What Does It Mean When Your Child Has Secondary Adrenal Insufficiency?

Stress is regulated by a hormone called cortisol — and it’s vital to your child’s health and wellbeing. Stress can happen if your child gets sick with the flu or breaks a bone.

Cortisol is the “stress hormone.” It helps to keep your child’s blood pressure and blood sugar normal and helps the body respond to stress. It is especially important when their body needs to fight an infection or recover from illness or injury.

Some cancers and cancer treatments affect the parts of the body that make cortisol, which can make cortisol levels lower than normal. This can cause a condition called secondary adrenal insufficiency.

Secondary Adrenal Insufficiency: The Basics

Secondary adrenal insufficiency occurs when your child’s pituitary gland — a small pea-sized organ located at the bottom of the brain — doesn’t make enough of a hormone called adrenocorticotropin (ACTH). If ACTH is low, cortisol levels in the adrenal glands (located above their kidneys) may also decrease or may be absent.

There are two major causes of secondary adrenal insufficiency:

1. The use of high dose steroid medications (glucocorticoids) for long periods of time. Glucocorticoids are steroid hormones that act like cortisol and send signals to the pituitary gland to make less ACTH.

2. Diseases or procedures that cause an absence of ACTH. For example, pituitary tumors and the surgery to remove them, radiation therapy to the pituitary gland, and some inflammatory diseases. If ACTH is absent, the adrenal glands won’t make cortisol.