Addison’s disease

What is Addison’s disease?

Addison’s disease is a rare condition, also known as primary adrenal insufficiency, where the body makes an insufficient amount of certain hormones. Addison’s disease typically results in the adrenal glands not making enough:

  • Cortisol
  • Aldosterone

 

Addison’s disease is most prevalent in people ages 30 to 50, but it can affect anyone at any point in their life. The disease may become life-threatening if left untreated. Treatment for it tends to involve taking lab-made hormones to replace the ones that are not being produced.

Speaking with your healthcare provider sooner rather than later can provide you with insight into the severity of your adrenal issues and provide an accurate diagnosis.

What are the symptoms of Addison’s disease?

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The primary symptoms of Addison’s disease tend to develop slowly and over the course of months. The slower progression may result in some people ignoring or not noticing certain symptoms. Symptoms can get worse quickly if there is physical stress, brought on by an:

  • Illness
  • Injury

 

The early symptoms of Addison’s disease that can result in discomfort or loss of energy are:

  • Extreme tiredness (fatigue)
  • Dizziness or fainting (low blood pressure: postural hypotension)
  • Upset stomach or diarrhea
  • Vomiting
  • Sweating due to low blood sugar (hypoglycemia)
  • Stomach (abdomenal) pain
  • Muscle cramps
  • Weakness
  • Widespread or joint pain

 

Speak with a doctor as soon as you notice any unexplained or sudden changes in your body or with your overall health. Other early symptoms that can affect your appearance include:

  • Body hair loss
  • Areas of darkened skin (often on scars and moles)
  • Weight loss (from a lack of appetite)

 

Try to monitor your emotions and mental health if you begin to notice the other symptoms. The emotional signs of possibly developing Addison’s disease are:

  • Irritable mood
  • Depression
  • Salt craving
  • Lower sex drive in women

 

What is considered an adrenal crisis?

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It is essential not to wait until your symptoms of Addison’s disease become rapidly worse. The aggressive worsening of symptoms is known as an adrenal crisis, referred to sometimes as an addisonian crisis or acute adrenal failure.

Call 911 or your local emergency number if you have Addison’s disease and experience:

  • Severe weakness
  • Significant upset stomach, vomiting, or diarrhea
  • Fever
  • Intense dehydration
  • Severe pain in the legs, lower back, or stomach area
  • Loss of consciousness
  • Low blood pressure and fainting
  • Confusion or disorientation

 

An adrenal crisis can feel scary, especially when doctors warn that it can result in death without quick and proper medical treatment. The good news is that you can reduce these concerns by monitoring your health and taking swift action if it is necessary.

What causes Addison’s disease?

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Addison’s disease is caused by damage to the adrenal glands, which are located just above the kidneys. When the outer layer of the adrenal glands cannot make hormones due to damage, it is typically related to the immune system attacking healthy tissues and organs. Individuals with Addison’s disease are predisposed to having another autoimmune disease with it.

Addison’s disease can also be caused by:

  • Tuberculosis (affects the lungs and can destroy the adrenal glands)
  • Cancer spreading to the adrenal glands
  • Bleeding into the adrenal glands
  • Congenital adrenal hyperplasia (a group of genetic conditions present at birth)
  • Checkpoint inhibitors (medicine treatment for cancer)
  • Medicines that prevent the body from making glucocorticoid
  • Other infections of the adrenal glands

How is Addison’s disease diagnosed?

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When you visit your doctor, they will likely start by asking you about your medical history and any symptoms that could be connected to Addison’s disease. Any of the following tests may then be run to check for Addison’s disease or secondary adrenal insufficiency.

  • A blood test, to measure blood levels of sodium, potassium, cortisol, and adrenocorticotropic hormone (ACTH)
  • A blood test, to measure Addison’s disease antibodies from an autoimmune disease
  • ACTH stimulation test, to measure the level of cortisol in a person’s blood before and after receiving a lab-made ACTH shot
  • Insulin-induced hypoglycemia test, to see your blood sugar and cortisol levels after receiving a shot of insulin
  • Imaging tests, like a CT scan to check the size of your adrenal glands

 

Speaking with a healthcare professional will give you a clearer idea of what the best diagnostic method might be to secure the best treatment.

Are there Addison’s disease risk factors?

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Many people who are diagnosed with Addison’s disease do not have obvious risk factors that cause immediate concern about developing the condition. However, there are certain medical conditions that can lead to adrenal insufficiency, such as:

  • A history of a disease or surgical procedure affecting the pituitary gland or adrenal glands
  • Genetic changes that influence the pituitary gland or adrenal glands
  • Autoimmune endocrine conditions (hypothyroidism or type 1 diabetes)
  • Traumatic brain injury (TBI)

How is Addison’s disease treated?

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Although treatment differs for each individual with Addison’s disease, it will commonly involve taking some type of medicine to address the low levels of steroid hormones in your body. The medications that can be taken orally to replace cortisol include:

 

  • Hydrocortisone (Cortef)

 

  • Prednisone (Rayos, Prednisone Intensol)

 

  • Methylprednisolone (Medrol)

 

Take the medicines on a schedule that aligns with how your cortisol levels would typically fluctuate over the course of 24 hours. Your doctor may also have you take fludrocortisone acetate to replace aldosterone.

People with Addison’s disease often need to add sodium to their diet. The addition is important:

  • During heavy exercise
  • When the weather is hot
  • If you have digestive issues (like diarrhea)

 

A doctor may recommend that you increase your medication dosage in periods of higher levels of stress. Stressful periods might include post-surgery, developing an infection, or experiencing a minor illness. Your doctor may prescribe you shots of corticosteroids if you cannot keep down your medicine.

Other treatment plan best practices if you have Addison’s disease include:

  • Always carrying a medical alert card and bracelet (with a written action plan)
  • Keeping extra medicine nearby
  • Carrying a corticosteroid medicine injection kit
  • Speaking regularly or as needed with a healthcare provider
  • Scheduling yearly checkups to monitor your hormone conditions
  • Screening for any other autoimmune diseases

What are the complications of Addison’s disease?

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Individuals who have Addison’s disease and have not begun treatment may experience an adrenal crisis, also known as addisonian crisis. The crisis may result in:

  • Low blood pressure
  • Low blood sugar levels
  • High blood levels of potassium

 

These complications require immediate treatment from your healthcare provider.

Is Addison’s disease preventable?

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Although Addison’s disease cannot be prevented, there are certain steps that people can take to reduce the risk of experiencing an adrenal crisis. These include:

  • Speaking with a healthcare provider if you notice symptoms
  • Asking your provider if you should get tested for adrenal insufficiency
  • Discussing medication adjustments if you have Addison’s disease and get sick with a healthcare professional
  • Going to an emergency room if you become sick and cannot take your medicine

 

Speaking transparently and honestly with a healthcare professional is a crucial part of taking care of yourself if you have Addison’s disease. Finding the right doctor or specialist will make those conversations easier.

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