Primary adrenal cortical insufficiency - not enough steroid hormones cortisol and aldosterone. Cortisol in the main issue
- Autoimmune is most common form
Triad of hyperpigmentation, postural hypotension and hyponatraemia
ACTH excess → increased melanin production → bronze appearance (hyperpigmentation)
Diagnosis via short synactin test (stimulation of cortisol)
Management
Cortisol replacement: Treatment with hydrocortosone (20-30mg) divided doses, with the majority of the dose given in the morning. Double dose in times of stress
**Aldosterone replacement:**flurocortisone