Addisons Disease

Overview

Definition

Addison disease is problem with the adrenal glands. They make hormones that help the body with blood pressure, metabolism, and the immune system.

With Addison disease, the glands do not make enough of a hormone called cortisol. Aldosterone may also be low.

The disease may be:

  • Primary—the glands can’t make hormones
  • Secondary—other hormones that tell glands what to do are missing or low

A severe problem from this disease is the Addisonian or adrenal crisis. It can result in death.

Adrenal Glands
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Causes

Primary Addison disease is caused by problems with the outer layer of the gland. This can happen slowly over time.

Addison disease is most often caused when the immune system attacks the gland. It is not known why this happens.

Damage may also be caused by infections such as:

  • Tuberculosis
  • Cytomegalovirus (CMV) infection
  • Fungal infections

Less common causes are:

  • Some cancers
  • Amyloidosis—build up of certain proteins in tissue
  • Bleeding within the glands—may happen because of blood thinning drugs or shock
  • Having the glands removed with surgery
  • Genetic problems or birth defects that make it hard for the glands to work the right way
  • Certain medicines

Secondary Addison disease can be caused by damage to the pituitary gland. This gland sends hormones that control the adrenal gland.

This disease may also happen after long term corticosteroids are stopped.

Risk Factors

This disease is more common in women.

These problems may raise your chances:

  • Sepsis—sickness caused by a bloodstream infection
  • Acute respiratory distress syndrome
  • Pneumonia
  • Liver disease

SymptomsandDiagnosis

Symptoms

You may have:

  • Tiredness
  • Loss of hunger
  • Weight loss
  • Nausea and vomiting
  • Muscle and joint pain
  • Dark freckles, nipples, scars, skin creases, gums, mouth, and nail beds
  • Craving salty foods
  • Mental health issues, such as depression
  • In woman:
    • Dry and itchy skin
    • Lack of sex drive

Diagnosis

You will be asked about your symptoms and health history. An exam will be done.

  • Blood tests
  • Urine tests

Pictures may be taken. This can be done with:

  • MRI scan
  • CT scan

Treatments

Treatment

Addison disease can’t be cured. Medicines can help replace the missing hormones and ease health problems from it. They can also help stop you from having adrenal crisis. You will need care right away if you have this.

Routine blood tests are needed when you are taking the drugs.

Wear an alert bracelet that states that you have this disease. This will let others know of your health problem if you can’t tell them yourself.

Cortisol helps the body deal with physical stress and sickness. Those with Addison disease need to take extra care during:

  • Surgery
  • Pregnancy
  • Severe sickness or trauma

Prevention

There is no way to prevent this disease.

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

Edits to original content made by Denver Health.

a (Adrenal Insufficiency; Adrenocortical Hypofunction; Chronic Adrenocortical Insufficiency; Hypoadrenalism)

RESOURCES

Family Doctor—American Academy of Family Physicians http://familydoctor.org 

National Adrenal Diseases Foundation http://www.nadf.us 

CANADIAN RESOURCES

Health Canada https://www.canada.ca 

The Canadian Addison Society http://www.Addisonsociety.ca 

References

Adrenal insufficiency and Addison's disease. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: http://www.niddk.nih.gov/health-information/health-topics/endocrine/adrenal-insufficiency-Addisons-disease/Pages/fact-sheet.aspx Updated May 2014. Accessed August 16, 2018.

Adrenal insufficiency in adults. EBSCO DynaMed Plus website. Available at:  http://www.dynamed.com/topics/dmp~AN~T116703/Adrenal-insufficiency-in-adults . Updated July 24, 2018. Accessed August 16, 2018.

Arlt W, Allolio B. Adrenal insufficiency. Lancet. 2003;361(9372):1881-1893.

Dorin RI, Qualls CR, Crapo LM. Diagnosis of adrenal insufficiency. Ann Int Med. 2003;138(3):194-214.

Hahner S, Allolio B. Therapeutic management of adrenal insufficiency. Best Pract Res Clin Endocrinol Metab. 2009;23(2):167-179.

Salvatori R. Adrenal insufficiency. JAMA. 2005;294(19):2481-2488.

Ten S, New M, Maclaren N. Clinical Review 130: Addison's disease. J Clin Endo Metabol. 2001;86(7):2909-2922.

Thomas Z, Fraser GL. An update on the diagnosis of adrenal insufficiency and the use of corticotherapy in critical illness. Ann Pharmather. 2007;419(9):1456-65.

Wallace I, Cunningham S, Lindsay J. The diagnosis and investigation of adrenal insufficiency in adults. Ann Clin Biochem. 2009;46(Pt 5):351-367.