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Addison's Disease: Symptoms, Causes, Risk Factors And Treatment

Addison's disease is also called adrenal insufficiency. It is a rare disorder and develops when your body doesn't produce certain hormones in the required quantity. The adrenal glands are located on top of your kidneys and produce the necessary hormones required for your (normal) bodily functions.

So, the disease occurs when the adrenal cortex gets damaged and fails to produce the required amount of steroid hormones cortisol and aldosterone. The hormone cortisol regulates one's body's reaction to stressful situations and aldosterone aids the regulation of sodium and potassium levels in your body [1] [2] .

Addison's disease can develop in individuals of any age group and can affect both men and women equally. The condition can be life-threatening if left untreated. Addison's disease is named after Thomas Addison, the British physician who first described the condition in On the Constitutional and Local Effects of Disease of the Suprarenal Capsules (1855).

Symptoms Of Addison's Disease

The condition usually develops gradually and can take more than two to three months. As the symptoms of the condition develop on a slow basis, it is often ignored until an injury or an illness worsen the symptoms [3] .

The symptoms of Addison's disease include the following [4] :

  • Nausea
  • Extreme fatigue
  • Low blood sugar (hypoglycaemia)
  • Weight loss and decreased appetite
  • Darkening of your skin (hyperpigmentation)
  • Low blood pressure, even fainting
  • Salt craving
  • Muscle or joint pains
  • Diarrhoea
  • Vomiting
  • Abdominal pain
  • Depression or other behavioural symptoms
  • Irritability

In women, it can cause body hair loss and sexual dysfunction. People with the condition are prone to experiencing neuropsychiatric symptoms. When left untreated, the condition can worsen to Addisonian crisis which can cause agitation, visual and auditory hallucinations and delirium.

If the condition worsens and develops the following symptoms, you must immediately get medical help [5] .

  • High fever
  • Confusion and fear
  • Restlessness
  • Loss of consciousness
  • Sudden pain in the lower back, belly, or legs

Causes Of Addison's Disease

The condition develops due to damage in your adrenal glands which results in the lack of production of the hormones. There are two major classifications for the cause of Addison's disease and they are as follows [6] :

Primary adrenal insufficiency: This occurs when the when there is severe damage to your adrenal glands and are unable to produce hormones. Primary adrenal insufficiency caused when the immune system attacks the adrenal glands.

This can also develop due to prolonged administration of glucocorticoids, infections, cancer and abnormal growths (tumours) and certain blood thinners used to control clotting in the blood.

Secondary adrenal insufficiency: This occurs when the pituitary gland fails to produce the adrenocorticotropic hormone (ACTH) required for the release of hormones. Most symptoms of secondary adrenal insufficiency are similar to those of primary adrenal insufficiency.

Secondary adrenal insufficiency can also develop due to medications, tumours, genetics and a traumatic brain injury.

Risk Factors For Addison's Disease

Individuals with the following aspects are prone to developing Addison's disease more [7] .

  • Cancer
  • Autoimmune disease, like type 1 diabetes or Graves' disease
  • Chronic infections like tuberculosis
  • Have had surgery to remove any part of your adrenal gland
  • Takes anticoagulants (blood thinners)

Diagnosis Of Addison's Disease

To understand and examine the condition, the doctor will begin by examining your medical history and the signs and symptoms.

Once done, the doctor may carry out the following tests [8] :

  • ACTH stimulation test
  • Blood test
  • Insulin-induced hypoglycaemia test
  • Imaging tests

Treatment For Addison's Disease

The medical care required for the condition will be dependent on the cause behind it.

Medicines for regulating the adrenal glands may be prescribed. A combination of glucocorticoids medications i.e. drugs that stop inflammation will be prescribed as it can help improve your overall health.

Apart from that, hormone replacement therapy is the most effective measure to correct the levels and clear the imbalance of steroid hormones in your body [9] .

Alternative therapies such as yoga and meditation can be helpful as it can help control and manage your stress levels. But, talk to your doctor before adopting alternative methods to treat your condition [10] .

Increase (in moderation) the level of salt in your diet, for the required sodium levels.

View Article References
  1. [1] Oliveira, D., Lages, A., Paiva, S., & Carrilho, F. (2018). Treatment of Addison’s disease during pregnancy. Endocrinology, diabetes & metabolism case reports, 2018(1).
  2. [2] Saevik, Å. B., Åkerman, A. K., Grønning, K., Nermoen, I., Valland, S. F., Finnes, T. E., ... & Skov, J. (2018). Clues for early detection of autoimmune Addison's disease–myths and realities. Journal of internal medicine, 283(2), 190-199.
  3. [3] Ten, S., New, M., & Maclaren, N. (2001). Addison’s disease 2001. The Journal of Clinical Endocrinology & Metabolism, 86(7), 2909-2922.
  4. [4] Nerup, J. (1974). Addison's disease–clinical studies. A report of 108 cases. European Journal of Endocrinology, 76(1), 127-141.
  5. [5] Manoharan, M., Sinha, P., & Sibtain, S. (2019). Adrenal disorders in pregnancy, labour and postpartum–an overview. Journal of Obstetrics and Gynaecology, 1-10.
  6. [6] Hernandez‐Bures, A., White, A. G., & Riordan, L. (2019). Presumptive iatrogenic hypoadrenocorticism induced by high‐dose ketoconazole administration in a dog. Journal of veterinary internal medicine.
  7. [7] Hoener, K., & Sharma, T. (2019). Type II polyglandular autoimmune syndrome: a case of Addison’s disease precipitated by use of levothyroxine. BMJ Case Reports CP, 12(8), e230760.
  8. [8] Arul, J. N., Rajkumar, M., & Suja, L. (2019). Hyponatraemia presenting as reversible cerebellar ataxia in Addison’s disease. BMJ case reports, 12(8).
  9. [9] George, S. T., Ramakrishnan, C., & Kanna, S. (2019). AN INTERESTING CASE OF ADDISONS DISEASE. International Journal of Scientific Research, 8(7).
  10. [10] van Haren Noman, S., Visser, H., Muller, A. F., & Limonard, G. J. (2018). Addison’s Disease Caused by Tuberculosis: Diagnostic and Therapeutic Difficulties. European journal of case reports in internal medicine, 5(8).
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