About Addison’s disease

A rare condition affecting the adrenal glands is called Addison's disease, commonly known as primary adrenal insufficiency or hypoadrenalism.

Two tiny glands called the adrenal glands are located above the kidneys. They generate cortical, aldosterone, and adrenaline, which are all necessary hormones.The adrenal gland is harmed in Addison's disease, which results in insufficient cortical and aldosterone production.

In the UK, there are about 8,400 cases of Addison's disease. Although it can affect anyone at any age, it is most prevalent in those between the ages of 30 and 50. Women experience it more frequently than men do.

Early Addison's disease symptoms resemble those of other, more prevalent medical diseases, like the flu or depression. You might encounter:

• Fatigue (lack of energy or motivation)
• Muscle weakness
• Low mood
• Loss of appetite and unintentional weight loss
• Increased thirst

 

These issues could worsen with time, and you could develop additional symptoms like fatigue, cramping, dizziness, and fainting. Additionally, you could get discoloured gums, lips, or small patches of skin.

Even if Addison's disease isn't necessarily the cause of these symptoms, you should nonetheless visit your GP so that they may be looked into.

Why it happens

The disorder is typically brought on by a problem with the immune system, which prompts it to target the adrenal cortex, the outer layer of the adrenal gland, interfering with the synthesis of the steroid hormones cortisol and aldosterone. It is unknown why this occurs, although in the UK, it accounts for 70–90% of instances.

Other probable causes include illnesses like tuberculosis (TB), which can harm the adrenal glands, albeit they are uncommon in the UK.

Treating Addison's disease

Addison's disease is treated with medications. Hormone replacement therapy restores the body's inadequate production of steroid hormones. Oral corticosteroids are used in some treatments, such as:

• Hydrocortisone (Cortef), prednisone (Rayos) or methylprednisolone (Medrol) to replace cortical. These hormones are given on a schedule to act like the changes in cortisol levels the body goes through over 24 hours.
• Fludrocortisone acetate to replace aldosterone.

Most likely, your diet needs a lot of salt. This is especially true if you've been engaging in strenuous exercise, it's hot outside, or you've been experiencing digestive issues like diarrhea. If your body is under stress, your healthcare professional may temporarily boost your medication. An infection, a small illness, or undergoing surgery can all cause such tension. You might require injections of corticosteroids if you're vomiting and having trouble swallowing your medication.

Other treatment recommendations include:

• Carry a medical alert card and bracelet at all times. Emergency personnel can determine the type of care you require by looking at your steroid emergency card and medical alert identification. Have a written action plan as well.
• Keep extra medicine handy. Even one day without taking your medication can be harmful. Therefore, carry a modest quantity with you while you travel and at work.
• Carry a glucocorticoid injection kit. In case of emergency, the package includes an injectable form of corticosteroids, a needle, and a syringe.
• Stay in contact with your care provider. Your doctor can keep an eye on your hormone levels. Your doctor may need to alter your medication's dosage or timing if you're experiencing side effects.
• Have yearly checkups. At least once a year, see your care provider or a doctor who treats hormone problems. Your provider may recommend yearly screening for autoimmune diseases.

Symptoms of Addison’s disease

• Fatigue (lack of energy or motivation)
• Lethargy (abnormal drowsiness or tiredness)
• Muscle weakness.
• Low mood (mild depression) or irritability.
• Loss of appetite and unintentional weight loss.
• The need to urinate frequently.
• Increased thirst.
• Craving for salty foods.

Causes of Addison’s disease

When the adrenal cortex, the outer layer of the adrenal glands, is harmed, it produces fewer hormones, which leads to Addison's disease.

Although it is uncommon in the UK, tuberculosis (TB) is the most frequent cause of Addison's disease globally. The bacterial infection known as tuberculosis (TB) mostly affects the lungs but can potentially spread to other body organs. If it harms your adrenal glands, it may result in Addison's disease.

Other possible causes of Addison’s disease include:

Infections – such as those linked to AIDS, or fungal infections

A hemorrhage – very heavy bleeding into the adrenal glands, sometimes associated with meningitis or other types of severe sepsis

Cancer – if cancer cells from elsewhere in your body spread to your adrenal glands

Amyloidosis – a disease where amyloid, a protein produced by your bone marrow cells, builds up in your adrenal glands and damages them

Surgical removal of both adrenal glands (adrenalectomy) – for example, to remove a tumour

Adrenoleukodystrophy (ALD) – a rare, life-limiting, inherited condition affecting the adrenal glands and nerve cells in the brain that most often affects young boys

Certain treatments needed for Cushing's syndrome – a collection of symptoms caused by very high levels of cortisol in the body

 

Diagnosing Addison’s disease

Your doctor will initially inquire about your symptoms and evaluate your medical history to assist in the diagnosis of Addison's disease.They may also inquire about any autoimmune diseases that may run in your family (a condition caused by a problem with their immune system).

Your doctor will inspect your skin to check for any signs of hyperpigmentation, especially in the following areas:

• Where skin creases on your palm
• In your elbow crease
• On any scars
• Your lips and gums

However, hyper pigmentation doesn't occur in all cases of Addison’s disease.