What Is Addison’s Disease?

Addison's Disease, also known as adrenal insufficiency or hypercorticism, is a chronic condition that affects the body when it does not produce enough of the hormone cortisol or aldosterone. This disease can lead to serious complications if left untreated and usually occurs in people who are middle-aged and older.

Addison's Disease got its name after English doctor Thomas Addison discovered it in 1855. The disease has many other names including Adrenal Insufficiency (AI), Hypoadrenia, Chronic Adrenocortical Insufficiency (CAI), or simply Addison’s.

Symptoms

The most common Addison's Disease symptoms are nausea, vomiting, fever, and fatigue.

Additional symptoms include:

• Dehydration
• Loss of appetite
• Low blood pressure
• Slower heart rate
• Muscle weakness
• Muscle pain
• Weight loss
• Salt craving
• Reduced blood sugar
• Diarrhea
• Irritability
• Fainting
• Depression
• Trouble sleeping
• Body hair loss
• Darkening skin
• Mouth sores
• Cold sensitivity
• Stomach pain

An Addisonian crisis is a life-threatening medical emergency. During an Addisonian crisis, your body does not have enough cortisol and cannot break down proteins. This results in a sudden drop in blood pressure that leads to shock. These situations require immediate medical attention at a hospital or urgent care clinic. Without treatment, death may occur within 24 hours.

Symptoms of an Addisonian crisis:

• Extreme mood change
• High fever
• Sudden back pain
• Sudden belly pain
• Sudden leg pain
• Severe weakness
• Unconsciousness
• Delirium
• Paleness

Causes

Addison's Disease is caused by damaged adrenal or pituitary glands. Stress, injury, another illness, and medications can damage these glands.

There are two types of adrenal insufficiency: primary and secondary.

Primary adrenal insufficiency

Primary adrenal insufficiency is the most common type of adrenal insufficiency and can be life-threatening if not treated properly. Primary adrenal insufficiency is caused when the immune system attacks the adrenal glands.

Other causes of primary adrenal insufficiency:

• Prolonged intake of Glucocorticoids, a type of hormone.
• Cancer, tumors, or other growths.
• Certain blood-thinning medications.
• Infections that invade your body.

Secondary adrenal insufficiency

Secondary adrenal insufficiency is when the pituitary glands malfunction or get damaged. The result is that the pituitary glands do not produce enough hormones.

Potential causes of secondary adrenal insufficiency:

• Brain injury
• Genetics
• Medications
• Tumors or growths

Diagnosis

Addison's disease diagnosis starts with a routine physical examination and review of your medical history. Your doctor will also ask you about your symptoms.

After the examination, your doctor may recommend some tests. Addison's disease is diagnosed by measuring cortisol, adrenocorticotropic hormone (ACTH), and aldosterone levels. These tests may be done at the same time or separately.

Addison's disease tests:

• Blood test — A blood test will identify the levels of hormones in your body. Your doctor will use the Addison's Disease blood test results to recommend the best treatment for your unique condition.
• ACTH stimulation test — The ACTH stimulation test is a blood test that measures cortisol levels.
• Aldosterone suppression test — The aldosterone suppression test is another blood test that evaluates how well the body manages salt and water balance. This balance is sometimes affected in patients with Addison's disease.
• Insulin-induced hypoglycemia test — The insulin-induced hypoglycemia test is a blood test that evaluates how the body manages sugar levels in response to insulin. This also allows your doctor to measure your cortisol levels.
• Imaging tests — Imaging tests such as X-rays, Magnetic Resonance Imaging (MRI), and computerized tomography (CT) will allow your doctor to examine your adrenal and pituitary glands for abnormalities.

Treatment

Addison's Disease cannot be cured, but the symptoms can be managed with medication and lifestyle changes. Surgery is also sometimes required.

Addison’s Disease treatment options:

• Medications — Immediately following diagnosis, your doctor will prescribe medications to replace the missing hormones. Sodium supplementation is often necessary for the treatment of Addison's Disease. In some cases, doctors recommend a medication to stimulate red blood cells due to chronic adrenal insufficiency.
• Lifestyle — Your doctor may suggest that you engage in moderate physical exercise or change your diet as part of your treatment plan.
• Surgery — If a tumor or growth caused your condition, your doctor may perform surgery to remove the tumor.

Prognosis

The Addison's Disease prognosis is generally good. If you have Addison's Disease, your life expectancy is not shortened. However, it is a chronic disease that usually requires lifelong treatment.

If you or a loved one experiences any of the symptoms of Addison's Disease, an endocrinologist at Baptist Health may be able to help.