Addison’s Disease: Symptoms, Diagnosis and Treatment

Addison’s disease occurs when the body fails to produce enough cortisol or aldosterone. It is named after Thomas Addison, the British physician who first described the condition. It can affect people of all ages and all groups and can be fatal if not treated properly. The disease develops gradually, and it is sometimes hard to diagnose. By the time a person learns they have Addison’s disease, it may already be established. It can sometimes be confused with other conditions and attributed to other health problems, as well.

Causes of Addison’s Disease

There are three main causes of Addison’s disease:

• Autoimmune adrenalitis: is the most common and happens when the body starts to destroy the adrenal cortex.
• Adrenal dysgeneses: is related to genetic mutations that affect the way the adrenal glands produce hormones.
• Impaired steroidogenesis: occurs when there is an interruption of the delivery of cholesterol to the adrenal gland.

Symptoms of Addison’s Disease

The symptoms of Addison’s disease can come on gradually and mimic many other illnesses and diseases. Many patients do not notice the symptoms until they become severe or after they have become chronic. Symptoms include:

• Low blood pressure
• Fainting
• Salt cravings
• Depression
• Darkening of the skin
• Extreme weight loss
• Abdominal pain
• Vomiting
• Body hair loss
• Sexual dysfunction
• Hypoglycemia

Some people do not seek medical attention until they experience an “Addisonian crisis.” This happens when there is a severe adrenal insufficiency. It is considered a medical emergency, and failure to seek treatment could result in death. At this point, the body could start to shut down and other organs may be affected. The symptoms for an Addisonian crisis are different and more severe than symptoms of the disease at mild stages. They include:

• Sharp leg pains
• Severe vomiting
• Low blood pressure
• Confusion
• Severe lethargy
• High fever
• Convulsions
• Slurred speech
• Inability to stand
• Diarrhea

Diagnosis

Doctors can diagnose Addison’s disease in several different ways.

• Blood Tests: Blood tests measure the amount of potassium, sodium, cortisol, and ACTH in the blood to determine if there is an adrenal deficiency.
• ACTH Stimulation Test: An ACTH stimulation test determines the level of cortisol in the blood before and after a patient is injected with synthetic ACTH.
• CT Scans: CT scans can also be performed to check the adrenal glands to determine if there are any growths or abnormalities.
• Insulin Induced Hypoglycemia Test: An insulin-induced hypoglycemia test is used to determine if the pituitary disease could be the cause of the adrenal problems.

Treatment

Addison’s disease can be treated with hormone replacement therapy and dietary changes.

• Corticosteroids: Corticosteroids, such as hydrocortisone prednisone or cortisone acetate, are often used to replace cortisol. These corticosteroids can be given orally or by injection. Sufferers who have other health problems may be given higher dosages of the corticosteroids.
• High–Sodium Diet: Patients are also usually directed to consume a lot of sodium if they are active, especially after exercising or if exposed to hot temperatures for long periods of time.

Prognosis

When treated, the outlook is typically good for Addison’s disease sufferers. A person who has been diagnosed with the disease should always be aware of their symptoms and watch for an Addisonian crisis, which can be deadly. They also need to be careful about certain activities that can put a strain on the body.

References:

• NIDDK
• Medline Plus