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adrenocortical_insufficiency [2018/03/14 08:02] (current)
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 +======= Adrenocortical Insufficiency =======
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 +[[wp>​Adrenocortical insufficiency]] relates to the deficient production of the [[wp>​adrenocortical hormones]]. It can result from [[stress]], injury or destruction of the [[wp>​adrenal gland]], [[wp>​pituitary]] or [[wp>​hypothalamic]] dysfunction,​ or the chronic usage of [[wp>​corticosteroids]]. Adrenocortical insufficiency is really only recognized as an overt disease in [[pathology]],​ but [[herbalist]]s recognize a subclinical form that affects people under chronic [[wp>​stress]].
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 +[[wp>​Addison’s disease]] is a [[chronic]],​ progressive disease caused by a failure of [[wp>​adrenocortical secretion]],​ characterized by a deficiency of [[wp>​glucocorticoids]],​ [[wp>​mineralcorticoids]] and [[wp>​androgen]]s. The [[etiology]] of [[Addison’s disease]] in most patients (75%) is unknown, but is thought to be related to an [[wp>​autoimmune process]], as patients typically present with other autoimmune [[wp>​endocrinal disease]]s. ​ The remainder of cases relate to [[wp>​granulomatous]] conditions from [[infection]] (e.g. [[wp>​tuberculosis]]),​ as well as [[wp>​amyloidosis]],​ [[cancer]], [[wp>​adrenal hemorrhage]],​ [[wp>​sarcoidosis]],​ and the treatment of [[fungal infection]]s with [[wp>​ketoconazole]]. (Rubin 2001, 615-16; Berkow 1992, 1088)
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 +Clinically apparent indications of Addison’s only occurs after 90% or more of the adrenal gland is destroyed. The initial symptoms are insidious, including weakness, poor appetite, and [[wp>​asthenia]]. As the condition progresses there is increased pigmentation,​ caused by increased melanocyte-stimuliting activity of pituitary pro-opiomelanocortin,​ which is commensurate with an increase in ACTH secretion. This is characterized by a diffuse “tanning” of both exposed and unexposed portions of the body, including on bony regions, skinfolds, and scars. Another common feature is the appearance of blackish freckles over the forehead, face, neck, and shoulders, as well as bluish-black discolorations of the areolae and mucous membranes. In some cases vitiligo may be present. Hypotension (e.g. 80/50 mm Hg) occurs as the result of mineralcorticoid insufficiency,​ from the resulting low serum sodium. As the condition progresses signs and symptom include nausea, vomiting, diarrhea, and cold intolerance. (Rubin 2001, 616p; Berkow 1992, 1088)
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 +An adrenal crisis is a life threatening emergency that results from an abrupt loss of adrenocortical function. Symptoms typically relate to a deficiency in mineral corticoid secretion, and are characterized by hypotension and shock, commensurate with profound weight loss, abdomen pain, and lower back and leg pain. If untreated renal failure with azotemia is a result. The crisis can be caused by the stress of acute infection or surgery, and in some cases from sodium loss due to excessive sweating. Waterhouse-Friederichsen syndrome relates to the acute injury of the adrenal glands secondary to meningococcal or pseudomonal infections of the blood, usually occurring in young patients and typified by sudden vascular collapse, hypotension,​ fever, myalgia and pupura. In most cases an adrenal crisis is caused by the abrupt withdrawal of corticosteroid therapy. (Rubin 2001, 616p; Berkow 1992, 1088)
 +Medical treatment
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 +The primary medical management of Addison’s disease consists hormone replacement with synthetic cortisone, hydrocortisone and fludrocortisone. Although these drugs can promote significant changes in the course of the disease, they also have a simultaneous immunosuppressant activity thus making the patient more susceptible to secondary infection. Prolonged use of corticosteroids may produce posterior subcapsular cataracts, glaucoma with possible damage to the optic nerves Dehydroepiandrosterone (DHEA) is an adrenal steroid hormone that is a precursor to cortisone and has recently undergone recent investigation in Addison’s disease, used in conjunction with glucocorticoid and mineral corticoid therapy, and was demonstrated to have a benefical effect upon mood and fatigue (Hunt et al 2000).
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 +Patients with Addison’s are advised to not restrict salt in their diets, and in patients that live in warm climates or exercise regularly to increase their salt and electrolyte intake because of an increased loss of sodium as a result of sweating.
 +Holistic treatment
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 +The holistic treatment of Addison’s disease is complimentary,​ using herbs and supplements to support adrenal function and prolong the half-life of the glucocorticoids. Perhaps the best studied herb for this is Licorice (Glycyrrhiza glabra), which was studied in the 1950’s for its synergistic activity with corticoids in the treatment of Addison’s (Borst et al 1953). Other botanicals to consider include [[Ashwagandha]] (Withania somnifera), Siberian Ginseng (Eleutherococcus senticosis),​ and American Ginseng (Panax quinquefolium). Adequate amounts of vitamins B and C should also be considered. The holistic treatment of Addison’s disease should occur under proper medical supervision to monitor the effects of treatment on glucocorticoid and mineralcorticoid levels.
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 +[[Fair Use]] Source: http://​www.toddcaldecott.com/​index.php/​healing/​conditions/​175-adrenocortical-insufficiency
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 +http://​www.ayurveda-california.com/​distance_learning/​index.php/​diseases-treatment-with-ayurveda-chinese-medicine/​adrenocortical-insufficiency
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adrenocortical_insufficiency.txt · Last modified: 2018/03/14 08:02 (external edit)