What is the Origin of Hypocortisolism?

The term combines the Greek prefix hypo- (meaning "under" or "deficient") with cortisol, the name of the primary human glucocorticoid hormone. The clinical recognition of this condition is historically linked to Thomas Addison, who first described the constellation of symptoms resulting from adrenal insufficiency in the mid-19th century. Modern endocrinology utilizes this term to precisely describe the state of insufficient circulating cortisol, regardless of the underlying etiology within the HPA axis.

What is the Mechanism of Hypocortisolism?

The primary mechanism involves a compromised steroidogenesis pathway within the adrenal cortex, typically due to autoimmune destruction in primary hypocortisolism, preventing the conversion of cholesterol into cortisol. In secondary cases, the pituitary fails to secrete adequate Adrenocorticotropic Hormone (ACTH), which is the necessary trophic signal for adrenal cortisol production. The resulting deficit in circulating cortisol compromises essential physiological functions, including glucose counter-regulation, vascular tone maintenance, and immune modulation, leading to systemic collapse if left untreated.

Hypocortisolism ∞ Area

Hypocortisolism

Meaning

Hypocortisolism is a clinical state characterized by the chronic underproduction of the glucocorticoid hormone cortisol by the adrenal cortex, leading to a spectrum of non-specific symptoms including persistent fatigue, muscle weakness, and orthostatic hypotension. This endocrine disorder can be classified as primary, such as Addison’s disease, due to adrenal gland destruction, or secondary/tertiary, due to insufficient ACTH or CRH secretion from the pituitary or hypothalamus, respectively. Accurate diagnosis requires rigorous biochemical testing, often involving ACTH stimulation tests, to determine the functional reserve of the adrenal glands.

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What Are the Long-Term Effects of Unmanaged Stress on Adrenal Hormones?

Unmanaged stress dysregulates the HPA axis, leading to systemic hormonal imbalance and a decline in physiological resilience.

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What Are the Early Indicators of Impaired Glucocorticoid Metabolism?

Early signs of impaired glucocorticoid metabolism are persistent fatigue, mood shifts, and sleep issues, reflecting a dysregulated stress response system.

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