SEARCH RESULTS FOR: Central-Adrenal-Insufficiency

Central Adrenal Insufficiency

Central Adrenal Insufficiency: Pathogenesis and clinical findings Exogenous
steroids &
narcotics suppress
the hypothalamus
Tumor or
inflammation
infiltrate the
hypothalamus
Surgery, radiation,
or trauma
injure the
hypothalamus
↓ Corticotropin-
releasing hormone
(CRH) produced in the
hypothalamus
Exogenous
steroids &
narcotics suppress
the pituitary
Tumor or
inflammation
infiltrate the
pituitary
Surgery,
radiation, or
trauma injure
the pituitary
↓ Adrenocorticotropic
hormone (ACTH) produced in
the pituitary
Adrenal zona reticularis
↓ androgen (sex
hormone) production
↓ ACTH causes ↓
melanocyte-
stimulating
hormone expressed
on the same gene
↓ Dehydroepiandrosterone
as ACTH
(DHEAS; a testosterone
precursor)
Aldosterone
produced in the
adrenal zona
glomerulosa is
unaffected as it is
predominantly
controlled by the
renin-angiotensin-
aldosterone system
Adrenal zona
fasciculata ↓
cortisol production
Adrenal crisis**
↓ Testosterone levels in
women (where adrenals
are the primary source)
Melanocytes ↓
melanin (pigment)
production
Skin
hypopigmentation
No change in
aldosterone levels
↓ Libido
(sex drive)
↓ Pubic &
axillary
(armpit)
hair
growth
**See corresponding Calgary Guide slide
Legend: ↓ Cortisol-mediated inhibition
leads to ↑ anti-diuretic
hormone (ADH) secretion
↓ Counter-regulatory hormone
response to ↓ blood sugar
↓ Cortisol-mediated lymphocyte
apoptosis (cell death)
↓ Cortisol-mediated
vasoconstriction ↑ vasodilation Adrenal medulla ↓
catecholamine (epinephrine &
norepinephrine) production
Multifactorial mechanisms
Author:
Jaye Platnich
Samantha McIntosh
Reviewers:
Mark Elliott
Matthew Harding
Alexander Arnold
Catherine R Jarvis
Hanan Bassyouni*
David Campbell*
* MD at time of publication
Hyponatremia
(↓ Serum sodium)
Hypoglycemia
(↓ Glucose)
Lymphocytosis
(↑ Lymphocytes)
↓ Blood pressure
Postural dizziness
Fatigue
Nausea
Vomiting
Weight loss
Musculoskeletal pain
Anorexia (↓ Appetite)
Pathophysiology Mechanism
Sign/Symptom/Lab Finding Complications
Published Oct 21, 2013; updated Mar 21, 2026 on www.thecalgaryguide.com