What is the aim of treatment for primary adrenal insufficiency?

The aim of treatment for primary adrenal insufficiency, also known as Addison's disease, primarily focuses on replacing the glucocorticoid hormone that the adrenal glands are unable to produce adequately due to damage or dysfunction. Cortisol is the main glucocorticoid, and its replacement is essential for maintaining normal physiological functions, including metabolism, immune response, and stress response.

In primary adrenal insufficiency, the adrenal glands do not produce sufficient cortisol, leading to a variety of symptoms such as fatigue, weakness, weight loss, and low blood pressure. Therefore, the administration of synthetic glucocorticoids, typically hydrocortisone, is necessary to restore normal cortisol levels in the body, helping to alleviate these symptoms and prevent adrenal crises.

While primary adrenal insufficiency may also affect aldosterone production, the primary goal of treatment is to correct the deficiency of cortisol specifically. Increasing ACTH levels or enhancing the adrenal hormone production are not feasible therapeutic goals because the underlying issue is the lack of hormone production from the glands rather than a simple deficiency that can be improved with stimulation. Reducing aldosterone levels would counteract the effects needed to manage the patient's condition effectively.