Glucocorticoid deficiency |
Gastrointestinal symptoms (nausea, vomiting) |
Fatigue, weakness |
Weight loss, anorexia |
Morning headache |
Fasting hypoglycemia (due to increased insulin sensitivity) |
Hyperpigmentation of skin, mucosa, palmar creases, axillae, gingival borders* |
Decreased gastric acidity |
Decreased free water clearance (causing hyponatremia)¶ |
Decreased height velocity (if deficiency is severe and chronic) |
Mineralocorticoid deficiency |
Hypotension, dizziness |
Muscle weakness |
Lethargy |
Gastrointestinal symptoms (nausea, vomiting, anorexia) |
Salt craving |
Weight loss |
Dehydration |
Hyponatremia, hyperkalemia, metabolic acidosis |
Adrenal androgen deficiency in femalesΔ |
Decreased pubic and axillary hair development in pubertal patients |
Decreased libido in older patients |
POMC: pro-opiomelanocortin; MSH: melanocyte-stimulating hormone; ACTH: adrenocorticotropic hormone.
* Hyperpigmentation is caused by increased POMC cleavage products. POMC is the precursor molecule for adrenocorticotropic hormone, several forms of MSH, and beta-endorphin.
¶ Glucocorticoid deficiency causes isolated hyponatremia due to decreasedvfree water clearance, but patients with concomitant mineralocorticoid deficiency may have both hyponatremia and hyperkalemia.
Δ A notable exception is that individuals with congenital adrenal hyperplasia have excessive rather than deficient production of adrenal androgens. The adrenal androgen overproduction is due to disrupted adrenal steroidogenesis leading to cortisol deficiency, which causes excessive ACTH signaling.Do you want to add Medilib to your home screen?