Exogenous adrenal insufficiency

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Endocrine glands

Exogenous adrenal insufficiency is a condition of low levels of hormones released by the adrenal glands, caused by factors other than problems with the glands themselves. See Addison's disease for information on adrenal deficiency caused by problems within these glands.

Drug-induced adrenal insufficiency

Glucocorticoid medications such as prednisone, hydrocortisone, and dexamethasone are similar to natural hormones produced by the adrenal glands. They are used to treat a variety of conditions, including many inflammatory diseases such as asthma and some forms of arthritis.

Treatment with glucocorticoids can slow down the production of adrenal hormones, because of the effect the medicine has on the pituitary gland, the master gland that controls the adrenal glands.

If glucocorticoids are stopped or decreased too quickly, the adrenal glands may not begin making their own hormones again fast enough to meet the body's needs, and symptoms of adrenal insufficiency result. This condition usually occurs when these drugs are given by pills or injections, rather than on the skin, or when they are given in inhaled forms. Higher doses and longer treatments increase the risk of adrenal insufficiency.

Abruptly stopping treatment with glucocorticoids is the most common cause of adrenal insufficiency.

Other drugs that may cause adrenal insufficiency include the following:

• Megestrol
• Ketoconazole
• Metyrapone
• Aminoglutethimide
• Mitotane

These drugs have direct effects on the adrenal glands, decreasing glucocorticoid production.

Review Date: 08/08/2006
Reviewed By: Robert Hurd, MD, Department of Biology, College of Arts and Sciences, Xavier University, Cincinnati, OH. Review provided by VeriMed Healthcare Network