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This is a relatively rare, serious disorder of the adrenal gland in which there is insufficient production of one or more hormones. Deficient production of aldosterone leads to excessive excretion of sodium and water in the urine, and increased retention of potassium. These changes lead, in turn, to lowered blood volume, dehydration, and hypotension. Patients may have a craving for salt, thirst, profound weakness, vomiting, diarrhea, and changes in heart rhythm.

Deficient production of other hormones, glucocorticoids, leads to rapid depletion of liver glycogen and to hypoglycemia a few hours after meals. If no food has been eaten for 10 to 12 hours hypoglycemia is severe.

Mild insufficiency is often controlled by increasing the salt intake and by giving five to six meals daily. Cortisone may be prescribed to control hypoglycemia. When the deficiency is severe deoxycorticosterone (DOCA) is prescribed to control the mineral metabolism.

A high-protein, low-carbohydrate diet is essential in order to reduce the stimulation by insulin and the subsequent hypoglycemia. Simple sugars are especially avoided. Midmorning, mid-afternoon, and late evening snacks high in Protein and low in carbohydrate are used.

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