by Kimberly Allen, RN
Addison’s disease is an endocrine disorder that affects the adrenal glands. It usually develops in adults between 30 and 50 years of age though it can affect anyone at any age. It affects both men and women of all ethnicity’s. Addison’s disease is considered a rare disorder occurring in approximately 1 out of every 100,000 people.
Addison’s disease is also called hypocortisolism because it develops because the adrenal glands do not produce sufficient cortisol and in most cases aldosterone too. Cortisol is a hormone that has numerous functions in your body including regulating the way your body uses proteins, carbohydrates, and fats. Cortisol also help maintain your cardiac function and blood pressure as well as controls inflammation. However, it’s most important purpose is to help your body respond to stress. The aldosterone levels are also usually affected in people with Addison’s disease. Aldosterone helps maintain the fluid balance in your body and when the levels are too low your kidneys are unable to maintain your sodium and keep your fluid levels balanced which causes your blood pressure to drop.
There are 2 types of Addison’s disease, primary adrenal insufficiency and secondary adrenal insufficiency. If the disease develops because of a problem with the adrenal glands it’s diagnosed as primary adrenal insufficiency, but if the problem starts somewhere else and causes a problem with the adrenal glands it’s diagnosed as secondary adrenal insufficiency. Approximately 70% of all cases of Addison’s disease are caused by the body’s immune system attacking the adrenal glands by mistake destroying the outer layer of the adrenal glands. There are also certain long term infections like HIV and tuberculosis as well as certain fungal infections that can damage the adrenal glands. Though not as common Addison’s disease can also be caused by problems with the pituitary gland or the hypothalamus which are located in the center of the brain. The hormones produced by these glands regulate the production of hormones in the rest of your body including those produced by the adrenal glands. Most commonly affected is the pituitary hormone ACTH. If the levels of this hormone are too low the adrenal glands are not signaled to produce their hormones, cortisol and aldosterone. The prolonged use of certain medications like prednisone can also cause adrenal insufficiency leading to Addison’s disease.
The symptoms of Addison’s disease usually develops gradually over time and usually includes increasing muscle weakness and fatigue as well as a poor appetite and weight loss. Some people also complain of nausea and vomiting as well as diarrhea. Because Addison’s disease causes a fluid and electrolyte imbalance many people with the disease also have a low blood pressure that tends to drop when standing which can cause dizziness and fainting. Changes in skin pigmentation causing the skin to darken is also not uncommon. Addison’s disease can also lead to depression and irritability. Because the symptoms develop so gradually most people either don’t notice them or ignore them until they become severe or something like a stressful event causes whats called an addisonian crisis. Left untreated an addisonian crisis can be fatal.
Treatment for Addison’s disease always involves hormone replacement therapy. There are several oral medications available that your Dr may recommend including cortisone acetate and prednisone to replace the cortisol as well as fludrocortisone to replace the aldosterone. For women with Addison’s disease the Dr may recommend dehydroepiandosterone to treat androgen deficiency. For people with severe symptoms or in an addisonian crisis injections of corticosteroids may be needed. It is also recommended that people with Addison’s disease increase their sodium intake during exercise or when the weather is very hot. You may also need to increase the dose of your medication during an infection or illness or if you need an operation.
It’s important to carry a medical alert card or wear a bracelet at all times in case you become incapacitated for some reason so that emergency personnel can provide the proper care.
Kimberly Allen is a registered nurse with an AND in nursing. She has worked in ACF, LCF and psychiatric facilities, although she spent most of her career as a home health expert. She is now a regular contributor to HealthAndFitnessTalk.com, dispensing advice and knowledge about medical issues and questions. You can reach her with any comments or questions at firstname.lastname@example.org.