Description

Addison's disease is a rare condition that occurs when the body does not make enough of certain hormones. Another name for Addison's disease is the primary adrenal insufficiency. With Addison's disease, the adrenal glands make too little of the hormone cortisol. Often, they also make too little of another hormone called aldosterone.

The damage to the adrenal glands causes of Addison's disease. Symptoms may begin gradually. The first symptoms may include extreme tiredness, salt, cravings and weight loss.

Addison's disease can affect any person. Without treatment, it can be deadly. The treatment consists in taking the laboratory of hormones to replace those that are missing.

Symptoms

Addison's disease symptoms usually occur slowly, often over months. The disease may occur so slowly that the people who have it can ignore the symptoms at the beginning. Physical stress, such as illness or injury can cause symptoms to worsen rapidly.

The first symptoms of Addison's disease can affect you in a variety of ways. Some of the first symptoms can cause discomfort or loss of energy, including:

  • Extreme fatigue, also called fatigue.
  • Dizziness, lightheadedness, or fainting when standing up after sitting or lying down. This is due to a type of low blood pressure is called postural hypotension.
  • Sweating due to low blood sugar, also called hypoglycemia.
  • Upset stomach, diarrhea, or vomiting.
  • Pain in the area of the stomach, also called the abdomen.
  • Muscle cramps, weakness, generalized pain or pain in the joints.

Other early symptoms can cause changes in the way they look, such as:

  • Body hair loss.
  • The dark areas of the skin, especially on scars and moles. These changes may be difficult to view in Black or brown skin.
  • The loss of weight because there is less hunger.

At the beginning of Addison symptoms of the disease can also affect emotions, mental health, and desires. These symptoms include:

  • Depression.
  • An Irritable mood.
  • Decreased sexual desire in women.
  • Salt craving.

The symptoms of emergency due to adrenal crisis

Sometimes the symptoms of Addison's disease get worse quickly. If this happens, an emergency is known as an adrenal crisis. You can also hear the name of addisonian crisis, or acute adrenal insufficiency. Call 911 or the local emergency number if you have Addison's disease with any of the following symptoms:

  • Serious weakness.
  • A sudden, terrible pain in the lower back, in the area of the stomach or legs.
  • Serious stomach upset, vomiting, or diarrhea.
  • The excessive loss of body water, also called dehydration.
  • Fever.
  • Confusion or much less awareness of the surroundings.
  • The loss of consciousness.
  • Low blood pressure and fainting.

Without quick treatment, an adrenal crisis can lead to death.

When to see a doctor

Consult a healthcare professional if you have the common symptoms of Addison's disease, such as:

  • Long-term fatigue.
  • The muscle weakness.
  • Loss of appetite.
  • Dark background of the skin.
  • Weight loss doesn't happen on purpose.
  • Serious stomach upset, vomiting, or stomach pain.
  • Feeling light-headed or fainting with the foot.
  • Salt cravings.

Get emergency care right away if you have any symptoms of an adrenal crisis.

Causes

The damage to the adrenal glands causes of Addison's disease. These glands sit just above the kidneys. The adrenal glands are part of the system of glands and organs that produce hormones, also called the endocrine system. The adrenal glands produce hormones that affect almost every organ and tissue in the body.

The adrenal glands are composed of two layers. The inner layer is called the medulla, makes hormones like adrenaline. These hormones control the body's response to stress. The outer layer, called the cortex, makes a group of hormones called corticosteroids. Corticosteroids include:

  • Glucocorticoids. These hormones include cortisol, and that affect the body's ability to convert food into energy. They also play a role in the immune system and helps the body respond to stress.
  • The mineralocorticoids. These hormones include aldosterone. The balance between the body of sodium and potassium to maintain the blood pressure within a healthy range.
  • Androgens. Of all the people, the adrenal glands to make small amounts of these sex hormones. Cause male sexual development. And affect the muscle mass, body hair, sexual appetite, and a feeling of well-being in all people.

Addison's disease is also known as primary adrenal insufficiency. A related condition is called secondary adrenal insufficiency. These conditions have different causes.

Addison's disease, also called primary adrenal insufficiency

This condition occurs when the outer layer of the adrenal glands are damaged and can't make enough hormones. Most often, the damage is due to a disease in which the immune system attacks healthy tissues and organs by mistake. This is called an autoimmune disease. People with Addison's disease are more likely than others to have another autoimmune disease as well.

Other causes of Addison's disease may include:

  • A serious infection called tuberculosis that primarily affects the lungs and it can also destroy the adrenal glands.
  • Other infections of the adrenal glands.
  • The spread of cancer of the adrenal glands.
  • The bleeding in the adrenal glands.
  • A group of genetic diseases that are present at birth that affect the adrenal glands. This is called congenital adrenal hyperplasia.
  • Medications that block the body's ability to do glucocorticoids, such as ketoconazole (Ketozole), mitotane (Lysodren) and etomidate (Amidate). Or drugs that block the action of glucocorticoids in the body, such as mifepristone (Mifeprex, Korlym).
  • The cancer treatment with drugs called checkpoint inhibitors.

Secondary adrenal insufficiency

This type of adrenal insufficiency have many symptoms in common with Addison's disease. But it is more common than Addison's disease. Secondary adrenal insufficiency occurs when the pituitary gland near the brain does not respond to the adrenal glands to make cortisol.

Normally, the pituitary gland produces a hormone called adrenocorticotropic hormone (ACTH). ACTH in turn causes the outer layer of the adrenal glands to make hormones, including glucocorticoids and androgens. But with secondary adrenal insufficiency, too little ACTH causes the adrenal glands to make too little of these hormones.

Most of the symptoms of secondary adrenal insufficiency are similar to those of Addison's disease. But people with secondary adrenal insufficiency do not develop dark skin. And are less likely to have a severe dehydration or low blood pressure. Are more likely to have low levels of sugar.

Factors that may cause the pituitary gland to produce too little ACTH include:

  • Pituitary tumors that are not cancer.
  • Surgery or radiation therapy of the pituitary gland.
  • The brain injury.

A short-term cause of secondary adrenal insufficiency may occur in people who suddenly stop taking medicines called corticosteroids. These medications for the treatment of conditions such as asthma and arthritis. But stopping the medicine suddenly in place of the suspension can lead to secondary adrenal insufficiency.

Risk factors

The majority of people who contract the disease, Addison disease do not have any factors that put them at greater risk of developing the condition. But the following may increase the risk of adrenal insufficiency:

  • A history of illness or surgery that affects the pituitary gland or the adrenal glands.
  • Certain genetic changes that affect the pituitary gland or the adrenal glands. These include changes in the genes that cause the inherited disorder congenital adrenal hyperplasia.
  • Other conditions endocrine autoimmune disorders, such as hypothyroidism or diabetes type 1.
  • Traumatic brain injury.

Complications

Addison's disease can lead to other health conditions so-called complications. These include adrenal crisis, also called addisonian crisis. If you have Addison's disease and I have not started the treatment, you may develop this life-threatening complication.

The stress in the body, such as injury, infection, or illness can trigger adrenal crisis. Normally, the adrenal glands do two or three times the normal amount of cortisol in response to physical stress. But with adrenal insufficiency, the adrenal glands do not produce enough cortisol to meet this need. And that can lead to adrenal crisis.

Adrenal crisis results in low blood pressure, low blood levels of sugar and high levels of potassium. This complication requires immediate treatment.

Prevention

Addison's disease can't be prevented. But you can take steps to reduce the risk of adrenal crisis:

  • Talk with your health care professional if you always feel tired or weak, or is losing weight without trying. Ask if you should be tested for adrenal insufficiency.
  • If you have Addison's disease, ask your healthcare provider what to do when you are sick. It is likely that you will need to learn how to adjust the amount of medication you take. You may also need to take medicine like a shot.
  • If you are sick, go to an emergency room. This is crucial if you are vomiting and cannot take your medicine.

Some people with Addison's disease to worry about serious side effects of medications with corticosteroids. But people with Addison's disease are not likely to get the side effects of high-dose corticosteroids used for the treatment of many other diseases. This is due to the fact that the prescribed dose is much lower, and only replaces the missing quantity.

If they take corticosteroids, follow-up with your doctor regularly to make sure the dose is not too high.

Diagnosis

The diagnosis involves the steps that your health care team takes to find out if you have Addison's disease. Your healthcare provider will talk to you about your medical history and your symptoms. You could have some of the following tests to check for Addison's disease or adrenal insufficiency secondary:

  • Blood test. This test measures blood levels of sodium, potassium, cortisol, and adrenocorticotropic hormone (ACTH). A blood test can also measure proteins called antibodies associated with Addison's disease caused by an autoimmune disease.
  • ACTH stimulation Test. ACTH tells the adrenal glands to make cortisol. This test measures the level of cortisol in the blood before and after a shot of lab-made of ACTH.
  • Insulin-induced hypoglycemia test. This test is done to find out if the pituitary gland is causing secondary adrenal insufficiency. The test consists in checking your blood sugar and cortisol levels after an injection of insulin.
  • Imaging tests. A ct scan of stomach area checks the size of the adrenal glands and search for other issues. A magnetic resonance imaging of the pituitary gland can see the damage they can cause secondary adrenal insufficiency.

Treatment

Addison's disease treatment involves taking medicines to correct the levels of steroid hormones that the body is not doing enough. Some treatments include corticosteroids are medicines taken by mouth, such as:

  • Hydrocortisone (Cortef), prednisone (Rays, Prednisone Intensol) or methylprednisolone (Medrol) to replace cortisol. Taking these medications on a schedule. This helps to mimic the changes in the levels of cortisol in the body typically goes through more than 24 hours.
  • Acetate fludrocortisone to replace aldosterone.

It is likely that you will have a lot of sodium in your diet. This is especially true during intense exercise, when the weather is hot. It is also true if you have digestive problems such as diarrhea.

Your healthcare provider may tell you to increase the dose of your medicine for a short time if your body is stressed. Stress can come from having surgery, an infection, or a disease of minor importance. If you are vomiting and cannot keep under your medication, you may need injections of corticosteroids.

Follow these treatment recommendations as well:

  • Wear a medical alert tag and wristband at all times. A steroid card and emergency medical alert bracelet or tag that we're going to the emergency care professionals know what kind of care you need. Also have a written plan of action.
  • Keep the medication on hand. It can be dangerous to miss a day of medication. In order to keep a small supply on the job and take the medicine with you when you travel.
  • Take a corticosteroid medicine injection kit. The kit contains a needle, a syringe and an injection of corticosteroid for use in case of emergency.
  • Stay in touch with your health care professional. Your health care team can monitor your hormone levels. If you have problems with your medication, your health care professional may be necessary to change the dose, or when they are taken.
  • Have annual check-ups. At least once a year, consult your health professional or a doctor who treats hormone conditions. Your health care professional may recommend annual screening of autoimmune diseases.

Addisonian crisis is a medical emergency. The treatment usually includes medications or solutions given through a vein. These include:

  • Corticosteroids.
  • The saline solution.
  • Sugar.

Preparing for your appointment

It is likely to start by seeing your primary healthcare professional. Then, you may be referred to a doctor called an endocrinologist who treats conditions related to hormones.

Here is the information to help you prepare for your appointment.

What you can do

Have a family member or friend with you if you can. This person can help you remember the information that is obtained.

Make a list of:

  • Your symptoms and when they began.
  • Key personal information, including major stresses or recent life changes.
  • All medications, vitamins or supplements that you take, including over-dose.
  • Questions to ask your health care professional.

Addison's disease, the questions may include:

  • What is likely causing my symptoms or condition?
  • What tests do I need?
  • Is my condition likely to be short-term or long-term?
  • What is the best course of action?
  • I have other health conditions. How can I best manage them together?
  • There are restrictions that must be followed?
  • Are there brochures or other printed material I can have? What sites do you recommend?

Feel free to ask questions as well.

What to expect from your doctor

Your health care professional may ask:

  • Do you have symptoms all the time or only sometimes?
  • How bad are the symptoms?
  • What, in any case, it makes your symptoms better?
  • What, in any case, it makes your symptoms worse?
Symptoms and treatment of Addison's disease