Talk:Adrenal insufficiency

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Congenital Adrenal Hyperplasia[edit]

Congenital Adrenal Hyperplasia is th primary cause of Adrenal Insufficiency. Stop deleting links when you haven't a clue about the subject!! I have two kids with CAH and people will come here looking for info about it. Dannycarlton 23:32, 6 June 2006 (UTC)

As I explained on my talkpage in response to your message, the link belongs on congenital adrenal hyperplasia. I do have a clue about the subject. The vast minority of people with adrenal insufficiency have CAH. JFW | T@lk 23:49, 6 June 2006 (UTC)
From eMedicine "Primary adrenocortical insufficiency is an uncommon disorder with an incidence in Western populations near 50 cases per 1,000,000 persons." Since, in the general population about one person in 50 carries the CAH gene (trait). That would make the instance of CAH one in every 2,500. It's actually a bit more rare than that, but obviously the figures account for quite a significant number of those with Adrenal Insufficieny. Dannycarlton 00:06, 7 June 2006 (UTC)

Danny: the link belongs on the CAH page. Most adrenal insufficiency is caused by steroid therapy and autoimmune causes. Have you reviewed our external links policy yet? JFW | T@lk 00:12, 7 June 2006 (UTC)

Please refrain from editing topics that you know so little about. You are one of the reasons Wikipedia has such a horrible reputation. I have been deeply involved in CAH for over 12 years now, and you apparently looked it up once. Stop turning WP into your personal site and let people offer information when they know the topic. Dannycarlton 02:05, 7 June 2006 (UTC)

DNFTT. JFW | T@lk 02:16, 7 June 2006 (UTC)

I've been involved in helping people with Addison's, primary and secondary adrenal insufficiency for years, dealt with at least 3000 people in that time and have run across CAH no more than half dozen times.Chrisgj (talk) 03:43, 25 August 2008 (UTC)

Waterhouse-Friderichsen syndrome?[edit]

This entry lists Waterhouse-Friderichsen syndrome as an adrenal insufficiency condition, but the page of that syndrome says that "It is sometimes said that the hemorrhage in Waterhouse-Friderichsen syndrome causes an acute adrenal insufficiency, but this is inaccurate, since blood cortisol levels are not decreased. The shock, purpura and intravascular clotting are probably the result of an endotoxin mediated immune reaction caused by sepsis." so it seems like there's a contradiction. DiamonDie 11:32, 30 August 2006 (UTC)

In every source I've seen, not one has mentioned sepsis as probable. Neither have I found anything to suggest that cortisol levels are normal in cases Waterhouse-Friderichsen syndrome In fact, it is likely that this statement is entirely speculative. I can find no sources to back up the statement. I have suggested editing the article on Waterhouse-Friderichsen syndrome. From [1]: "24 patients (among 35 clinical cases) with meningococcal Waterhouse-Friderichsen syndrome were submitted to pathologic anatomical examinations (including 18 microscopic investigations). Two aspects were found: 12 cases of mild suprarenal hemorrhage (histological evidence only), but associated with massive degeneration of the adrenocortical cells, leptomeningitis, distinct thymic hypertrophy with microthrombi in various organs. The other 12 cases presented massive bilateral suprarenal hemorrhage with medium status thymo-lymphaticus and distinct capillary thromboses in all organs investigated (consumptive coagulopathy)."
Tiny.ian 00:38, 16 September 2006 (UTC)

I'm adopting this article[edit]

I noticed this article was started 4 years ago, but hasn't had any real attention. Hadn't not changed hardly, stayed a stub for 4 years. I'm finishing with ACTH stimulation test which I started and been working on for 6 months and about to call it all done. Submitting reassessment of grade Sept 1st, then I will focus all my attention on this article which I've worked on some the last two nights and will work on for the next few months. This article I will devote to the same as I did ACTH stimulation test.Chrisgj (talk) 01:54, 22 August 2008 (UTC)

I found several problems with the previous version, but really tried to keep as many bits of the original as I could which unfortunately isn't that much.Chrisgj (talk) 03:10, 26 August 2008 (UTC)

Possible source[edit]

ISBN 9780198570158 (medical textbook) is available at books.google.com, and chapter 12.7 is entirely about adrenal problems. I think that it could be a useful citation for many currently unsupported statements in this article. WhatamIdoing (talk) 18:06, 8 September 2008 (UTC)

Problems with "Simple Diagnosis Chart" Section[edit]

I noticed a problem with the "simple diagnostic table": there seems to be some disagreement among various sources about whether or not aldosterone levels are affected (i.e. decreased) during secondary adrenal insufficiency.

Aldosterone NOT Affected Aldosterone Affected Equivocal
This source (cited in the article) states: "This form of Addisons [sic] disease [secondary AI] can be traced to a lack of ACTH, which causes a drop in the adrenal glands [sic] production of cortisol but not aldosterone."

"With secondary adrenal insufficiency, aldosterone production is usually not affected." --LabTestsOnline

"Because the adrenal hormone aldosterone is not primarily regulated by pituitary ACTH, patients with secondary adrenal insufficiency continue to produce aldosterone." --Adrenal Insufficiency, Pejman Cohan, M.D. and Anne Peters, M.D.

"An additional feature distinguishing primary adrenocortical insufficiency is the near-normal level of aldosterone secretion seen in pituitary and/or isolated ACTH deficiencies." --Harrison's Endocrinology

McPhee et al. write: "No matter what the origin, the clinical manifestations of adrenocortical insufficiency are a consequence of deficiencies of cortisol, aldosterone, and (in women) androgenic steroids." --Pathophysiology of Disease: an Introduction to Clinical Medicine, 4th ed., p. 597; Lange, 2003

"In secondary adrenal insufficiency, baseline aldosterone levels may be low or normal...." --Manual of Endocrinology and Metabolism, by Norman Lavin

I think the value for aldosterone for secondary AI should be changed to "normal." Also, perhaps this table could use some more scrutiny. —Preceding unsigned comment added by Dwstultz (talkcontribs) 16:47, 17 May 2011 (UTC)

A suggestion: the intent of most of the table is far from clear. An umbrella heading over columns CRH to K, such as "possible pathologies", could fix that.

And a query: the meaning that I understand the phrase "exogenous steroid use" to intend to convey is use of exogenous corticosteroids. Would there be any disagreement with that? Thanks…

Signatorius (talk) 12:35, 17 March 2013 (UTC)

Medical legitimacy of adrenal fatigue / hypoadrenia?[edit]

The "See also" section contained the following entry for adrenal fatigue, which seems to misleadingly suggest an air of medical legitimacy which the article itself does not:

  • Hypoadrenia (adrenal fatigue), the precursor to adrenal insufficiency.


I replaced it with the following, based on the adrenal fatigue article's text:


--Piet Delport (talk) 23:38, 12 April 2012 (UTC)

Treatment in case of exogenous steroid use[edit]

Can someone add the recommended treatment in the relevant section, in case the adrenal insufficiency is caused by exogenous steroid use? Is it simply a matter of tapering off the medication and waiting for endogenous function to return to normal, or is there something else that can be done in addition to speed up endogenous production recovery?

62.195.45.181 (talk) 19:33, 17 January 2014 (UTC)

"ADH" Disambiguation[edit]

This page was identified as including a disambiguation error based on the term "ADH".

In order to resolve this problem I have removed the wikilink from the term as I am unable to determine, from the context, what it is referring to. If you wish to restore the link please ensure that the term and the link are fully resolved so that no further disambiguation occurs. Perry Middlemiss (talk) 06:23, 22 January 2015 (UTC)

Yes check.svg Done BakerStMD T|C 15:28, 22 January 2015 (UTC)
Many thanks. Perry Middlemiss (talk) 19:24, 22 January 2015 (UTC)