Production of cortisol is controlled by the action of ACTH. ACTH is produced
pituitary gland. This gland is controlled by
hypothalamus in the brain. If either the
hypothalamus or pituitary gland is damaged, less ACTH
is produced. This can lead to problems with the adrenal glands and reduced
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Past radiation of the hypothalamus or pituitary
Past surgery to the pituitary gland.
conditions such as
sarcoidosis, or Sheehan's syndrome (hypopituitarism).
Sheehan's syndrome is sometimes caused by severe blood loss after giving birth.
The symptoms of secondary adrenocortical insufficiency are similar to
Addison's disease. (But darkening of the skin
and high levels of potassium in the blood are not present like they are in Addison's disease.)
With secondary adrenocortical insufficiency, only cortisol is low.
The adrenal glands can still make normal amounts of aldosterone. Symptoms
Fatigue and muscle weakness. These may get
worse over time.
Weight loss. Profound weight loss is a prominent
Loss of appetite.
Diagnosis starts with a medical history and physical exam. If
your doctor suspects adrenal insufficiency, he or she will check your blood
cortisol and ACTH levels. You may have imaging tests of the
adrenal glands, the pituitary gland, or the hypothalamus.
If your doctor suspects secondary adrenocortical insufficiency, you
may get infusions of ACTH on 2 days in a row. In most cases, your
adrenal glands will make cortisol by the end of the
second treatment. This is true even if you
have problems with the
pituitary gland or
hypothalamus. If possible, your doctor will treat the condition that is
causing secondary adrenocortical insufficiency. Your doctor may start treatment
during the testing if he or she thinks adrenal insufficiency is likely. If
it turns out that you don't need treatment, you can stop treatment after testing is
CT scan or
MRI can be used to see
if there are signs of damage to the brain or pituitary gland (such as a
tumor) that is causing adrenal failure.
In this article
This information is produced and provided by the National
Institute (NCI). The information in this topic may have changed since it was written. For the most current information, contact the National
Institute via the Internet web site at http://
.gov or call 1-800-4-CANCER.
WebMD Medical Reference from Healthwise
November 14, 2014
This information is not intended to replace the advice of a doctor.
Healthwise disclaims any liability for the decisions you make based on this