Addison’s Disease – Addison’s disease is a rare autoimmune disease in which the immune system mistakenly attacks the adrenal glands and severely damages the adrenal cortex. Once the adrenals have been destroyed beyond 90% of their function, the glands will no longer be able to produce enough cortisol and alosterone.
About Addison’s Disease
Adrenal insufficiency occurs when the adrenal glands cannot make enough of the hormones cortisol or aldosterone. Depending on the cause of decreased hormone production, adrenal insufficiency can either be diagnosed as primary adrenal insufficiency, secondary adrenal insufficiency, or tertiary adrenal insufficiency. A primary, secondary, or tertiary designation directly relates to where the breakdown originates in the body that ultimately causes insufficient adrenal activity.
Primary adrenal insufficiency occurs when the adrenal glands themselves become damaged in some way. This impairs their ability to produce the proper amount of hormones necessary to keep the body working efficiently. The lack of cortisol affects regulation of certain important actions including infection fighting, weight control and heart function. Cortisol is needed for skin and bone health as well. Deficiencies in aldosterone can cause low blood pressure, dizziness, heart palpitations and high pulse rate. High potassium and low sodium are also hallmarks of low aldosterone production.
Primary adrenal insufficiency is known as Addison’s disease.
Secondary adrenal insufficiency has its origin in the pituitary gland located at the base of the brain. The pituitary gland normally produces a hormone known as adrenocorticotropic (ACTH). Its job is to stimulate the adrenal glands into producing cortisol. If the pituitary gland fails to produce enough ACTH, the correct amount of cortisol cannot be produced by the adrenal glands. If adrenal insufficiency is caused for this reason, the adrenal glands may shrink and stop producing cortisol altogether.
Tertiary adrenal insufficiency originates in the hypothalamus, located close to the pituitary gland in the brain. One of its functions is to produce corticotropin-releasing hormone (CRH). This hormone stimulates the pituitary gland into making ACTH. Without ACTH communication is lost between the pituitary and the adrenals and cortisol production is insufficient.
Addison’s Disease Symptoms
+ chronic, or long lasting, fatigue
+ muscle weakness
+ loss of appetite
+ weight loss
+ abdominal pain
+ flank pain
+ painful muscles and/or join pain
+ prolonged recovery from minor infections
+ nausea
+ vomiting
+ diarrhea
+ low blood pressure that drops further when a person stands up, causing dizziness or fainting
+ irritability and depression
+ craving salty foods
+ hypoglycemia, or low blood sugar
+ headache
+ sweating
+ darkening of the skin
+ irregular or absent menstrual periods in women
+ loss of interest in sex
Addison’s Disease Diagnosis
SPECIALISTS
+ Endocrinologist
+ Primary Care Physician
BLOOD TESTS
+ An ACTH (cortrosyn) Stimulation Test
MEDICATIONS
+ Corticosteroids – Usually in the form of Hydrocortisone or Prednisone, tablet form
+ Fludrocortisone
Addison’s Disease Treatment
People who have Addison’s disease should be taught to recognize signs of potential stress that may cause an acute adrenal crisis. Most people with Addison’s disease are taught to give themselves an emergency injection of hydrocortisone or increase their dose of oral prednisone in times of stress.
It is important for the individual with Addison’s disease to always carry a medical identification card that states the type of medication and the proper dose needed in case of an emergency.
Most Addison’s patients have found that splitting their steroid dosage into several times during the day (like 3 or 4) really helps to not have the highs and lows that come with steroid life.
Addison’s Disease Diet
A diet change is essential when taking steroids to live. Gluten free s best as weight gain is common the year after diagnosis.
