Problem of frequent urination and sweating

Hello,

Your symptoms of frequent urination, sweating associated with low b.p (hypotension) indicate a problem with your adrenal glands. Adrenal glands situated above kidneys secrete steroid hormones which are important to maintain blood pressure, fluid balance and reproductive functions. They are controlled by pituitary gland situated in brain through a regulating hormone called ACTH (Adrenal cortico trophic hormone). Deficiency of adrenal hormone secretion can be either due to defective adrenal glands or pituitary gland.

Chronic primary adrenal insufficiency called Addison's disease can be due to destruction of adrenal glands due to autoimmune disease or infections like tuberculosis or cancer metastasis. There can also be a congenital enzyme deficiency in adrenal glands which can impair steroid production. 21- hydroxylase enzyme deficiency an autosomal recessive genetically inherited disease can cause congenital adrenal hyperplasia (CAH) with symptoms like hypotension, excessive fluid loss by sweating and urination and masculine features in females. Secondary adrenal insufficiency is due to defective ACTH production by pituitary gland. Pituitary gland can be defective due to pituitary adenoma, brain injury etc. Empty sella syndrome which usually occurs in obese females can cause atrophy of pituitary gland.

Hormonal analysis should be done to know the cause of deficiency. If it is the problem of adrenal gland, steroid hormones like cortisol and aldosterone will be low in blood, but ACTH will be increased. If the problem is with pituitary gland ACTH will be decreased along with steroid hormone levels. ACTH stimulation test can also be done to distinguish between primary and secondary adrenal deficiency. Further CT/MRI scans can be helpful in visualizing pituitary gland. After proper evaluation, appropriate treatment can be given by substituting defective hormones. Surgery may be required to remove any pituitary adenoma if detected. Take a consult with either general physician or endocrinologist for detailed evaluation.

Thank you. Do get back with any further queries.