A rare condition known as Addison's disease occurs when your adrenal glands do not produce enough cortisol and aldosterone. Your body relies on these hormones when stressed, to regulate blood pressure, to function your immune system, and to regulate blood sugar levels. If not treated properly, Addison's disease can be life-threatening. Here's how to prevent, recognize, and treat Addison's disease.
Causes of Addison’s Disease
It is most often caused by an autoimmune disorder, where the immune system damages your own adrenal glands. Infections, tumors, bleeding, or surgery that affects your adrenal glands or the pituitary gland that controls them can also result in Addison's disease. This can result in a gradual loss of hormone production.
Addison's disease can be caused by a number of factors, including:
-
A family history of autoimmune diseases or Addison's disease.
-
A genetic condition that affects your adrenal glands or immune system, such as autoimmune polyendocrine syndrome or congenital adrenal hyperplasia.
-
Other autoimmune diseases that can affect your adrenal glands, such as type 1 diabetes, pernicious anemia, Graves' disease, or vitiligo.
-
Steroids, anticoagulants, and antifungals can interfere with adrenal function.
Symptoms of Addison’s Disease
Depending on the severity and duration of your hormone deficiency, Addison's disease symptoms can vary over months or years. Some common symptoms include:
-
Extreme fatigue and weakness.
-
Weight loss and loss of appetite.
-
Low blood pressure and fainting.
-
Salt craving and dehydration.
-
Low blood sugar and nausea.
-
Abdominal pain and diarrhea.
-
Muscle and joint pain.
-
Darkening of the skin in certain areas.
-
Mood changes and depression.
-
Hair loss and sexual dysfunction.
An addisonian crisis occurs when the symptoms of Addison's disease suddenly worsen due to a stressful event, such as a surgery, illness, or injury. The signs of an addisonian crisis include:
-
Severe weakness and confusion.
-
Severe abdominal pain and vomiting.
-
Low blood pressure and shock.
-
Loss of consciousness or coma.
Diagnosis of Addison’s Disease
Your doctor will ask you about your symptoms and medical history, as well as perform a physical exam and tests to check your hormone levels and adrenal function.
-
You can have your blood tested for cortisol, aldosterone, sodium, potassium, ACTH (a hormone that stimulates your adrenal glands), and antibodies (proteins that indicate an autoimmune disorder).
-
This test involves injecting synthetic ACTH into your vein and measuring how your adrenal glands respond by producing cortisol. An insufficient response indicates adrenal insufficiency.
-
An imaging test can show any abnormality in the size, shape, or function of the adrenal glands or pituitary glands using X-rays, ultrasounds, CT scans, MRI scans, or PET scans.
Treatment of Addison’s Disease
To treat Addison's disease, hormone replacement therapy is used to restore cortisol and aldosterone levels to normal. In order to prevent complications and maintain your health, you will have to take these medications for the rest of your life. Some of the medications you may be prescribed include:
-
As a synthetic form of cortisol, hydrocortisone regulates metabolism, the immune system, inflammation, and stress response. You will need to take it orally once or twice a day at regular intervals. Depending on how active you are, how sick you are, or how stressed you are, the dose may need to be adjusted.
-
Fludrocortisone is a synthetic form of aldosterone that regulates your blood pressure, fluid balance, and electrolyte levels. It needs to be taken orally once a day, along with salt supplements.
-
As well as cortisol and aldosterone, DHEA is produced by your adrenal glands. It promotes sex drive, mood, and energy. If you have low levels of DHEA or experience symptoms like depression, fatigue, or sexual dysfunction, you may need to take it orally once a day.
To manage your condition and prevent complications, you will also need to make some lifestyle changes and precautions. Some of them include:
-
In case of an emergency, wear a medical alert bracelet or carry an identification card that states you have Addison's disease.
-
You should carry an emergency kit that contains injectable hydrocortisone, a syringe, and instructions on how to use it.
-
Any procedure or surgery should be discussed with your doctor, dentist, or surgeon.
-
If you experience any signs of infection, such as fever, sore throat, or cough, seek medical attention right away.
-
You should consume enough calories, protein, carbohydrates, fats, vitamins, and minerals. Avoid foods high in potassium, such as bananas, oranges, potatoes, and tomatoes.
-
To stay hydrated and prevent low blood pressure, drink plenty of fluids and salt. Avoid alcohol and caffeine, as they can dehydrate you and interfere with your medication.
-
You should exercise regularly to improve your blood circulation, muscle strength, bone density, and mood. Avoid prolonged or strenuous exercise that can cause dehydration or low blood sugar levels.
-
Meditation, yoga, breathing exercises, and hobbies can help you manage your stress levels.
Prevention of Addison’s Disease
It is impossible to prevent Addison's disease, since it is often caused by factors beyond your control. However, you can reduce your risk of developing it or having complications from it.
-
Regularly check your adrenal glands and immune system for infections, tumors, bleeding, or autoimmune diseases.
-
If you have a condition that can affect your adrenal glands or immune system, follow your doctor's advice and treatment plan.
-
Secondhand smoke can damage your adrenal glands and increase your risk of infections, so avoid smoking or being exposed to secondhand smoke.
-
Pesticides, solvents, and drugs that can harm your adrenal glands or immune system should be avoided.
-
Be sure to maintain a healthy weight and avoid obesity and malnutrition, which can affect your hormone production and metabolism.
-
Don't be afraid to get vaccinated against diseases that can infect or inflame your adrenal glands or immune system, such as measles, mumps, rubella, chickenpox, hepatitis B, tetanus, diphtheria, pertussis (whooping cough), pneumococcal disease (pneumonia), meningococcal disease (meningitis), influenza (flu), and COVID-19.
By knowing the causes, symptoms, diagnosis, treatment, and prevention of Addison's disease, you can protect yourself and others from its harmful effects.
