Addison’s disease is a rare disorder where the adrenal glands make too little of key hormones, mainly cortisol and sometimes aldosterone. Symptoms appear gradually, and without treatment, the disease can be life-threatening. The condition is named after Thomas Addison, the British doctor who first identified it in 1855. It is also called primary adrenal insufficiency.
What are the symptoms?
Symptoms appear gradually over months. They can be easy to ignore at first. Common signs include:
- Extreme fatigue and weakness
- Dizziness or fainting on standing
- Sweating from low blood sugar
- Nausea, vomiting, diarrhea, or stomach pain
- Muscle cramps, weakness, or joint pain
Changes in appearance
The change may include:
- Dark patches on skin, scars, or moles
- Loss of body hair
- Unintentional weight loss
Emergency symptoms
Symptoms can worsen suddenly. This is called an adrenal crisis. Seek immediate help if you notice:
- Severe weakness
- Sudden intense pain in the back, abdomen, or legs
- Severe vomiting or diarrhea
- Dehydration
- Confusion or fainting
- Low blood pressure or fever
Why does this disease occur?
Addison’s disease happens when the adrenal glands are damaged. Often, the immune system mistakenly attacks them. Other causes include:
- Tuberculosis or other infections
- Cancer affecting the adrenal glands
- Bleeding into the glands
- Genetic conditions like congenital adrenal hyperplasia
- Medicines that block hormone production
- Cancer treatments using checkpoint inhibitors
Secondary adrenal insufficiency occurs when the pituitary gland does not signal the adrenal glands properly. Causes include:
- Pituitary tumors
- Surgery or radiation on the pituitary
- Brain injury
- Suddenly stopping corticosteroid medications
Who is at risk?
Most people have no clear risk factors. Some risks include:
- Past pituitary or adrenal problems
- Genetic conditions affecting these glands
- Other autoimmune endocrine diseases, such as type 1 diabetes or hypothyroidism
- Brain injury
What are the possible complications?
Addison’s disease can lead to serious health problems. The most dangerous is an adrenal crisis, also called an Addisonian crisis. This life-threatening complication may occur if the disease is untreated. An adrenal crisis may result in:
- Low blood pressure
- Low blood sugar
- High potassium levels
- This condition requires immediate medical attention.
How is it diagnosed?
Diagnosis uses medical history, symptoms, and tests:
- Blood tests to check cortisol, ACTH, sodium, potassium, and antibodies
- ACTH stimulation test to see the adrenal response
- Insulin-induced hypoglycemia test for pituitary function
- CT scan of the adrenal glands or MRI of the pituitary
- Possible complications
Without treatment, Addison’s disease can cause adrenal crisis. This life-threatening condition is triggered by stress, infection, or injury. It can cause low blood pressure, low blood sugar, high potassium, and dehydration, and require immediate treatment.
What is the treatment?
Treatment replaces missing hormones:
- Corticosteroids such as hydrocortisone, prednisone, or methylprednisolone for cortisol
- Fludrocortisone to replace aldosterone
- Adequate salt intake, especially during illness, hot weather, or exercise
- Medication doses may increase temporarily during stress or illness. Emergency injections may be needed if oral medicine cannot be taken.
How to take care at home?
- Carry a medical alert card and bracelet
- Keep extra medicine at home, work, and while traveling
- Have an emergency injection kit
- Attend regular follow-ups and check hormone levels
- Get yearly checkups and screenings for autoimmune diseases
How can the disease be prevented?
Addison’s disease cannot be prevented. But adrenal crisis risk can be reduced:
- Get tested if you have ongoing fatigue, weakness, or unexplained weight loss
- Adjust medication during illness or stress as advised
- Seek emergency care if you cannot take medicine due to vomiting
When to see a doctor?
See a doctor for:
- Persistent fatigue or muscle weakness
- Unexplained weight loss
- Dark skin patches or salt cravings
- Nausea, vomiting, diarrhea, or stomach pain
- Dizziness or fainting when standing
- Seek emergency care immediately for adrenal crisis symptoms.
Frequently Asked Questions (FAQs)
Q1. Can Addison’s disease be cured?
No. But hormone replacement helps manage symptoms and prevent complications.
Q2. Can lifestyle changes help?
Yes. Proper diet, stress management, and following medical advice reduce risks.
Important Note: This information is for awareness only. Consult a healthcare professional for medical advice, diagnosis, or treatment.
