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Adrenal insufficiency: Clinical
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Cortisol production is normally under the control of the hypothalamus and pituitary. The hypothalamus secretes corticotropin-releasing hormone, or CRH, which makes the pituitary gland secrete adrenocorticotropic hormone, or ACTH.
ACTH then stimulates the release of cortisol from the adrenal glands. Aldosterone, on the other hand, is the final product of a physiological chain called the renin-angiotensin-aldosterone system, or RAAS for short.
Renin is produced by the kidneys, so aldosterone production is actually independent of hypothalamic and pituitary stimulation. This is important, because adrenal insufficiency actually comes in three distinct flavors.
The most common cause for primary adrenal insufficiency in high income countries is autoimmune destruction of the adrenal gland. Another common cause can be due to tuberculosis, HIV, or disseminated fungal infections.
Addison's disease, or adrenal insufficiency, is a rare disorder that occurs when the adrenal glands do not produce enough hormones. Adrenal insufficiency can be caused by several conditions, including autoimmune disease, infection, or failure of the adrenal glands.
Symptoms of adrenal insufficiency include fatigue, muscle weakness, weight loss, darkening of the skin (hyperpigmentation), and low blood pressure. Addison's disease is a serious condition that can be life-threatening if not treated properly.
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