What Is the Most Common Cause of Addison’s Disease?

Reviewed on 4/16/2020

What Is Addison’s Disease?

Illustration of a cross section of the adrenal gland, one of which sits atop each kidney. Your adrenals do not function properly in Addison's disease.
Illustration of a cross section of the adrenal gland, one of which sits atop each kidney. Your adrenals do not function properly in Addison's disease.

Adrenal gland insufficiency causes Addison’s disease. The adrenal glands are small glands that sit on top of each of the kidneys and work under the direction of the pituitary gland in the brain. 

The pituitary gland produces adrenocorticotropic hormone (ACTH) which stimulates the adrenals to make mineralocorticoids, glucocorticoids, and androgens: three hormones necessary for the body to function.

When the adrenal glands fail to make these important hormones, it is called adrenal insufficiency. If the adrenal insufficiency is due to the adrenal gland not functioning properly (i.e., not making one or all the three of the important hormones) it is called “primary adrenal insufficiency,” also known as Addison’s disease.

What Are the Symptoms of Addison’s Disease?

Symptoms of Addison’s disease include: 

An acute flare of Addison symptoms is called an acute adrenal crisis and symptoms include: 

What Causes Addison’s Disease?

The most common cause of Addison’s disease is idiopathic autoimmune adrenocortical insufficiency. For some unknown reason the body attacks the adrenal glands, causing them to shrink and scar, and not produce sufficient adrenal hormones. Addison’s disease is often also associated with Hashimoto’s thyroiditis (also called Schmidt syndrome).

Other causes of chronic Addison’s disease include:

Causes of acute Addison’s disease (acute adrenal crisis):

  • Stress or other acute illness
  • Failure to increase steroids
  • Bilateral adrenal hemorrhage
  • Bilateral adrenal artery emboli and bilateral vein thrombosis (rare)
  • Bilateral adrenalectomy for any reason


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How Is Addison’s Disease Diagnosed?

Addison’s disease is diagnosed with blood tests. These tests may include: 

Usually performed in the morning, and abnormal levels may lead to further testing. 

Other lab tests may be recommended, including:

Imaging studies may also be indicated, such as a chest X-ray and CT scan of the abdomen. 

What Is the Treatment for Addison’s Disease

Treatment for Addison’s disease usually involves medications to replace the hormones that are not being made by the adrenal gland.

These medications include:

What Are the Complications of Addison’s Disease?

If Addison’s disease is not properly managed, patients can experience adrenal crisis, which can result in shock, low blood pressure, high fever, coma, and even death.

What Is the Life Expectancy for Addison’s Disease?

If treated properly, people with Addison’s disease can have a normal life expectancy. Patients who experience adrenal crisis have a high rate of complications and can die from their disease.

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Reviewed on 4/16/2020
Medscape Medical Reference