Addison’s disease is a rare chronic condition that occurs when the adrenal glands don’t produce enough of the hormones cortisol and aldosterone. Another name for Addison’s disease is primary adrenal insufficiency.
With Addison’s disease, the damage to your adrenal glands happens slowly over time, so symptoms occur gradually and vary from person to person. Symptoms of Addison’s disease include:
- Steadily worsening fatigue
- Patches of dark skin, especially around scars and skin creases and on your gums
- Abdominal pain
- Nausea and vomiting
- Diarrhea
- Loss of appetite and unintentional weight loss
- Muscle pain, muscle spasms, and/or joint pain
- Dehydration
- Low blood pressure, which can cause lightheadedness or dizziness upon standing
- Changes in mood and behavior, such as irritability, depression, and poor concentration
- A craving for salty food
- Low blood sugar
People assigned female at birth with Addison’s disease may also have abnormal periods, lose body hair, and have a decreased sex drive. In some cases, such as after an injury, severe illness, or time of intense stress, symptoms can come on quickly and cause a life-threatening event called an addisonian crisis or acute adrenal failure.
An addisonian crisis is a medical emergency. If it is not treated, it can lead to shock and death. Symptoms of an addisonian crisis include:
- Extreme weakness
- Sudden, severe pain in your lower back, belly, or legs
- Feeling restless, confused, afraid, or other mental changes
- Severe vomiting and diarrhea, possibly leading to dehydration
- Low blood pressure
- Loss of consciousness
The most common cause of Addison’s disease is an autoimmune response, which occurs when the immune system attacks healthy tissues for an unknown reason. With Addison’s disease, the immune system attacks the outer portion of the adrenal glands, the adrenal cortex, where cortisol and aldosterone are made. Symptoms don’t usually develop until 90% of the adrenal cortex has been damaged which can take several months to years.
Other causes of Addison’s disease can include:
- Tuberculosis
- Other infections of the adrenal glands
- The spread of cancer to the adrenal glands
- Bleeding into the adrenal glands
- Congenital adrenal hyperplasia
- Medicines that block the body’s ability to make glucocorticoid or medicines that block the action of glucocorticoid in the body
- Treatment for cancer with medicines called checkpoint inhibitors
- The surgical removal of the adrenal glands
Since symptoms of Addison’s disease usually develop slowly over time and can be vague and common to many different conditions, it often leads to a delay in the proper diagnosis. Healthcare providers often “accidentally” discover Addison’s disease when a routine blood test, such as a basic metabolic panel shows low levels of sodium or high levels of potassium. Another common symptom that signals healthcare providers to test for Addison’s disease is dark patches on the skin.
Other tests a healthcare provider may use to diagnose Addison’s disease include:
- Blood tests
- ACTH stimulation test
- Insulin-induced hypoglycemia test
- Imaging tests
Treatment for Addison’s disease involves taking medicines that correct the levels of steroid hormones that the body isn’t making enough of. Some treatments include corticosteroid medicines taken by mouth.
If you’re experiencing symptoms of Addison’s disease, you can receive treatment from an endocrinologist at Flushing Hospital Medical Center’s Ambulatory Care Center. To schedule an appointment, please call (718) 670-5486.
All content of this newsletter is intended for general information purposes only and is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Please consult a medical professional before adopting any of the suggestions on this page. You must never disregard professional medical advice or delay seeking medical treatment based upon any content of this newsletter. PROMPTLY CONSULT YOUR PHYSICIAN OR CALL 911 IF YOU BELIEVE YOU HAVE A MEDICAL EMERGENCY.