Coronavirus News: Tiredness And Fatigue In the COVID-19 Era Could be Due To Addison’s Disease As SARS-CoV-2 Also Attacks The Adrenal Glands

Coronavirus News: Tiredness And fatigue are two common complains  by individuals who recovered from COVID-19, either from the severe forms of the disease or simply those who had experienced mild and moderate symptoms upon being tested. Muscular pains are also another common accompanying symptom. Even individuals who have tested positive in the early stages and were typically asymptomatic are complaining of experiencing these symptoms weeks or months down the line. What is even interesting is that there are millions more out who are already infected with the SARS-CoV-2 coronavirus as the virus is highly infectious plus it is airborne, but are simply clueless and they are asymptomatic and have never been tested but are still plagued with this constant tiredness and fatigue conditions.


 
Although this tiredness and fatigue symptoms and conditions can be attributed to a variety of neurological conditions, more research is emerging it is due to the fact the SARS-CoV-2 coronavirus is able to infect the adrenal glands as the adrenal glands are also rich with ACE-2 receptors, ie the virus favourite binding and entry sites.
 
Numerous published studies already support the fact that the SARS-CoV-2 coronavirus also attacks the endocrine system including the adrenal glands. https://www.thailandmedical.news/news/breaking-covid-19-endocrine-system-new-study-shows-that-sars-cov-2-damages-the-endocrine-system
 
https://pmj.bmj.com/content/postgradmedj/early/2020/06/11/postgradmedj-2020-137934.full.pdf
 
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7186765/
 
https://link.springer.com/article/10.1007/s40618-020-01311-8
 
https://idpjournal.biomedcentral.com/articles/10.1186/s40249-020-00662-x
 
The adrenal glands also known as suprarenal glands) are endocrine glands that produce a variety of hormones including adrenaline, androgen (the male hormone) and the steroids aldosterone and cortisol. They are found above the kidneys. Each gland has an outer cortex which produces steroid hormones and an inner medulla.
 
The adrenal cortex produces three main types of steroid hormones: mineralocorticoids, glucocorticoids (essential for a variety of immune functions), and androgens. Mineralocorticoids (such as aldosterone) produced in the zona glomerulosa help in the regulation of blood pressure and electrolyte balance. The glucocorticoids cortisol and cortisone are synthesized in the zona fasciculata; their functions include the regulation of metabolism and immune system suppression. The innermost layer of the cortex, the zona reticularis, produces androgen s that are converted to fully functional sex hormones in the gonads and other target organs.
 
The production of steroid hormones is called steroidogenesis, and involves a number of reactions and processes that take place in cortical cells. The medulla produces the catecholamines, which function to produce a rapid response throughout the body in stress situations.
 
It is a known fact that a number of endocrine diseases involve dysfunctions of the adrenal gland. Overproduction of cortisol leads to Cushing's syndrome, whereas insufficient production is associated with Addison's disease. 
 
In the case of COVID-19, as a result of the pathogen’s damage to the adrenal glands, hormone production is disrupted and the condition: Addison’s disease materializes.
 
Although in numerous cases Addison’s disease is classified as an autoimmune that attacks the adrenal glands and causes steroid hormone disruption, in this case it the virus and the viral proteins that is causing the damage.
 
Addison's disease, also known as primary adrenal insufficiency and hypocortisolism, is a long-term endocrine disorder in which the adrenal glands do not produce enough steroid hormones.
 
Symptoms generally come on slowly but in the case of where damage is a result of aggressive viral infections such as SARS-CoV-2 coronavirus, the symptoms can appear fast.
 
Typical symptoms of Addison’s Disease can include: abdominal pain, abnormal menstrual periods, craving for salty food, dehydration, depression, diarrhea, irritability, lightheadedness or dizziness when standing up, loss of appetite, low blood glucose, low blood pressure, muscle weakness, nausea, patches of dark skin, especially around scars, skin folds, and joints, sensitivity to cold, unexplained weight loss,hair loss, vomiting and worsening fatigue (extreme tiredness).


 
In what has been seen in most COVID-19 patients however, tiredness, fatigue and muscular pains are most often the symptoms present.
 
It should be noted that Addison’s disease also leads to a variety of disruptions and dysregulation of the immune system as a result of the hormones cortisol and  the various other  glucocorticoids production being disrupted.
 
In a study published in the lancet, it was advocated that glucocorticoids be administered to help COVID-19 patients undergoing cytokine storms and inflammatory damage to the organs. https://www.thelancet.com/journals/landia/article/PIIS2213-8587(20)30149-2/fulltext#%20
 
In most recovered patients and asymptomatic patients, the damage to the adrenal glands can be slow and still ongoing. Contrary to thoughts that recovered patients do not have any SARS-CoV-2 in them, newer studies are showing that this is not true and besides it has now even been demonstrated that the viral proteins released by the virus could also be transported to cells and tissues and organs through a usage of structures known as filopodia where they are sent to healthy cells to cause disruptions and damage. These chain reaction cellular processes can still be taking place for a while in the human host body even if viral shedding is complete.
 
Typically there are a few blood test to determine if you are having Addison’s disease and this involves testing for cortisol or ACTH levels or what is known as the ACTH stimulation tests to gauge the adrenal glands’ response after you are given a shot of artificial ACTH. If the adrenal glands produce low levels of cortisol after the shot, it indicates that the glands may not be functioning properly.
 
Imaging diagnostics involving X-rays and CT Scans can also help identify the disease.
 
Anyone experiencing constant tiredness and fatigue should consult a medical doctor immediately and get a check up and if test confirms Addisons disease, an endocrinologist specialists should be consulted to see what steroids one should be put on for instance hydrocortisone pills to replace cortisol. If you are also lacking aldosterone, you may receive fludrocortisone acetate pills. If you are taking fludrocortisone, your doctor might tell you to increase your salt intake, especially in hot and humid weather and after vigorous exercise.
 
Also for those who have never been tested for COVID-19 but are experiencing tiredness and fatigue, it is highly recommended that both a COVID-19 PCR NAT test and also COVID-19 antibody test be conducted.
 
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