Addison's Disease

Written by Brindles Lee Macon and Winnie Yu | Published on July 25, 2012
Medically Reviewed by George Krucik, MD

Overview

Addison’s disease occurs when the adrenal cortex is damaged and the adrenal glands do not produce enough steroid hormones called cortisol and aldosterone. Cortisol regulates the body’s reaction to stressful situations. Aldosterone helps with sodium and potassium regulation. Additionally, the adrenal cortex produces sex hormones (androgen).

What Causes Addison’s Disease?

There are two major classifications for Addison’s disease: primary adrenal insufficiency and secondary adrenal insufficiency. For proper treatment, your doctor will need to find out which type is responsible for your condition.

Primary Adrenal Insufficiency Causes

Addison’s disease is often caused when your immune system attacks the adrenal gland. This is called an autoimmune disease. In an autoimmune disease, your body’s immune system mistakes any organ or area of the body for a virus, bacteria, or another outside invader.

Other primary causes:

  • Prolonged administration of glucocorticoids(e.g. prednisone)    
  • Infections in your body may cause Addison’s disease. Fungal infections may also contribute to the condition.
  • Cancer and abnormal growths (tumors) may be contributors.
  • Certain blood thinners used to control clotting in the blood may affect the adrenal glands over time.

Secondary Adrenal Insufficiency Causes

Secondary adrenal insufficiency occurs when the pituitary gland can’t produce adrenocorticotropic hormone (ACTH). ACTH tells the adrenal gland when to release hormones.

It’s also possible to develop adrenal insufficiency if you do not take the corticosteroid medications your doctor prescribes. Corticosteroids help control chronic health conditions like asthma.

Who Is at Risk for Addison’s Disease?

You may be at a risk than normal for this disorder if you:

  • have cancer
  • take coagulants (blood thinners)
  • have chronic infections like tuberculosis
  • had surgery to remove any part of your adrenal gland
  • have an autoimmune disease, like type 1 diabetes or Graves’ disease

What are the Symptoms of Addison’s Disease?

People who have Addison’s disease may experience:

  • weakness in the muscles
  • fatigue and tiredness
  • an increase in skin pigmentation (becomes darker than usual)
  • weight loss or decreased appetite
  • a decrease in your heart rate or blood pressure
  • low blood sugar levels
  • fainting
  • sores in your mouth
  • cravings for salt
  • nausea
  • vomiting
  • irritability or depression

Diagnosing Addison’s Disease

After hearing your symptoms, your doctor will do a physical examination. More than likely, he will check your potassium and sodium levels. Other tests include hormone level monitoring and imaging (CT scan).

How is Addison’s Disease Treated?

Depending on the cause of the disease, your treatments may involve taking medications to regulate the adrenal gland. If you’ve progressed to a life-threatening condition called Addisonian crisis, your physician may prescribe medication to treat that first. Addisonian crisis causes low blood pressure, high potassium in the blood, and low blood sugar levels.

Medications

You need to take a combination of glucocorticoids medications (drugs that stop inflammation) to improve your health. These medications are taken for life and cannot be missed.

Hormone replacements may be prescribed to replace hormones your adrenal glands are not making.

Home Care

Keep an emergency kit that contains your medications on hand at all times. Ask your doctor to write a prescription for an injectable corticosteroid for emergencies. You may want to keep a medical alert card in your wallet and a bracelet on your wrist to let others know about your condition.

Alternative Therapies

Talk to your doctor about alternative ways to relieve stress, such as yoga.

What Is Expected in the Long Term?

If you take your hormone replacement medications as prescribed, you should see improvements in your condition. You will be able to live a productive life without complications if you follow your doctor’s advice.

Always take your medications exactly as directed. Taking too little or too much may be dangerous to your health. In order to stay on track with your treatment, discuss any problems with your doctor.

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