Addison’s disease is a chronic condition that requires lifelong treatment. If not treated, it can lead to a life-threatening event called an adrenal crisis.
The adrenal glands are small hormone-releasing organs located on top of the kidneys. They produce glucocorticoid hormones that help control sugar (glucose) levels and blood pressure, mineralocorticoid hormones that regulate sodium, water, and potassium balance, and sex hormones.
Symptoms
Addison’s disease happens when your adrenal glands, which sit on top of your kidneys, stop making the hormone cortisol and other chemicals that control almost every function in your body. These hormones include the way your body turns food into energy and the ways your body responds to stress and illness.
In people with Addison’s, a problem with the pituitary gland reduces production of ACTH (adrenocorticotropin). This stops the adrenal glands from responding to messages they receive from the brain to make cortisol.
This makes symptoms appear suddenly and get worse quickly. The symptoms of Addison’s are often similar to the symptoms of other illnesses and may not be recognized. If left untreated, the signs and symptoms of Addison’s can cause a medical emergency called adrenal crisis. Adrenal crisis can lead to a coma or death if it isn’t treated immediately.
You can have a blood test to check your levels of the adrenal hormones. Your doctor can also measure your blood pressure to see if it’s low and look for signs of dehydration. You may also have radiographic imaging tests, like CT scans or MRI. These can help your doctor find out what is causing the adrenal glands to make less cortisol than they should.
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Hyperpigmentation — darkening of the skin and nails — is another sign of Addison’s disease. It usually occurs around the creases of the palms, scars, and knuckles, but it can be all over the body.
There is no cure for Addison’s, but medicines can help control your symptoms. You need to take these medicines for the rest of your life. It’s important to keep up with your health care appointments so you can be sure you are getting the right dose of medicine. You should carry a card, tag, or medical alert bracelet that says you have Addison’s and tell the people you live with how to give you hydrocortisone injections in an emergency. People with Addison’s can have a normal life span when they follow treatment, and some famous people with the condition are still alive in their 90s.
Diagnosis
Addison’s disease happens when your body attacks the outer layer of your adrenal glands (adrenal cortex). It’s an autoimmune reaction, and symptoms are usually the result of the destruction of at least 90% of the adrenal cortex. The adrenal glands make the steroid hormones cortisol and aldosterone, which control your stress response and help regulate your sodium and potassium levels.
Addison’s disease can develop at any age, but is most common between the ages of 30 and 50. Men and women are equally at risk for developing this condition. If you have other autoimmune conditions, like Graves’ disease, hypothyroidism, type 1 diabetes, or pernicious anaemia, there is a higher chance you will also get Addison’s disease.
Your doctor will diagnose Addison’s disease with a physical exam and blood tests. In some cases, your doctor may also order a CT scan of your pituitary and adrenal glands to check for damage and to see how well the hormones are working.
You will be given medicine to replace the hormones that your adrenal glands can’t produce. This includes taking corticosteroid pills and injecting yourself with the hormone fludrocortisone. The medication can help prevent you from going into an adrenal crisis, which can be deadly.
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People with Addison’s disease need to take their medications daily, even when they feel fine. They should always carry a medical alert bracelet or emergency card that says they have Addison’s disease and what their medicine is. They should also keep a small supply of their medication with them at all times and be prepared to give themselves an emergency injection of hydrocortisone.
When treated correctly, most people with Addison’s disease can lead a normal life. They must follow their treatment plan and keep up with regular visits to the doctor for tests. In addition, they must wear a medical alert bracelet and bring an emergency medication kit with them. It is important to let their doctors know if they have an infection or are experiencing physical or emotional stress so the doctor can increase their medication. They should also be sure to tell their friends and family members how to administer the emergency injection.
Treatment
Addison’s disease happens when the adrenal glands, located on top of each kidney, are damaged. They are responsible for making hormones that affect every organ and tissue in your body. When they are damaged, they can’t make enough of the steroid hormones cortisol and aldosterone. These hormones help your body manage stress and regulate salt and water in the blood to control your blood pressure. In addition, the adrenal glands produce a number of other hormones, including androgens (male type hormones), which are important in men’s health.
Symptoms of Addison’s disease can range from mild to severe and vary from person to person. The most common symptom is slowly worsening fatigue that lasts for more than a few months. Other symptoms include low blood pressure, dizziness when standing up, weight loss, stomach pain, and changes in mood and behavior. Some people with Addison’s disease develop small areas of dark skin, especially around scars, creases in the skin and on the gums. In addition, some women with Addison’s disease experience abnormal menstruation and have a lower sexual drive.
In order to diagnose Addison’s disease, doctors will run tests to see how your adrenal glands are functioning. These include an ACTH stimulation test, which measures blood and urine cortisol levels before and after a synthetic form of ACTH is given by injection. Normally, the ACTH injection triggers the secretion of cortisol in the body, but in Addison’s disease this doesn’t happen.
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Other tests may be done to determine how the adrenal glands are functioning and whether they are infected with tuberculosis, which causes up to 20% of Addison’s disease cases. A computed tomography (CT scan) of the adrenal glands and pituitary gland can show damage to the adrenal glands or other signs of illness.
Treatment for Addison’s disease involves replacing the missing hormones with drugs called hydrocortisone and fludrocortisone. Taking your medicine as directed is critical to helping you lead a normal life. In addition, some people with Addison’s disease are taught how to give themselves an emergency shot of hydrocortisone during stressful situations. If you have this option, it’s a good idea to keep an emergency kit with the medication on hand at all times. In addition, wear a medical alert card or bracelet and let friends and family know about your condition so they can contact your doctor or hospital in an emergency.
Prevention
Addison’s disease affects the adrenal glands, which sit on top of the kidneys. They make hormones, including cortisol and aldosterone, that are important for many functions, including managing stress, regulating blood pressure, and keeping the body’s fluid and electrolyte balance. The disorder can cause symptoms like weakness, tiredness, weight loss, low blood pressure, and changes in the skin and hair. People with the condition often feel better after taking medicine to replace the missing hormones, and most live a normal life with few limitations.
Doctors don’t know what causes Addison’s disease, but it may be caused by a medical problem that damages the glands or by some other disease that interferes with their function. It can also be triggered by infections, cancer treatment, or surgery that involves the pituitary gland or adrenal glands. It can also happen as a side effect of taking certain medicines, especially if you take them for a long time. These include medicines used to treat conditions such as asthma, allergies, arthritis, and other immune system problems.
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Symptoms of Addison’s disease usually develop slowly over months. You may have mild ones, such as fatigue or nausea, before you notice any other problems. Some people don’t have any symptoms, while others have symptoms such as dizziness and fainting, stomach upset, depression, and weight loss. It’s important to see your doctor if you have these symptoms.
If you have Addison’s disease, your doctor can help prevent a crisis by checking your hormone levels with blood tests. They can also prescribe medicines that replace the missing hormones, such as hydrocortisone or prednisone. If you have this condition, you should always carry an emergency card with information about your diagnosis and a list of your medicines. You can find an emergency card on the Addison’s Disease Self-Help Group website.
Once you’re diagnosed with Addison’s disease, you can reduce your risk of a crisis by seeing your doctor when you have symptoms and following their advice about diet and lifestyle. You should also get regular blood tests to check your hormone levels and a skin exam.
