Adrenal Intro

• Key Concepts

Steroids

• Output can be measured over 24H
  • High amounts of Glucocorticoids, Androgens - and their precursors
  • Fewer Mineralocorticoids

Hormones Produced: Glucocorticoids, Mineralocorticoids, Catecholamines

• Corticosteroids: Lipid soluble, bind to Intracellular receptors, alter gene transcription, Exact Action on tissue and ability to bind to specific receptors (and recruit cofactors)
• Mineralocorticoids
• Glucocorticoids
• Androgens
• Catecholamines

Adrenal Disorders

Primary Adrenal Insufficiency

Addison's Disease (Autoimmune)

Described 1855, Thomas Addison

Atrophy, Fibrosis of Glands

Glucocorticoid, Mineralocorticoid, Androgen

Hyperpigmentation (Areas of Abrasion/scarring) as Cortisol reduced → ACTH Secretion Increases by Negative Feedback → ACTH increases Melanocyte stimulating Hormone?

Vitiligo = Autoimmune, may with Autoimmune Adrenalitis (PAI)

• Primary Insufficiency - ACTH High/Normal, Cortisol Low (Adrenal) RAAS Differences
• Secondary Insufficiency - ACTH Low, Cortisol Low (Pituitary/Hypothalamus) NO RAAS Differences, Other HPA Axes may show effects
  • Exogenous Steroid use suppressing Hypothalamus/Pituitary
  • Tumour
• Pharmacology GC