How much cortisol is normally produced and what is Addison’s disease?

How much cortisol is normally produced and what is Addison’s disease?

Under normal conditions approximately 30 mg of cor-tisol is produced daily. During periods of extreme stress (e.g., thoracic aortic surgery or septic shock) up to 300 mg may be produced over the course of 24 hours.

Addison’s disease results from chronic lack of endoge-nous cortisol (and usually aldosterone) production and results in fatigue, weakness, anorexia, increased skin pig-mentation, hypotension, hypoglycemia, hyponatremia, and hyperkalemia. The majority of cases are idiopathic.

Addisonian “crisis” is an acute adrenocortical insuffi-ciency resulting in these same findings but with a more severe presentation in which shock, coma, and death can occur. Acute adrenocortical insufficiency may occur in the face of an absolute or relative lack of glucocorticosteroids. 

Chronic exogenous steroid administration impairs the adrenal gland’s ability to respond with increased produc-tion of glucocorticosteroids during periods of stress. In such instances, additional exogenous steroid administra-tion will be necessary to prevent the above-mentioned sequelae.