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Message: <blockquote data-quote="JohnEGreen" data-source="post: 1483621" data-attributes="member: 223921">Further to this."What is Secondary Adrenal InsufficiencyThere are normally two adrenal glands, located one above each kidney. The adrenal glands are really two endocrine glands in one. The inner part produces epinephrine (also called adrenaline). The outer portion of the adrenal is called the cortex. It makes two important steroid hormones, cortisol and aldosterone.Cortisol mobilizes nutrients, modifies the body’s response to inflammation, stimulates the liver to raise the blood sugar, and also helps to control the amount of water in the body.Aldosterone regulates salt and water levels which affects blood volume and blood pressure.Cortisol production is regulated by another hormone, adrenocorticotrophic hormone (ACTH), made in the pituitary gland, which is located just below the brain. In most individuals, aldosterone production is not dependent on ACTH.Primary adrenal insufficiency, also known as Addison’s disease, is caused by the total or near total destruction of the adrenal glands and results in the severe deficiency of both cortisol and aldosterone.Secondary adrenal insufficiency, in contrast, is due to the absence of the normal stimulation to the adrenal cortex from a lack of ACTH. This results in a partial or total deficiency of cortisol, but often a normal or near normal production of aldosterone.What Causes Secondary Adrenal InsufficiencyThe two major types of secondary adrenal insufficiency are diseases that cause a total absence of ACTH and those that cause a suppression of ACTH production. Since ACTH is made in the pituitary under the control of the part of the brain called the hypothalamus, diseases that destroy either the hypothalamus or pituitary can cause this lack of ACTH. Most common are pituitary tumors, craniopharyngiomas, surgery to remove a tumor, radiation therapy to the pituitary, cysts in the pituitary, and some inflammatory diseases.The most common cause of suppression of ACTH is the use of glucocorticoid medications to treat a large variety of illnesses. Glucocorticoids are steroid hormones that act like cortisol. They include cortisone, hydrocortisone, prednisone, prednisolone, dexamethasone, as well as intravenous, intramuscular, inhaled and topical “steroids.” All of these medications have an effect on ACTH because the pituitary is producing this hormone in response to the body’s need for cortisol. When the cells in the pituitary recognize any of these drugs, they sense that there is cortisol present and therefore produce less ACTH. This ACTH suppression from glucocorticoid medication can be very temporary, prolonged, or permanent depending on the dose, potency and length of use of the medication. For example, a few days of prednisone will not produce a significant problem, but several weeks of prednisone at a dose of 10 mg will diminish the cortisol level and the ability to fight a stressful situation. Recovery of the pituitary-adrenal response after use of a suppressive dose for more than one month will take about one month. Generally, this one for one recovery time is typical up to about 9 to 12 months, when recovery will often take up to a year or may not occur at all."<a href="http://www.nadf.us/adrenal-diseases/secondary-adrenal-insufficiency/" target="_blank">http://www.nadf.us/adrenal-diseases/secondary-adrenal-insufficiency/</a></blockquote>

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