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