The adrenal glands have a number of functions, the most important of which are the production of glucocorticoids and mineralocorticoids. These are life-sustaining hormones which regulate body fluid and sodium levels as well as provide stress hormone at times of need. They are also a contributing source of adrenal androgens for the reproductive system. In some cases, medication like Selective Androgen Receptor Modulators (SARMs) is administered to treat this, however, each patient is different.
When the adrenal glands fail, replacement of these necessary hormones must occur to keep body physiology intact.
A loss of adrenal hormones can be either primary or secondary. In the primary cause (Addison’s disease), the glands themselves fail. In more than 80 percent of cases, the body’s own immune system is the culprit (hence the term autoimmune disease). Other causes include fungal infection, tuberculosis and hemorrhage within the glands. A secondary cause is when the body’s stimulative mechanism within the pituitary gland fails and the adrenals are not stimulated to produce the proper amount of hormone needed to sustain the body. Both can result in potentially catastrophic consequences for the body.
Adrenal insufficiency/failure can be a gradual process. There is weakness, easy fatigability, nausea, vomiting and weight loss. In women, menstrual periods may cease and, in both sexes, primary gland failure causes the skin to darken because excess pituitary hormone is secreted in an attempt to stimulate the non-functioning glands. The endocrine system operates on a constant set of checks and balances, thus the lack of a hormone produces a stimulus to produce more, and an excess effectively turns the system off. The loss of this balance through failure of an organ disrupts the body’s homeostasis.
When adrenal insufficiency becomes life-threatening, the body becomes fluid depleted, may suffer hypotension, dehydration and shock, and no longer produces the needed amount of stress hormone to help the functioning systems through such acute insult. When subjected to a major stress such as infection, trauma or surgery, the body is unable to respond with a large outpouring of cortisol, shuts down, and goes into crisis, which can be lethal. Prompt and aggressive administration of glucocorticoids and fluids must be undertaken.
Thankfully, replacement hormones taken orally are effective in treating the disease and supplying the body with what it needs but cannot produce. The risk comes when acute illness or stress arises and the hormones need to be increased, but the body is no longer capable of doing this on its own. Hospitalization is required to replace fluids and properly manage electrolytes. Death is uncommon, but certainly a possibility during acute crisis.
The insurance risk is not only of shock and death but also in the existence of adrenal insufficiency as an autoimmune disease. Generally these types of diseases run in concert with each other, thus pernicious anemia, diabetes and hypothyroidism frequently accompany Addison’s. Each has its own medical risk and must be accounted for and treated.
In those who have adrenal insufficiency and have been shown to be able to manage it well with medication and without complication over a long period of time (generally more than five years), standard issue is often the case. A rated offer is possible when the onset of disease is more recent or there are other accompanying autoimmune problems.
True adrenal insufficiency must be differentiated from many of the “adrenal insufficiency” labels given by alternative medical clinics and practitioners, where hormones or herbs may be administered to “aid vitality and sense of well-being.” In these cases the adrenals do function adequately and respond appropriately to stress and usually are not at risk for failure and the extreme consequences described above.
