The Basics of Adrenal Gland Suppression

Our adrenal glands, although small in size, play a big role in the body’s daily functioning thanks to the hormones they produce. However, it cannot be denied that there are conditions that can develop in the body, whether inherited or not, wherein even these small organs may be affected. One of these conditions is called Adrenal Gland Suppression.

What is Adrenal Gland Suppression?

Adrenal Gland Suppression is the condition wherein the adrenal glands no longer function at an optimal state, more specifically, when they no longer produce enough hormones. It is also loosely called “adrenal insufficiency” and may be naturally occurring (i.e. hereditary) or caused by external factors (steroid abuse).[1]

Primary Adrenal Insufficiency or Addison’s Disease is an autoimmune disease characterized by a damage in the adrenal glands, due to the immune system attacking them. This leads to the adrenal glands producing too little cortisol or aldosterone.

Secondary Adrenal Insufficiency is characterized by a lack of adrenocorticotropic hormone (ACTH) whether or not there is damage in the adrenal glands. [2]

Causes of Adrenal Gland Suppression

Adrenal gland suppression through Addison’s disease is caused by a problem in the body’s immune system. It is not clear what exactly triggers the antibodies to attack the adrenal glands, severely damaging the adrenal cortex, but health professionals believe it may be hereditary and those already with other autoimmune diseases are much more likely to develop this.[3]

Secondary adrenal insufficiency may be caused by abnormalities in the pituitary gland such as tumors, but it may also be caused by taking steroids of any kind for any illness. Patients required to take steroidal treatments for longer than two weeks are at a huge risk of adrenal gland suppression.

The following steroidal treatments increase the risk of adrenal gland suppression:

These steroidal treatments can cause suppression of cortisol production as they mimic the effect of cortisol in the body. The pituitary gland and hypothalamus would then stop signaling the adrenal glands to produce cortisol, leading to the adrenal glands to atrophy over time.[4]

Symptoms of Adrenal Gland Suppression

Symptoms to adrenal gland suppression often start gradually and may often be the same as other more common diseases, which makes the condition difficult to pin point. Chronic fatigue, muscle weakness, constant loss of appetite, and weight loss are just some of the more common symptoms. Hyperpigmentation of the skin is also seen in patients with Addison’s disease.

Non-treatment due to ignoring these symptoms can lead further to “Addisonian Crisis” wherein the symptoms are far worse – lower back pain, severe vomiting, or diarrhea, low blood pressure – and could be fatal.[5]

Possible Treatment for Adrenal Gland Suppression

Hormone replacement therapy for hormones no longer produced is one way to treat Adrenal gland suppression. Oral medication such as hydrocortisone tablets can supplement as the body’s cortisol.[6]

The gradual reduction of steroidal treatments can also help treat patients. Nevertheless, steroid treatments must never be abruptly stopped as this may cause more harm than good. The adrenal glands must be given enough time to go back to its normal functioning before the steroids can be fully stopped.

[1] Recovery of steroid induced adrenal insufficiency. Younes A K, Younes N K. (2017 October). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5682381/

[2] Addison’s Disease. The Mayo Clinic. (2018 November 10). https://www.mayoclinic.org/diseases-conditions/addisons-disease/symptoms-causes/syc-20350293

[3] Causes – Addison’s Disease. National Health Service UK. (2018 June 14). https://www.nhs.uk/conditions/addisons-disease/causes/

[4] Steroids and Adrenal Suppression: Taking Steroids for any illness can cause Adrenal Suppression and Insufficiency. Adrenal Insufficiency United. http://aiunited.org/wp-content/uploads/STEROIDS-ASTHMA.pdf

[5] Adrenal Insufficiency (Addison’s Disease). Pituitary Network Association. https://pituitary.org/knowledge-base/disorders/adrenal-insuffieciency-addison-s-disease

[6] Addison Disease. Encyclopedia Britannica. https://www.britannica.com/science/Addison-disease

 

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