Production of cortisol is controlled by the action of ACTH. ACTH is produced by the pituitary gland. This gland is controlled by the 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 cortisol production.
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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 complete.
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.
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WebMD Medical Reference from Healthwise
November 14, 2014
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