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Underactive Adrenal Glands / Addison's Disease

What is Addison's disease?

Addison's disease is the result of an underactive adrenal gland. An underactive adrenal gland produces insufficient amounts of cortisol (a steroid hormone that helps to control the body's use of fats, proteins, and carbohydrates, suppresses inflammatory reactions in the body, and affects immune system functions) and aldosterone (a steroid hormone that controls sodium and potassium in the blood). Addison's disease is considered rare, and the onset of this disease may occur at any age.

What causes Addison's disease?

Most of the time, the cause of the disease is unknown. About one-third of Addison's disease cases are caused by the actual destruction of the adrenal glands through cancer, infection, or other diseases. Other causes may include:

• Use of corticosteroids as a treatment (such as prednisone) causes a slow down in production of natural corticosteroids by the adrenal glands.
• Certain drugs used to treat fungal infections may block production of corticosteroids in the adrenal glands.

What results from inadequate corticosteroid production?

Lack of adrenal hormones may cause:

• elevated levels of potassium.
• extreme sensitivity to the hormone insulin, which normally is present in the bloodstream. This sensitivity may lead to low blood sugar levels.
• increased risk during stressful periods, such as surgery, infection, or injury. Corticosteroids play an important role in helping the body fight infection and promote health during physical stress.

What are the symptoms of Addison's disease?

Mild Addison's disease symptoms may only be apparent when the patient is under physical stress. The following are the most common symptoms of Addison's disease. However, each individual may experience symptoms differently. Symptoms may include:

• weakness
• fatigue
• dizziness
• dark skin
• black freckles
• bluish-black discoloration around the nipples, mouth, rectum, scrotum, or vagina
• weight loss
• dehydration
• lack of appetite
• muscle aches
• nausea
• vomiting
• diarrhea
• intolerance to cold

If not treated, Addison's disease may lead to severe abdominal pain, extreme weakness, low blood pressure, kidney failure, and shock - especially when the patient is experiencing physical stress.

The symptoms of Addison's disease may resemble other conditions or medical problems. Always consult your physician for a diagnosis.

How is Addison's disease diagnosed?

In addition to a complete medical history and medical examination, diagnostic procedures for Addison's disease may include:

• blood tests to measure corticosteroid hormone levels
• kidney function tests to determine if urine is concentrated

Treatment of Addison's disease:

The goal of treatment is to restore the adrenal glands to normal function, producing normal levels of corticosteroid hormones. Specific treatment for Addison's disease will be determined by your physician based on:

• your age, overall health, and medical history
• extent of the disease
• your tolerance for specific medications, procedures, or therapies
• expectations for the course of the disease
• your opinion or preference

Since Addison's disease can be life threatening, treatment often begins with administration of corticosteroids. Corticosteroids, such as prednisone, may be taken orally or intravenously, depending on the patient's condition. Usually the patient has to continue taking the corticosteroid the rest of his/her life. Treatment may also include taking fludrocortisone, a drug that helps restore the body's level of sodium and potassium.

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Online Resources of Endocrinology

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