adrenal hypofunction. A hormone produced by the pituitary gland called corticotrophin, which is responsible for controlling the production of cortisol. This hormone encourages the adrenal gland to produce and release sufficient cortisol in body. So, if the pituitary gland is having any problem, then the cortisol production by adrenal gland will be hampered due to insufficient stimulation.

Some of the other factors causing adrenal hypofunction in people are:

• Causes of Primary Adrenal Hypofunction – Autoimmune diseases are a main cause of primary adrenal hypofunction. This happens when the body’s defense system destroys its own tissues by attacking them. In the process, it damages the adrenal glands and as a result it stops producing the required hormones. Other causes of adrenal hypofunction include: genetic diseases, infections, bleeding in glands, surgical removal of adrenal glands and more.
• Causes of Secondary Adrenal Hypofunction – Condition affecting the pituitary gland can cause secondary adrenal hypofunction. The pituitary glands are liable for producing a hormone which conveys message to adrenal gland to produce required cortisol for bodily functioning. If the pituitary gland fails to do this, then no more cortisol will be produced and this causes secondary adrenal hypofunction.

Diagnosis of adrenal hypofunction is done with proper review of medical history and the symptoms. One of the diagnostic blood tests performed to diagnose primary and secondary adrenal hypofunction is the bold serum level of cortisol, adrenocorticotropic hormone (ACTH) and Corticotropin-releasing hormone (CRH) levels in blood. The level of ACTH and CRH is normal or increased in primary adrenal hypofunction. Similarly, the level of ACTH and CRH is decreased in secondary hypofunction of adrenal gland. In few cases of secondary adrenal hypofunction CRH level may be normal with low ACTH level. More specific blood test for diagnosis of primary and secondary disease is ACTH stimulation test and CRH stimulation test. The primary dysfunction is caused by failure of adrenal glands to secrete cortisone hormone, thus injection of ACTH and CRH fails to trigger the secretion of cortisol. The secondary adrenal gland failure is associated with normal functional adrenal gland but lack or secretion of ACTH and CRH hormone. In such cases external injection of ACTH and CRH increases secretion of cortisone by adrenaline gland. In few cases of long standing secondary adrenaline gland failure, the adrenaline gland fails to secrete cortisol hormone after injection of ACTH and CRH.The blood test results and results of imaging test often conclude the diagnosis of primary and secondary adrenaline insufficiency. Imaging tests performed are X-Ray, ultrasound, MRI or CT Scans. These changes helps to detect any changes or problems in the adrenal glands or the pituitary glands.

Treatment of adrenal hypofunction depends on the cause, which needs to be treated at once. Usually persons may benefit from shots of cortisol replacement steroids to survive. There are oral replacements that can be taken to replace the level of cortisol in body. The doses are set by your doctor based on the type of medication used and your weight. Hence, it is essential to follow medical advice regarding treatment of adrenal hypofunction.

Consult your doctor about the emergency prescribe injections which can be used during serious symptoms of adrenal hypofunction or adrenal crisis. There are many injectable drugs available which can be used to replace the insufficiency of cortisol in body, depending on the symptoms of adrenal hypofunction. These injections are prescribed only for emergency situations.

However, supplements, herbs and specialized diet can also help to replace the level of cortisol of in body and treat adrenal hypofunction. But, it is advisable to seek medical opinion prior to using any specialized diet or herbal supplement. Symptoms of adrenal hypofunction can be managed well, if treated properly in time. However, since it is a life threatening condition, you must not delay in opting for proper treatment of adrenal hypofunction.

References:

Also Read:

• https://www.epainassist.com/diet-and-nutrition/adrenal-fatigue-diet-foods-to-include-and-foods-to-avoid
• ACongenital Adrenal Hyperplasia: Causes, Types, Features, Diagnosis, Treatment, Prevention
• https://www.epainassist.com/endocrine/adrenal-gland-its-functions-and-what-happens-in-case-of-adrenal-gland-hormone-imbalance