Addison’s disease, also called adrenal insufficiency, is a long-term endocrine disorder in which the adrenal glands — which sit on top of the kidneys — do not produce enough steroid hormones cortisol and aldosterone.
Cortisol helps the body respond to stress, including the stress of illness, injury or surgery. It also helps maintain blood pressure, heart function, the immune system and blood glucose (sugar) levels.
Aldosterone affects the balance of sodium and potassium in the blood. This in turn controls the amount of fluid the kidneys remove as urine, which affects blood volume and blood pressure.
Addison’s disease symptoms usually develop slowly, often over several months. Often, the disease progresses so slowly that symptoms are ignored until a stress such as illness or injury, occurs and makes symptoms worse.
Signs and symptoms may include;
- Extreme fatigue
- Weight loss and decreased appetite
- Darkening of the skin (hyperpigmentation)
- Low blood pressure, even fainting
- Salt craving
- Low blood sugar (hyperglycemia)
- Nausea, diarrhea or vomiting (gastrointestinal symptoms)
- Abdominal pain
- Muscle or joint pains
- Depression or other behavioural symptoms
- Body hair loss or sexual dysfunction in women
Why It Happens
The condition is usually the result of a problem with the immune system, which causes it to attack the outer layer of the adrenal gland (the adrenal cortex), disrupting the production of steroid hormones aldosterone and cortisol.
Other potential causes include conditions that can damage the adrenal glands, such as tuberculosis.
Treatment for Addison’s disease involves replacing the absent hormones. This involves taking a corticosteroid such as hydrocortisone and fludrocortisone. These medications are usually taken orally.
Lifelong, continuous steroid replacement therapy is required, with regular follow-up treatment and monitoring for other health problems. A high-salt diet may also be useful in some people. If symptoms worsen, an injection of corticosteroid is recommended and the patient should always carry a dose with them.
Often, large amounts of intravenous fluids with the sugar dextrose are also required. Without treatment, an adrenal crisis can lead to death.
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