What Is Addison’s Disease?
Addison’s disease (primary adrenal insufficiency) is a condition that occurs when the body's adrenal glands do not work normally.
The adrenal glands are small organs located on top of each kidney that produce different hormones: glucocorticoids, mineralocorticoids, and androgens. When the adrenal glands produce fail to produce enough of these hormones, this results in adrenal insufficiency.
What Are Symptoms of Addison’s Disease?
Symptoms of Addison's disease (primary adrenal insufficiency) include:
- Loss of appetite
- Weight loss
- Darkening of the skin, especially on the face, neck, and back of the hands
- May also appear on scars, skin folds, elbows, knuckles, knees, toes, lips, and mucous membranes such as the inside lining of the cheek
- Abdominal pain
- Low blood pressure on standing or sitting up
- Muscle pain
- Joint pain
- Salt cravings
- Loss of hair from the armpits and pubic area (in women)
- Decreased sex drive (in women)
- Low blood sugar (hypoglycemia)
- Irregular or no menstrual period.
When symptoms of Addison's disease become severe and life-threatening, it is called an "adrenal crisis." Adrenal crisis can occur when a person's body is under stress, such as from an infection or injury, or if a person is not taking their medicine regularly.
Symptoms of adrenal crisis include:
Adrenal crisis can be a life-threatening condition that requires emergency medical treatment. If you think you are having adrenal crisis, call 9-1-1.
What Causes Addison’s Disease?
Addison’s disease is caused by damage to the adrenal glands. There are several reasons this could occur:
- Autoimmune disease (the most common cause)
- Certain infections
- Cancer of the adrenal glands
- Surgical removal of the adrenal glands to treat other conditions
- Bleeding into the adrenal glands
- Certain medicines
- Genetic disorders that affect the way the adrenal glands develop or function (rare)
How Is Addison’s Disease Diagnosed?
Addison's disease is diagnosed with the following tests:
- Blood cortisol levels
- Corticotropin (ACTH) levels
- Abdominal computed tomography (CT) scan to evaluate the adrenal glands
What Is the Treatment for Addison’s Disease?
Treatment for Addison's disease involves hormones to replace the hormones deficient in the body. There is no cure for Addison’s disease.
Patients frequently need a glucocorticoid along with mineralocorticoid pills, which must be taken every day for the rest of their life. Women may also need androgen replacement.
- Oral hydrocortisone
- Fludrocortisone (Florinef)
- Dehydroepiandrosterone (DHEA)
Medications may also be prescribed to have on hand in case of adrenal crisis, which is a life-threatening condition that requires emergency medical treatment. If you think you are having an adrenal crisis, use your prescribed medication and call 9-1-1.
In the ambulance or emergency department, treatment for adrenal crisis usually involves:
- Several liters of salt solution (saline)
- Injection of a glucocorticoid (dexamethasone or another form of glucocorticoid)
- Mineralocorticoid treatment may be administered when saline treatment is completed
What Are Complications of Addison’s Disease?
The main complication of Addison’s disease is adrenal crisis, which can be a life-threatening condition that requires immediate medical care.