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Adrenal insufficiency may be difficult to differentiate from other conditions, such as chronic fatigue syndrome and depression, if the onset is gradual. Hyperpigmentation may be seen in primary adrenal insufficiency due to the elevated ACTH overproduction by the pituitary. The ACTH molecule contains the sequence for alpha-melanocyte-stimulating hormone (MSH), which stimulates melanocytes.
Injectable glucocorticoid must be provided to all patients with adrenal insufficiency.