Adrenal insufficiency

As part of an adrenal insufficiency, the adrenal cortex does not work adequately. The disorder is classified in three forms.

In the primary form (also Addison's disease) there is a lack or a low production of NNR-hormones by a destruction of the NNR-cells. This is usually caused by autoimmune adrenalitis. The diasease can be acute or chronic.

The secondary form is characterized by the loss of ACTH, which controls the hormone production of the adrenal cortex. The failure comes due to a pituitary insufficiency due to tumors or injuries (traumatic brain injury, circulatory disorders and autoimmune reactions).

Tertiary adrenal insufficiency is caused by organic brain disorders of the hypothalamus and inadequate CRH (Corticotropin releasing hormone) secretion.

Clinically, Addison's disease is characterized by a lack of or lack of release of the two adrenocortical hormones aldosterone and cortisone, which typically results in low blood pressure, lack of energy, and weight loss and dehydration.

Due to special stress situations, such as surgery, trauma, or infections, NNR insufficiency can suddenly get worse. This potentially life-threatening condition (Addison's crisis) is characterized by dizziness, coma, hypotension, fever, massive dehydration, hypoglycaemia, and pseudoperitonitis.

In secondary or tertiary adrenocortical insufficiency, there is only a lack of cortisol. The release of aldosterone takes place here largely independently. The diseases leading to NNR insufficiency are usually not curable.

However, the non-steroidal insufficiency is well treatable and there are usually no restrictions on the quality of life and life expectancy with good attitude, training and therapy monitoring.