Addison's disease

Addison's disease affects the adrenal glands, which sit on top of your kidneys.

What is Addison's Disease?
Also known as Adrenal Insufficiency, this is a rare disorder where your adrenal glands do not produce enough hormones (specifically Cortisol and Aldosterone).

Key Function: These hormones are vital for regulating blood pressure, metabolism, and the body's response to stress. Without them, simple illnesses can become life-threatening.

Symptoms

Symptoms usually develop slowly over several months. The most distinctive signs include:

• Hyperpigmentation: Darkening of the skin, especially in creases, scars, and gums.
• Salt Craving: An intense need to eat salty foods due to sodium loss.
• Extreme Fatigue: Progressive muscle weakness.
• Weight Loss: Unintentional weight loss and decreased appetite.
• Low Blood Pressure: Often causing dizziness or fainting upon standing.
• Gastrointestinal Issues: Nausea, vomiting, or diarrhea.

Hyperpigmentation (darker skin) compared to a normal hand.

⚠️ EMERGENCY: ADDISONIAN CRISIS
Sometimes, symptoms appear suddenly, usually triggered by stress, injury, or infection. This is a medical emergency called Acute Adrenal Failure.

Signs include:

• Severe pain in lower back, abdomen, or legs.
• Severe vomiting/diarrhea leading to dehydration.
• Loss of consciousness.
• High potassium and extremely low blood pressure.

Action: Call 911 immediately and use an emergency hydrocortisone injection if available.

Causes

The condition is classified by where the problem originates:

1. Primary Adrenal Insufficiency

The adrenal glands themselves are damaged. Common causes:

• Autoimmune Disease: The body's immune system mistakenly attacks the adrenal cortex (most common cause).
• Infections: Tuberculosis, HIV, or fungal infections.
• Cancer: Metastasis to the adrenal glands.

2. Secondary Adrenal Insufficiency

The adrenal glands are healthy, but the Pituitary Gland (in the brain) fails to send the signal (ACTH) to produce hormones.

• Steroid Withdrawal: Abruptly stopping corticosteroid medication (like prednisone) after long-term use is a common cause.

Diagnosis

Doctors use specific blood tests to confirm low hormone levels:

• ACTH Stimulation Test: Measuring cortisol levels before and after an injection of synthetic ACTH. In a healthy person, cortisol should rise; in Addison's, it remains low.
• Insulin-Induced Hypoglycemia Test: Used to check for secondary insufficiency (pituitary issues).
• Imaging (CT/MRI): To visualize the size of the adrenal or pituitary glands.

Treatment

Treatment involves lifelong hormone replacement therapy to mimic what the body cannot produce.

1. Daily Medications

• Hydrocortisone (Cortef): Replaces Cortisol. Usually taken 2-3 times a day.
• Fludrocortisone: Replaces Aldosterone to balance sodium and fluids.

2. "Sick Day" Rules (Stress Dosing)

Because your body cannot produce extra cortisol in response to stress, you must manually increase your medication dosage during:

• Illness (Fever/Flu).
• Surgery or dental procedures.
• Severe emotional stress.

Lifestyle & Safety

Living with Addison's requires preparation.

• Medical Alert Bracelet: You must wear one stating "Adrenal Insufficiency." If you are in an accident and cannot speak, paramedics need to know you require steroids to survive.
• Emergency Kit: Always carry an injectable form of corticosteroids (like a glucagon kit style injection) for times when you are vomiting and cannot keep pills down.
• Sodium Intake: Unlike most people, you may need to increase salt intake, especially during exercise or hot weather.

Disclaimer: The content provided on this blog is for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician regarding any medical condition.