Addison’s disease


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Addison’s disease, also referred to as primary adrenal insufficiency, is a chronic endocrine disorder, characterized by underproduction of the steroid hormones. It is caused by damaged adrenal glands, and it usually affects adults in their middle age. Treatment involves lifelong hormone intake to maintain the proper levels of steroids. In most cases, the disease is mild when the patient take the medicine according to schedule and with accurate dosage. However, without treatment it leads to death. The most common symptoms include fatigue, muscle weakness, fever, weight loss and mood changes.

Addison’s disease characteristics

symbol_aptekiAddison’s disease is a state, in which adrenal glands does not deliver required amount of cortisol and aldosterone. Cortisol and aldosterone are the type of steroid hormones, which are responsible for controlling metabolism, osmoregulation, injury and illness recovery and sexual features. Their deficiency may lead to several serious consequences, including death. The disease can affect both sexes of any age, but usually it involves middle-aged adults. Interestingly, prevalence among women is slightly higher.

Addison’s disease is not exclusive for humans. This condition can also affect dogs, and it has been observed in all breeds of those pets.

Addison’s disease causes and symptoms

Addison’s disease may occur as a result of deformed or damaged adrenal gland, which leads to underproduction of the cortisol and aldosterone hormones. Adrenal glands comprise two layers, the outer layer called cortex and inner layer called medulla. In most cases, the disease is caused by autoimmune disorders, which are leading to the destruction of adrenal cortex. Other possible causes include fungal infections, infections like tuberculosis, adrenal tumours, adrenal hemorrhage  or pituitary gland disease.

Addison's diseaseAddison’s disease often evolves slowly, and begins with mild symptoms, which may be underestimated or linked with other conditions. Those signs can be divided into 2 categories. First of them are initial symptoms, which are usually mild in nature or barely noticeable. The others are adrenal crisis symptoms, caused by severe, chronic or sudden adrenal disorder. Adrenal crisis is life threatening and requires immediate health care.

Early phase symptoms include:

  • Fatigue
  • Muscle weakness
  • Weight loss
  • Headache
  • Fever
  • Mood changes

Adrenal crisis symptoms include:

  • Pain in abdomen or lower back
  • Syncope
  • Hypotension
  • Confusion
  • Gastrointestinal disorders, resulting in dehydration

Addison’s disease diagnosis and treatment

probka_badaniaAddison’s disease can be suggested during routine examinations, if they reveal one of the following: hypercalemia, low blood sugar, low blood sodium level, raised blood potassium level, eosinophilia or metabolic acidosis. Dedicated tests include ACTH stimulation test and imaging. ACTH stimulation is performed by injection of synthetic ACTH, which stimulate adrenal glands emission. If the adrenal glands are not working properly, they will not respond to ACTH, thus resulting in decreased hormone production. Imaging is done in order to reveal any abnormalities in adrenal glands structure.

Treatment involves hormone replacement by corticosteroids, that will result in stabilizing steroid hormones level. This therapy will greatly reduce associated symptoms, allowing the patient to live normal life. Unfortunately, this course is often lifelong.

People affected with Addison’s disease should always carry injectable form of cortisol in case of emergency.

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