Table 2. Symptoms and laboratory changes in adrenal cortical insufficiency (AI).

Hormone	Symptoms
ACTH (POMC) stimulation (primary AI)	Hyperpigmentation
ACTH (POMC) suppression (secondary/tertiary AI)	Pale complexion
Glucocorticoid deficiency	Fatigue and decreased performance
	Appetite / Weight loss
	Nausea, vomiting, and abdominal pain
	Myalgias and joint pain
	Orthostatic hypotension
	Anemia, lymphocytosis, eosinophilia
	Hypoglycemia / hypoglycemic tendency
	Hyponatremia (no inhibition of ADH secretion)
	Hypercalcemia
	Slight TSH increase
Mineralocorticoid deficiency (primary AI)	Hypotonia, hypovolemia, creatinine increase, orthostatic dysregulation
	Hyponatremia
	Hyperkalemia
	Salt hunger
Androgen deficiency	Loss of axillary and pubic hair (females)
	Dry skin (females)
	Depression, loss of libido (females)

ACTH, adrenocorticotropic hormone; ADH, antidiuretic hormone; POMC, proopiomelanocortin; TSH, thyroid stimulating hormone