Hello and welcome to the zero to finals podcast.

My name is Tom and in this episode I'm going to be going through adrenal insufficiency.

And if you want to follow along with written notes on this topic, you can follow along at

0.0.com or in the endocrinology section of the zero to finals medicine book.

So let's get straight into it.

Adrenal insufficiency is where the adrenal glands do not produce enough steroid hormones,

particularly cortisol and aldosterone.

And these steroid hormones are essential for life.

Therefore the condition is life-threatening unless the hormones are replaced.

Addison's disease refers to the specific condition where the adrenal glands have been damaged,

resulting in a reduction of the secretion of cortisol and aldosterone by these glands.

This is also called primary adrenal insufficiency and the most

common cause is autoimmune disease. Secondary adrenal insufficiency is a

result of inadequate ACTH stimulating the adrenal glands resulting in low cortisol

release. This is a result of loss or damage to the pituitary gland,

and this can be due to surgery to remove a pituitary tumour, infection, loss of blood flow to

the pituitary gland or radiotherapy. There's also a condition called Sheehan syndrome,

where massive blood loss during childbirth leads to

pituitary gland necrosis, and this will result in low ACTH and adrenal insufficiency.

Tertiary adrenal insufficiency is the result of inadequate CRH released by the hypothalamus.

And this is usually the result of patients being on long-term

oral steroids for more than three weeks, resulting in suppression of the hypothalamus.

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