SECONDARY AND TERTIARY ADRENAL INSUFFICIENCY
In secondary adrenal insufficiency, an insufficient amount of ACTH is produced by the pituitary gland. In tertiary adrenal insufficiency, an insufficient amount of CRH is produced by the hypothalamus.
Symptoms — The symptoms of secondary and tertiary adrenal insufficiency are similar to those of primary insufficiency, with a few exceptions:
- Darkening of the skin and dehydration do not occur
- Gastrointestinal symptoms are less common
- Symptoms of hypoglycemia (low blood sugar) are more common, including sweating, anxiety, shaking, nausea, or heart palpitations
A tumor or other growth in the pituitary or hypothalamus can cause other symptoms, including headaches and difficulty seeing objects in the periphery of vision (to the far left and right). Also, low levels of pituitary hormones can develop and may cause infertility, impotence, fatigue, hoarseness, constipation, or a delay in beginning puberty or short stature in children.
Adrenal Insufficiency New Zealand 