Also called adrenal insufficiency or hypocortisolism, Addison’s disease often develops in adults between 30 and 50 years old and affects men and women equally. Without proper treatment, it can become life-threatening.
Causes of Addison’s Disease
Addison’s disease, known as primary adrenal insufficiency, occurs when the adrenal glands are damaged and can’t produce enough cortisol and aldosterone. This damage is commonly caused by autoimmune reactions, where the body attacks its own glands. Other possible causes include:
- Tuberculosis infection
- Infections affecting the adrenal glands
- Bleeding inside the adrenal glands
- Cancer spreading to the adrenal glands
- Inherited genetic conditions
Additionally, secondary adrenal insufficiency can happen when the adrenal glands are intact but don’t receive proper signals from the pituitary gland. This often occurs when corticosteroid medications are stopped suddenly.
Symptoms of Addison’s Disease
Many patients report symptoms such as:
- Muscle weakness and aches
- Persistent fatigue
- Dizziness or lightheadedness
- Headaches
- Loss of appetite
- Anxiety and mood changes
- Low blood pressure
- Nausea, vomiting, or diarrhea
- Unintended weight loss
Some people develop a craving for salt due to sodium loss. A characteristic sign can be hyperpigmentation—darkening of the skin—especially on scars, elbows, knees, knuckles, toes, and lips.
A sudden worsening of symptoms, known as an Addisonian crisis, is a medical emergency. Signs include:
- Severe pain in legs and back
- Prolonged vomiting and diarrhea causing dehydration
- Loss of consciousness
If you or someone you know experiences these symptoms, call emergency services immediately. Addisonian crisis often happens in undiagnosed cases or if medication is stopped abruptly.
Diagnosis of Addison’s Disease
Early diagnosis can be challenging. If your doctor suspects Addison’s disease based on your symptoms, they may order:
- Blood tests to check hormone levels
- ACTH stimulation test to assess adrenal function
- Ultrasound imaging
- CT scan for detailed adrenal gland evaluation
These tests help determine how well your adrenal glands and pituitary gland are functioning.
Treatment for Addison’s Disease
Treatment involves lifelong hormone replacement therapy, typically with hydrocortisone and fludrocortisone to restore normal hormone levels. The dosage may need adjustment during stress, illness, surgery, or pregnancy.
Because Addison’s disease can cause sudden emergencies, patients are advised to carry medical identification indicating their condition. This helps emergency responders provide timely treatment, such as cortisol injections, if needed.
Many patients tell us that staying consistent with medication and monitoring symptoms makes a big difference in managing their condition.