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Addison's disease develops when the adrenal glands, which are above the kidneys, are not able to make enough of the hormones cortisol and, sometimes, aldosterone.
Your body needs both of these hormones to work as it should. Cortisol helps the body cope with extreme physical stress from illness, injury, surgery, childbirth, or other reasons. Aldosterone helps the body hold on to the salt it needs, and it keeps your blood pressure steady.
Normally, the level of these hormones increases through a chain reaction. First, the hypothalamus in the brain makes a hormone that the pituitary gland needs to make another hormone called ACTH. ACTH then tells the adrenal glands to make cortisol or aldosterone. But with Addison's disease, the adrenal glands can't make enough of the hormones.
If you have Addison's disease, you need to take medicine for the rest of your life to replace the hormones your body can't make. If you don't treat the disease, an adrenal crisis may occur that can lead to death because of a steep drop in blood pressure.
Addison's disease can occur:
People can get Addison's disease at any age.
The most common symptoms are:
You may also have other symptoms, such as:
If you have diabetes, you may have low blood sugar more often, and it may be more severe than usual.
Symptoms usually start slowly. You may not even notice them until your body is under extreme stress, such as when a severe infection, trauma, surgery, or dehydration causes an adrenal crisis. An adrenal crisis means that your body can't make enough cortisol to cope with the stress.
In a few cases, Addison's disease gets worse quickly. These people may already be in an adrenal crisis when they see a doctor.
During an adrenal crisis, the body can't make enough cortisol to deal with extreme physical stress. This can cause:
Call your doctor right away if you have these symptoms. If an adrenal crisis isn't treated, you could die of shock from a steep drop in blood pressure.
To diagnose Addison's disease, the doctor will ask about your health, such as if you have had cancer or have HIV or if you have a family history of Addison's disease. You'll also have a physical exam so the doctor can look for changes in your skin color, check your blood pressure, and look for signs of dehydration.
Your doctor may also order tests, such as:
Treatment includes medicine, self-care, and being prepared for when your body is under stress. If your doctor thinks that you have Addison's disease, he or she may start treatment right away, even before you get your test results.
Take your medicine as prescribed. You will need to take medicine for the rest of your life to replace the cortisol and aldosterone your body can't make on its own. You may take just one medicine, or you may need more than one.
Take care of yourself at home. You may need to:
Be prepared for times when your body is under stress.Here are a few ways you can prepare:
Finding out that you have Addison's disease can be scary. But if you get treatment and follow your doctor's advice, you can lead a long and healthy life.
Other Works Consulted
Carroll TB, et al. (2011). Glucocorticoids and adrenal androgens. In DG Gardner, D Shoback, eds., Greenspan's Basic and Clinical Endocrinology, 9th ed., pp. 285–327. New York: McGraw-Hill.
Miller M (2007). Selected endocrine problems. In LR Barker et al., eds., Principles of Ambulatory Medicine, 7th ed., pp. 1367–1394. Philadelphia: Lippincott Williams and Wilkins.
Moore J (2015). Adrenocortical insufficiency. In ET Bope, RD Kellerman, eds., Conn's Current Therapy 2015, pp. 722–725. Philadelphia: Saunders.
Stewart PM (2008). Glucocorticoid deficiency section of The adrenal cortex. In HM Kronenberg et al., eds., Williams Textbook of Endocrinology, 11th ed., pp. 445–485. Philadelphia: Saunders.
Current as ofNovember 6, 2018
Author: Healthwise StaffMedical Review: E. Gregory Thompson, MD - Internal MedicineKathleen Romito, MD - Family MedicineDavid C. W. Lau, MD, PhD, FRCPC - Endocrinology
Current as of:
November 6, 2018
E. Gregory Thompson, MD - Internal Medicine & Kathleen Romito, MD - Family Medicine & David C. W. Lau, MD, PhD, FRCPC - Endocrinology
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