Your adrenal glands are located on top of your kidneys. These glands produce many of the hormones that your body needs for normal functions. Addison’s disease occurs when the adrenal cortex is damaged and the adrenal glands do not produce enough of the steroid hormones cortisol and aldosterone. Cortisol regulates the body’s reaction to stressful situations. Aldosterone helps with sodium and potassium regulation. The adrenal cortex also produces sex hormones (androgens).
People who have Addison’s disease may experience the following symptoms:
- weakness in the muscles
- fatigue and tiredness
- darkening in skin color
- weight loss or decreased appetite
- a decrease in heart rate or blood pressure
- low blood sugar levels
- fainting spells
- sores in the mouth
- cravings for salt
- irritability or depression
If Addison’s disease goes untreated for too long, it can become an Addisonian crisis. An Addisonian crisis is a life threatening medical emergency. Call 911 immediately if you or someone you know begins to experience:
- mental status changes (confusion, fear, or restlessness)
- loss of consciousness
- high fever
- sudden pain in the lower back, belly, or legs
An untreated Addisonian crisis can lead to shock and death.
There are two major classifications for Addison’s disease: primary adrenal insufficiency and secondary adrenal insufficiency. In order to treat your disease, your doctor will need to find out which type is responsible for your condition.
Primary Adrenal Insufficiency
Primary adrenal Insufficiency occurs when your adrenal glands are damaged so severely that they can no longer produce hormones. This type of Addison’s disease is most often caused when your immune system attacks the adrenal glands. 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 causes of primary adrenal insufficiency include:
- Prolonged administration of glucocorticoids (e.g. prednisone)
- Infections in your body
- Cancer and abnormal growths (tumors)
- Certain blood thinners used to control clotting in the blood
Secondary Adrenal Insufficiency
Secondary adrenal insufficiency occurs when the pituitary gland (located in your brain) 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.
You may be at a higher risk for Addison’s disease if you:
- have cancer
- take anticoagulants (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
Your doctor will ask you about your medical history and the symptoms you’ve been experiencing. They will do a physical examination and they may order some lab tests to check your potassium and sodium levels. Your doctor may also order imaging tests and measure your hormone levels.
Your treatment will depend on what is causing your condition. Your doctor may prescribe medications that regulate the adrenal gland.
Following the treatment plan that your doctor creates for you is very important. Untreated Addison’s disease can lead to an Addisonian crisis.
If your condition has gone untreated for too long, and has 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.
You may need to take a combination of glucocorticoids medications (drugs that stop inflammation) to improve your health. These medications will be taken for the rest of your life and you cannot miss a dose.
Hormone replacements may be prescribed to replace hormones that your adrenal glands are not making.
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 also want to keep a medical alert card in your wallet and a bracelet on your wrist to let others know about your condition.
It’s important to keep your stress level down if you Addison’s disease. Major life events, such as a death of a loved one or an injury, can raise your stress level and affect the way you respond to your medications. Talk to your doctor about alternative ways to relieve stress, such as yoga and meditation.
The Long Term Outlook
People with Addison’s disease will have to get treatment for the rest of their lives. Treatments, such as hormone replacement medications, will make symptoms more manageable.
As long as you follow the treatment plan your doctor creates for you, it is possible to live a productive life.
Always take your medications exactly as directed. Taking too little or too much medicine may be dangerous to your health. Your treatment plan may need to be reevaluated and changed throughout your life. For this reason, it’s important that you see your doctor regularly.