Tag Archives: ACTH Stimulation Test

Addison’s Disease

Definition:
Addison’s disease is a disorder that results when your body produces insufficient amounts of certain hormones produced by your adrenal glands. In Addison’s disease, your adrenal glands produce too little cortisol, and often insufficient levels of aldosterone as well.

click & see the pictures

Also called adrenal insufficiency or hypocortisolism, Addison’s disease can occur at any age, but is most common in people ages 30 to 50. Addison’s disease can be life-threatening.

Symptoms:

Addison’s disease symptoms usually develop slowly, often over several months, and may include:
*Muscle weakness and fatigue
*Weight loss and decreased appetite
*Darkening of your skin (hyperpigmentation)
*Low blood pressure, even fainting
*Salt craving
*Low blood sugar (hypoglycemia)
*Nausea, diarrhea or vomiting
*Muscle or joint pains
*Irritability
*Depression

Acute adrenal failure (addisonian crisis)
Sometimes, however, the signs and symptoms of Addison’s disease may appear suddenly. In acute adrenal failure (addisonian crisis), the signs and symptoms may also include:

*Pain in your lower back, abdomen or legs
*Severe vomiting and diarrhea, leading to dehydration
*Low blood pressure
*Loss of consciousness
*High potassium (hyperkalemia)

Causes :
Your adrenal glands are located just above each of your two kidneys. These glands are part of your endocrine system, and they produce hormones that give instructions to virtually every organ and tissue in your body.

Your adrenal glands are composed of two sections. The interior (medulla) produces adrenaline-like hormones. The outer layer (cortex) produces a group of hormones called corticosteroids, which include glucocorticoids, mineralocorticoids and male sex hormones (androgens).

Some of the hormones the cortex produces are essential for life — the glucocorticoids and the mineralocorticoids.

*Glucocorticoids. These hormones, which include cortisol, influence your body’s ability to convert food fuels into energy, play a role in your immune system’s inflammatory response and help your body respond to stress.

*Mineralocorticoids. These hormones, which include aldosterone, maintain your body’s balance of sodium and potassium and water to keep your blood pressure normal.

*Primary adrenal insufficiency: Addison’s disease occurs when the cortex is damaged and doesn’t produce its hormones in adequate quantities. Doctors refer to the condition involving damage to the adrenal glands as primary adrenal insufficiency.

The failure of your adrenal glands to produce adrenocortical hormones is most commonly the result of the body attacking itself (autoimmune disease). For unknown reasons, your immune system views the adrenal cortex as foreign, something to attack and destroy.

Other causes of adrenal gland failure may include:
*Tuberculosis
*Other infections of the adrenal glands
*Spread of cancer to the adrenal glands
*Bleeding into the adrenal glands

Secondary adrenal insufficiency
Adrenal insufficiency can also occur if your pituitary gland is diseased. The pituitary gland makes a hormone called adrenocorticotropic hormone (ACTH), which stimulates the adrenal cortex to produce its hormones. Inadequate production of ACTH can lead to insufficient production of hormones normally produced by your adrenal glands, even though your adrenal glands aren’t damaged. Doctors call this condition secondary adrenal insufficiency.

Another more common possible cause of secondary adrenal insufficiency occurs when people who take corticosteroids for treatment of chronic conditions, such as asthma or arthritis, abruptly stop taking the corticosteroids.

Addisonian crisis
If you have untreated Addison’s disease, an addisonian crisis may be provoked by physical stress, such as an injury, infection or illness.

When to seek medical advice:
See your doctor if you have signs and symptoms that commonly occur in people with Addison’s disease. Most people with this condition experience darkening areas of skin (hyperpigmentation), severe fatigue, unintentional weight loss, and gastrointestinal problems, such as nausea, vomiting and abdominal pain. Dizziness or fainting, salt cravings, and muscle or joint pains also are common.

Your doctor can determine whether Addison’s disease or some other medical condition may be causing these problems.

Tests and diagnosis:-

Your doctor will talk to you first about your medical history and your signs and symptoms. If your doctor thinks that you may have Addison’s disease, you may undergo some of the following tests:

*Blood test. Measuring your blood levels of sodium, potassium, cortisol and ACTH gives your doctor an initial indication of whether adrenal insufficiency may be causing your signs and symptoms. A blood test can also measure antibodies associated with autoimmune Addison’s disease.

*ACTH stimulation test. This test involves measuring the level of cortisol in your blood before and after an injection of synthetic ACTH. ACTH signals your adrenal glands to produce cortisol. If your adrenal glands are damaged, the ACTH stimulation test shows that your output of cortisol in response to synthetic ACTH is blunted or nonexistent.

*Insulin-induced hypoglycemia test. Occasionally, doctors suggest this test if pituitary disease is a possible cause of adrenal insufficiency (secondary adrenal insufficiency). The test involves checking your blood sugar (blood glucose) and cortisol levels at various intervals after an injection of insulin. In healthy people, glucose levels fall and cortisol levels increase.

*Imaging tests. Your doctor may have you undergo a computerized tomography (CT) scan of your abdomen to check the size of your adrenal glands and look for other abnormalities that may give insight to the cause of the adrenal insufficiency. Your doctor may also suggest a CT scan or MRI scan of your pituitary gland if testing indicates you have secondary adrenal insufficiency.

Treatments and drugs:-
If you receive an early diagnosis of Addison’s disease, treatment may involve taking prescription corticosteroids. Because your body isn’t producing sufficient steroid hormones, your doctor may have you take one or more hormones to replace the deficiency. Cortisol is replaced using hydrocortisone (Cortef), prednisone or cortisone acetate. Fludrocortisone (Florinef) replaces aldosterone, which controls your body’s sodium and potassium needs and keeps your blood pressure normal.

You take these hormones orally in daily doses that mimic the amount your body normally would make, thereby minimizing side effects. If you’re facing a stressful situation, such as an operation, an infection or a minor illness, your doctor will suggest a temporary increase in your dosage. If you’re ill with vomiting and can’t retain oral medications, you may need corticosteroid injections.

In addition, your doctor may recommend treating androgen deficiency with an androgen replacement called dehydroepiandrosterone. Some studies indicate that, for women with Addison’s disease, androgen replacement therapy may improve overall sense of well-being, libido and sexual satisfaction.

You may click to learn more about:-
-> Natural Addison’s Disease Treatment
->Natural Help for Addison’s Disease
->AN ALTERNATIVE AND COMPLEMENTARY MEDICINE RESOURCE GUIDE
->Treatment For Addison’s Disease – Herbal Remedies – Natural Cures

Addisonian crisis
An addisonian crisis is a life-threatening situation that results in low blood pressure, low blood levels of sugar and high blood levels of potassium. This situation requires immediate medical care. Treatment typically includes intravenous injections of:

*Hydrocortisone
*Saline solution
*Sugar (dextrose

Coping and support:-

These steps may help you cope better with a medical emergency if you have Addison’s disease:

Carry a medical alert card and bracelet at all times. In the event you’re incapacitated, emergency medical personnel know what kind of care you need.

Keep extra medication handy. Because missing even one day of therapy may be dangerous, it’s a good idea to keep a small supply of medication at work, at a vacation home and in your travel bag, in the event you forget to take your pills. Also, have your doctor prescribe a needle, syringe and injectable form of corticosteroids to have with you in case of an emergency.

Stay in contact with your doctor. Keep an ongoing relationship with your doctor to make sure that the doses or replacement hormones are adequate but not excessive. If you’re having persistent problems with your medications, you may need adjustments in the doses or timing of the medications.

Sources:http://www.mayoclinic.com/health/addisons-disease/DS00361/DSECTION=symptoms

Enhanced by Zemanta
Advertisements

Adrenal Fatigue

Definition:
One common condition that frequently accompanies thyroid problems is adrenal exhaustion, also known as adrenal fatigue. It is claimed by alternative medicine practioners to be a condition of the body in which the adrenal glands are exhausted and unable to produce adequate hormones, notably cortisol, the stress hormone of the body.

click & see the pictures

This so-called condition is unrecognized by the medical community. However, this fact accompanied by the suffering of many people gave rise to an industry of supplements and treatments for this supposed syndrome. General practitioners and psychologists routinely ascribe other causes for the claimed symptoms of adrenal fatigue, especially mental.

There is large confusion regarding the relation of this supposed syndrome to another very misunderstood syndrome, chronic fatigue syndrome. The two may have common symptoms and it is difficult to distinguish.

About Adrenal Glands: Your two adrenal glands are small, triangular-shaped endocrine glands located on the top of each kidney. Each adrenal gland is approximately 3 inches wide, and a half inch high.

Each gland is divided into an outer cortex and an inner medulla. The cortex and medulla of the adrenal gland secrete different hormones. The adrenal cortex is essential to life, but the medulla may be removed with no life-threatening effects.

Symptoms:
Persons claimed to be suffering from adrenal fatigue often suffer from chronic fatigue, sleep disorders, trouble getting out of bed in the morning, depression, low energy, cannot recuperate/regain energy levels, lack of endurance, decreased libido, weight gain/loss,feeling rundown or overwhelmed, craving salty and sweet foods, low stamina, slow to recover from exercise, slow to recover from injury, illness or stress, difficulty concentrating, brain fog, poor digestion low immune function, food or environmental allergies, premenstrual syndrome or difficulties that develop during menopause, consistent low blood pressure, extreme sensitivity to cold and trouble handling stress(physical/emotional).

Causes:
Adrenal fatigue is not typically said to be caused by one source, rather a host of lifestyle factors that supposedly contribute to adrenal fatigue as a whole. Such contributing factors include: stress (physical and emotional), poor diet, lack of exercise, significant use of stimulants (caffeine, nicotine, amphetamines), lack of refreshing sleep, lack of relaxation, illness, being overworked, being post-surgery, as well as other stressors.

Adrenal stress is claimed to tend to occur suddenly after a serious illness or stressful point in life.
Diagnosis:
Adrenal insufficiency can be difficult to diagnose. Your doctor will begin by asking about your medical history and about any obvious symptoms you are experiencing.

Tests that measure the levels of cortisol and aldosterone are used to make a definite diagnosis and include the following:

*ACTH Stimulation Test — This is the most specific test for diagnosing adrenal insufficiency. Blood cortisol levels are measured before and after a synthetic form of adrenocorticotrophic hormone (ACTH), a hormone secreted from the anterior pituitary, is given by injection.

*Insulin-Induced Hypoglycemia Test –– The insulin-induced hypoglycemia test is used to determine how the hypothalamus, pituitary and adrenal glands respond to stress. During this test, blood is drawn to measure the blood glucose and cortisol levels, followed by an injection of fast-acting insulin. Blood glucose and cortisol levels are measured again 30, 45 and 90 minutes after the insulin injection. The normal response is for blood glucose levels to fall (this represents the stress) and cortisol levels to rise.

Other Tests:
Once a diagnosis of adrenal insufficiency has been made, a computed tomography (CT) scan of the abdomen may be taken to see if the adrenal glands are diminished in size, reflecting destruction, or enlarged, reflecting infiltration by some independent disease process. The scan also may show signs of calcium deposits, which may indicate previous exposure to tuberculosis. A tuberculin skin test may be used to address the latter possibility.

A number of imaging tools may be used to examine the size and shape of the pituitary gland. The most common is the magnetic resonance imaging (MRI) scan, which produces a series of images that provide a cross-sectional picture of the pituitary and the area of the brain that surrounds it.

In addition, the function of the pituitary and its ability to produce other hormones are tested. Typically, measurements of ACTH — the pituitary hormone most relevant for maintenance of normal adrenal function — along with thyroid stimulating hormone (TSH), follicle stimulating hormone (FSH), luteinizing hormone (LH) and prolactin are made under resting conditions and following provocative simulation, such as following the administration of corticotrophin releasing hormone (CRH), which leads to an increase in ACTH levels under normal conditions.
Treatment:

Naturopathic Treatment:
According to various “specialists”, usually naturopaths, adrenal fatigue can be treated and reversed with proper lifestyle changes and dietary considerations. By leading a lifestyle more conducive to a healthy lifestyle, avoiding stressful situations, and eating a balanced diet, the adrenal glands can supposedly repair themselves and return to proper functioning. There is wide acceptance among the supplement-makers for adrenal fatigue that the most important nutrient deficiencies are vitamin C, pantothenic acid, vitamin B5. Of the claimed herbal remedies it is worth mentioning licorice, that has a claimed effect of slowing down the breakdown of cortisol. This is said to keep more cortisol in the body, thus relieving some symptoms of adrenal fatigue.

The naturopathic treatment is known as a “long road”, with lots of ups-and-downs, and the way to recovery is said to long and difficult. However, naturopaths consider this more “healthy” since it is based on “healing the body”, rather than simply replacing the missing hormones.

You may click to see:->Articles about “natural thyroid treatments”

Drug Treatment:
Of great supposed importance to treatment of adrenal fatigue is the adrenal hormone cortisol. It is generally recommended by alternative medicine practitioners that in severe cases of adrenal fatigue, the patient should consume low-doses of cortisol for quick relief of symptoms. This also supposedly (never proven) allows the adrenal glands time to heal themselves, and then the person can wean himself off cortisol.

If there are other hormonal deficiencies, they should be corrected as well using either HRT or supporting nutrients (this includes a malfunctioning thyroid gland, and the sex hormones). The medical treatment (using cortisol mostly) is claimed to be quick and efficient, with no noticeable side effects. However most medical doctors tread this treatment as dangerous. This results from the fact that cortisol is usually given in very high doses (~300mg/day) to relief various serious illnesses, resulting in very serious side effects. The doctors believe that giving low dosages (~20-30mg/day) would bear the same side effects, only taking longer. However, in one research paper it has been shown that low dosages of cortisol (<15mg/day) or low dosages of prednisone (<10mg/day) bear no long-time or short-term side effects in the patients, even at long term treatment.

Click on this for some tips that may help

Herbal Treatment:
YOU can protect against adrenal stress with symptoms that include blood sugar swings, low energy, weakness, lethargy, dizziness, headaches, memory problems, food cravings, allergies, Addison’s disease and Cushing’s syndrome with the herbs like:Milk thistle guaranteed-potency extract, licorice root, eleuthero root, suma root, astragalus.

Criticisms:
As of 2008, adrenal fatigue is not an accepted medical diagnosis. It has gained popularity primarily through alternative-medicine books which claim to offer cures for this “disorder”, which is allegedly ignored by the mainstream medical community.

The term adrenal fatigue may also refer to:->

Addison’s Disease
Hypoadrenia
chronic fatigue syndrome

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
http://en.wikipedia.org/wiki/Adrenal_fatigue
http://herbnews.org/adrenaldone.htm

http://www.ucsfhealth.org/adult/medical_services/hormone/adrenal/conditions/insufficiency/diagnosis.html