| Hyper-pigmentation |
(+) |
(-) |
Lack of glucocorticoid negative feedback increases the release of ACTH and other POMC-peptides; these POMC-peptides are responsible for hyperpigmentation by acting on the MSH receptors in the skin |
| Hyperkalemia |
(+) |
(-) |
Due to mineralocorticoid deficiency |
| Signs of other pituitary hormone deficiencies |
(-) |
(+) |
Pan-hypopituitarism from lesions directly affecting pituitary gland |
| Headaches; visual field deficits |
(-) |
(+) |
From direct effect of pituitary lesion |
| Hyponatremia |
(+) |
(+) |
Due to mineralocorticoid deficiency, GC deficiency (leading to SIADH) in primary adrenal insufficiency, and dilutional in secondary adrenal insufficiency |
| Hypoglycemia |
(+) |
(++) |
Glucocorticoid deficiency |
| Orthostatic hypotension |
(+) |
(+) |
Mineralocorticoid deficiency is not seen in secondary adrenal insufficiency, as mineralocorticoids are principally regulated by the plasma renin-angiotensin system. Hypotension in secondary adrenal insuffiency occurs due to decreased vascular tone as a result of reduced vascular responsiveness to angiotensin II and norepinephrine |
| Anorexia; weight loss; fatigue; generalized malaise; decreased libido |
(+) |
(+) |
Glucocorticoid deficiency |
| Loss of axillary/pubic hair in women |
(+) |
(+) |
Loss of adrenal androgens |
