Addison’s Disease

Addison’s disease is a disorder in which the adrenal glands – which sit on top of the kidneys – do not produce enough of the hormones cortisol and aldosterone. 

Cortisol helps the body respond to stress, including the stress of illness, injury, or surgery. It also helps maintain blood pressure, heart function, the immune system and blood glucose (sugar) levels.

Aldosterone affects the balance of sodium and potassium in the blood. This in turn controls the amount of fluid the kidneys remove as urine, which affects blood volume and blood pressure.

Symptoms:

  • Extreme fatigue
  • Weight loss and decreased appetite
  • Darkening of your skin (hyperpigmentation)
  • Low blood pressure, even fainting
  • Salt craving
  • Low blood sugar (hypoglycemia)
  • Nausea, diarrhea or vomiting (gastrointestinal symptoms)
  • Abdominal pain
  • Muscle or joint pains
  • Irritability
  • Depression or other behavioral symptoms
  • Body hair loss or sexual dysfunction in women

Treatment

All treatment for Addison’s disease involves medication. You will be given hormone replacement therapy to correct the levels of steroid hormones your body isn’t producing. Some options for treatment include oral corticosteroids such as:

  • Hydrocortisone (Cortef), prednisone or methylprednisolone to replace cortisol. These hormones are given on a schedule to mimic the normal 24-hour fluctuation of cortisol levels.
  • Fludrocortisone acetate to replace aldosterone.

You will need to get plenty of salt (sodium) in your diet, especially during heavy exercise, when the weather is hot or if you have gastrointestinal upsets, such as diarrhea.

Risk Factors

  • Swelling (inflammation) of the thyroid gland that often results in reduced thyroid function (chronic thyroiditis)
  • Thyroid gland produces too much thyroid hormone (overactive thyroid, Graves disease)
  • Itchy rash with bumps and blisters (dermatitis herpetiformis)
  • Parathyroid glands in the neck do not produce enough parathyroid hormone (hypoparathyroidism)
  • Pituitary gland does not produce normal amounts of some or all of its hormones (hypopituitarism)
  • Autoimmune disorder that affects the nerves and the muscles they control (myasthenia gravis)
  • Body does not have enough healthy red blood cells (pernicious anemia)
  • Testicles cannot produce sperm or male hormones (testicular failure)
  • Type I diabetes
  • Loss of brown color (pigment) from areas of the skin (vitiligo)

Prevention:

Addison’s disease cannot be prevented, but there are steps you can take to avoid an addisonian crisis:

  • Talk to your doctor if you always feel tired, weak, or are losing weight. Ask about having an adrenal shortage.
  • If you have been diagnosed with Addison’s disease, ask your doctor about what to do when you’re sick. You may need to learn how to increase your dose of corticosteroids.
  • If you become very sick, especially if you are vomiting and you can’t take your medication, go to the emergency room.
References:

Addison’s disease. (2019, October 9). Retrieved from https://www.mayoclinic.org/diseases-conditions/addisons-disease/symptoms-causes/syc-20350293.

Addison’s Disease. (n.d.). Retrieved from https://my.clevelandclinic.org/health/diseases/15095-addisons-disease.