Addison's Disease

Overview

In Addison's disease, also called adrenal insufficiency, the adrenal glands located just above our kidneys produce too little cortisol and often too little aldosterone.

This rare disease most often occurs when the immune system attacks the adrenal glands (autoimmune).

Addison's disease occurs in all age groups and in both sexes and can be life-threatening. Treatment consists of replacing the missing hormones.

Symptoms

The symptoms of Addison's disease usually develop slowly, often over several months. The disease often progresses so slowly that symptoms are ignored until stress, such as an illness or injury, occurs and makes them worse. Signs and symptoms may include:

• Extreme fatigue
• Unintentional weight loss and decreased appetite
• Darkening of your skin
• Low blood pressure, dizziness and even fainting
• Salt craving
• Low blood sugar
• Nausea, diarrhea or vomiting
• Abdominal pain
• Muscle or joint pain
• Irritability
• Depression or other behavioral symptoms
• Hair loss or sexual dysfunction in women

Acute adrenal insufficiency (Addisonian crisis)

Sometimes the signs and symptoms of Addison's disease can appear suddenly. Acute adrenal insufficiency can lead to life-threatening shock. Seek emergency medical care if you experience the following signs and symptoms:

• Severe weakness
• Pain in the lower back and legs
• Changes in consciousness
• Severe abdominal pain, vomiting and diarrhea

In an Addisonian crisis, the following may also be seen:

• Low blood pressure
• Low sodium levels and high potassium levels.

Diagnosis

The diagnosis is made by measuring the hormones produced by the adrenal gland in the blood and by imaging the adrenal gland.

Treatment and follow-up

The disease is treated successfully by replacing the missing hormones.

You will need to take in plenty of salt, especially during heavy exercise, in hot weather and in situations such as diarrhea.

Your doctor will also recommend a temporary increase in your medication dose in situations such as a febrile illness or surgery.

Other treatment and follow-up recommendations

Carry an ID card, issued by your doctor, stating your condition.

Missing even one day of medication can be dangerous, so keep a small supply of spare medication with you when traveling or at work.

Do not skip regular check-ups with your doctor to make sure your medication dose is adequate but not excessive, and to detect other accompanying autoimmune diseases.