1) Adrenal dysgenesis – when the adrenal glands failed to develop adequately
2) Impaired steroidogenesis – when the glands are present but are unable to produce cortisol)
3) Adrenal destruction due to a disease such as:
• An autoimmune condition
• Infections of the adrenal glands
• Cancer metastizing to the adrenal glands
• Bleeding into the adrenals
The pituitary gland produces the adrenocorticotropic hormone (ACTH), which stimulates the adrenal cortex to produce its hormones. Secondary adrenal insufficiency occurs when the ACTH is produced in inadequate amounts leading to insufficient production of adrenal hormones. This can occur even if the adrenal glands are in good condition.. Secondary adrenal insufficiency also occurs when people who are on corticosteroids (as a part of their treatment for asthma or arthritis) stop taking the supplements abruptly.