Adrenal suppression

Adrenal suppression is a medical condition characterized by decreased function of the adrenal glands, leading to insufficient production of certain hormones, primarily cortisol. This condition can arise as a consequence of exogenous steroid use or due to diseases affecting the adrenal glands.

Causes

Adrenal suppression is most commonly caused by the prolonged use of corticosteroids, which are often prescribed for conditions like asthma, rheumatoid arthritis, and lupus. When corticosteroids are taken externally, the body's natural feedback mechanisms cause the adrenal glands to reduce their production of cortisol. Other causes include diseases such as Addison's disease, adrenal insufficiency, and other disorders that directly impair adrenal function.

Symptoms

The symptoms of adrenal suppression can vary widely depending on the severity of cortisol deficiency. Common symptoms include:

• Fatigue
• Muscle weakness
• Weight loss
• Low blood pressure
• Abdominal pain
• Nausea
• Dizziness

In severe cases, adrenal suppression can lead to an adrenal crisis, a life-threatening condition that requires immediate medical attention.

Diagnosis

Diagnosis of adrenal suppression typically involves a series of endocrine tests to measure cortisol levels. The ACTH stimulation test is commonly used to assess the functionality of the adrenal glands. Additional blood tests may be conducted to measure levels of other hormones and electrolytes.

Treatment

Treatment of adrenal suppression focuses on addressing the underlying cause and managing the symptoms. If the condition is caused by the use of corticosteroids, a gradual tapering of the medication is usually necessary to allow the adrenal glands to resume normal cortisol production. In cases where adrenal function is severely impaired, lifelong replacement therapy with synthetic corticosteroids may be required.

Prevention

Preventing adrenal suppression involves the judicious use of corticosteroids, monitoring their use closely, and using the lowest effective dose for the shortest period necessary. Regular follow-up with a healthcare provider is essential to monitor adrenal function and adjust treatment as needed.

See also

• Cushing's syndrome
• Hypopituitarism
• Steroid use