Addison's disease: Adrenal
Your adrenal glands are composed of two sections. The interior (medulla)
produces adrenaline-like hormones. The outer layer (cortex) produces a
group of hormones called corticosteroids, which include glucocorticoids,
mineralocorticoids and male sex hormones (androgens).
Some of the hormones the cortex produces are essential for life — the
glucocorticoids and the mineralocorticoids.
These hormones influence your body's ability to convert food fuels
into energy, play a role in your immune system's inflammatory
response, and help your body respond to stress.
These hormones maintain your body's balance of sodium and potassium
and water to keep your blood pressure normal.
Primary adrenal insufficiency
Addison's disease occurs when the cortex is damaged and doesn't produce
its hormones in adequate quantities. Doctors refer to the condition
involving damage to the adrenal glands as primary adrenal insufficiency.
The failure of your adrenal glands to produce adrenocortical hormones is
most commonly the result of the body attacking itself (autoimmune
disease). For unknown reasons, your immune system views the adrenal
cortex as foreign, something to attack and destroy.
Other causes of adrenal gland failure may include:
of the adrenal glands
Spread of cancer
to the adrenal glands
Bleeding into the
Secondary adrenal insufficiency
Adrenal insufficiency can also occur if your pituitary gland is
diseased. The pituitary gland makes a hormone called adrenocorticotropic
hormone (ACTH), which stimulates the adrenal cortex to produce its
hormones. Inadequate production of ACTH can lead to insufficient
production of hormones normally produced by your adrenal glands, even
though your adrenal glands aren't damaged. Doctors call this condition
secondary adrenal insufficiency.
Another more common possible cause of secondary adrenal insufficiency
occurs when people who take corticosteroids for treatment of chronic
conditions, such as asthma or arthritis, abruptly stop taking the
If you have untreated Addison's disease, an addisonian crisis may be
provoked by physical stress, such as an injury, infection or illness.
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