ADRENAL INSUFFICIENCY

Adrenal insufficiency, or the so-called Addison's disease, is a disorder that occurs when the adrenal glands, which are located above the kidneys, do not produce sufficient amounts of the hormones cortisol and aldosterone, which causes the appearance of many symptoms. Addison's disease can occur at all ages and in both sexes, and it can sometimes be life-threatening. Treatment usually involves hormone replacement. The adrenal gland produces many hormones that are important in regulating many vital processes in the body, which include the following: • Glucocorticoids: These hormones have an important role in converting food into energy in the body, and they also have an important role in the immune response. • Aldosterone: This hormone helps maintain a balance of water and salts in the body to maintain blood pressure. • Androgens: Small amounts of androgens are secreted from the adrenal glands, which are responsible for sexual development in men. Symptoms of adrenal insufficiency Symptoms of Addison's disease develop so slowly that they are often ignored until the condition worsens. Symptoms include: 1. exhaust. 2. Weight loss and appetite. 3. Pigmentation in the skin. 4. Reduction of Blood pressure. 5. dizziness; 6. Abdominal pain. 7. muscle pain; 8. Depression. 9. hair loss; 10. Impotence in women. 11. Gastrointestinal disorders. 12. Low blood sugar. Adrenal insufficiency is caused by damage to the adrenal gland and its causes can be divided according to the type of adrenal insufficiency as follows: 1. Primary adrenal insufficiency This type of insufficiency occurs when the adrenal cortex does not produce sufficient amounts of hormones, and this is most often due to autoimmune diseases, where the immune system recognizes the adrenal cortex as a foreign body and attacks it. Other causes of primary adrenal insufficiency include: • tuberculosis. • Adrenal gland infections. • Cancer has spread to the adrenal gland. • Adrenal hemorrhage. 2. Secondary adrenal insufficiency In this type of hypothyroidism, there is a decrease in the production of thyroid hormone, which in turn reduces the secretion of adrenal hormones, due to several reasons, as follows: • Benign thyroid tumors. • Thyroiditis. • Previous thyroid surgery. • Take corticosteroid medications. • Complications of adrenal insufficiency If left untreated, Addison's disease can cause an Addisonian attack, which is often life-threatening. Some of the complications that an Addisonian crisis may cause are: • A sharp drop in blood pressure. • Low blood sugar levels. • High levels of potassium in the blood. • Increased possibility of infection. Diagnosis of adrenal insufficiency The condition is diagnosed by knowing the patient's medical history, in addition to the symptoms and signs that appear on him, and some tests may be undergone, such as the following: 1- Blood tests These tests help to know the levels of sodium, potassium and cortisol in the blood, in addition to the levels of adrenocorticotropic hormone, which is responsible for regulating the levels of adrenal hormones. 2- Adrenocorticotropic hormone stimulation test ACTH stimulation leads to the production of cortisol, the levels of which are measured before and after ACTH stimulation. 3- Check for hypoglycemia This test is performed if the patient is suspected of having secondary adrenal insufficiency. Blood sugar levels and cortisol levels are checked after insulin injections. 4- Imaging examinations These tests are done to check the size of the adrenal gland and look for any abnormalities in it, computed tomography and magnetic resonance imaging may be used. Adrenal insufficiency treatment In most cases, Addison's disease is treated with corticosteroid replacement therapy, such as the following: • Hydrocortisone (Hydrocortisone). • Prednisolone (prednisone). • Fludrocortisone acetate. Treatment can be taken orally or intravenously with a local injection or inhaled, and the side effects of taking cortisone depend on the dose, method and duration of treatment; Therefore, it is always advised to discontinue treatment gradually. Among the side effects that may be caused by taking cortisone are the following: • Peripheral edema. • High blood pressure due to fluid and sodium retention. • Osteoporosis. • Imbalance of blood sugar level. • Increased possibility of infection. • face rotation. • Increased hair growth on the body. • Menopause. • Addisonian crisis treatment Addisonian crisis is usually treated with intravenous administration of the following: • corticosteroids; • Brine. • dextrose sugar. Prevention of adrenal insufficiency There are no clear ways by which to prevent adrenal insufficiency, but some things can be taken to help avoid Addisonian nucleus, such as the following: See your doctor immediately if you feel some symptoms, such as: permanent fatigue, lack of fluids. Take the necessary treatment in the event of Addison's disease according to the doctor's instructions. Go to the doctor immediately in the event of vomiting and inability to eat.

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