Addison's Disease - About Addison's Disease (Hypocortisolism)
Endocrine System Topic Posted by David Mangusan Jr., PTRP
Addison’s disease, also called adrenal insufficiency or hypocortisolism, is an endocrine disorder characterized by:
You have two adrenal glands, each sitting on top of each kidney. They produce hormones such as cortisol, aldosterone, and sex hormones.
Cortisol belongs to a class of hormones called glucocorticoids that have effects on almost every organ in the body. Some important functions of cortisol include:
Aldosterone belongs to a group of hormones called mineralocorticoids. It primarily helps in maintaining blood pressure and water and salt balance in the body.
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Signs and Symptoms
Signs and symptoms of adrenal insufficiency usually develop gradually and may vary from person to person. It may include:
When signs and symptoms occur suddenly, the condition is called acute adrenal failure or addisonian crisis. Signs and symptoms of addisonian crisis may include:
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Causes
A variety of problems can cause failure of the adrenal glands to produce enough cortisol. The problem may be in the adrenal glands themselves, a condition called primary adrenal insufficiency. In some cases, the problem arises when the pituitary gland fails to secrete ACTH, a condition called secondary adrenal insufficiency.
Causes of primary adrenal insufficiency may include:
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Diagnosis
Addison’s disease may be difficult to diagnose in its early stages. The doctor will likely review the patient’s medical history based on the symptoms. In addition, the dark tanning of the skin may lead a doctor to suspect Addison’s disease.
The diagnosis of Addison’s disease is made by laboratory tests, such as ACTH stimulation test and the CRH stimulation test. Imaging tests may also be ordered by the doctor to help establish the cause of the condition.
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Treatment
Treatment of Addison’s disease involves replacing the hormones that the adrenal glands are not making. For example, the hormone cortisol is replaced orally with a certain synthetic glucocorticoid. The doctor will determine which particular medication is best for individual patients.
For more information about the treatment of Addison’s disease, you can visit the National Endocrine and Metabolic Diseases Information Service website, which is an information dissemination service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).
Must Reads:
Reference:
National Endocrine and Metabolic Diseases Information Service (July 2004). Addison’s Disease (NIH Publication No. 04-3054). National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), National Institutes of Health (NIH), Bethesda, MD. Web URL: http://www.endocrine.niddk.nih.gov/pubs/addison/addison.htm. Accessed: November 5, 2008
Page Last Revised: November 27, 2010
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Weight lossAddison’s disease occurs when your adrenal glands become underactive or are unable to produce enough cortisol and, in some cases, aldosterone. It can occur in all age groups and afflicts women and men equally.
Muscle weakness
Fatigue that gets worse over time
Low blood pressure
Darkening of the skin
You have two adrenal glands, each sitting on top of each kidney. They produce hormones such as cortisol, aldosterone, and sex hormones.
Cortisol belongs to a class of hormones called glucocorticoids that have effects on almost every organ in the body. Some important functions of cortisol include:
Helping the body respond to stressSecretion of hormones by the adrenal glands is regulated by the adrenocorticotropic hormone (ACTH) from the pituitary gland.
Maintaining blood pressure and cardiovascular function
Balancing the effect of insulin in breaking down sugar for energy
Regulating metabolism of proteins, carbohydrates, and fats
Slowing down the immune system’s inflammatory response
Maintaining proper arousal and sense of well-being
Aldosterone belongs to a group of hormones called mineralocorticoids. It primarily helps in maintaining blood pressure and water and salt balance in the body.
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Signs and Symptoms
Signs and symptoms of adrenal insufficiency usually develop gradually and may vary from person to person. It may include:
Muscle weaknessAcute Adrenal Failure (Addisonian crisis)
Chronic, worsening fatigue
Weight loss
Decreased appetite
Low blood pressure
Nausea and vomiting
Diarrhea
Low blood sugar (hypoglycemia)
Darkening or dark tanning of skin (hyperpigmentation)
Craving for salty foods
Irritability
Depression
When signs and symptoms occur suddenly, the condition is called acute adrenal failure or addisonian crisis. Signs and symptoms of addisonian crisis may include:
Pain in the lower back, abdomen, or legsIf addisonian crisis is left untreated, the condition can be fatal.
Severe vomiting and diarrhea, which can lead to dehydration
Low blood pressure
Loss of consciousness
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Causes
A variety of problems can cause failure of the adrenal glands to produce enough cortisol. The problem may be in the adrenal glands themselves, a condition called primary adrenal insufficiency. In some cases, the problem arises when the pituitary gland fails to secrete ACTH, a condition called secondary adrenal insufficiency.
Causes of primary adrenal insufficiency may include:
An autoimmune disorder in which the body’s immune system attacks the adrenal cortex, the outer layer of the adrenal glands.Secondary adrenal insufficiency, the more common form of the disease, may occur when a person taking glucocorticoid hormone such as prednisone for a long time suddenly stops or interrupts taking the medication. In some cases, the condition is caused by the surgical removal of benign, noncancerous, ACTH-producing tumors of the pituitary gland. As a result, the source of ACTH is suddenly removed. Replacement hormone must be taken until normal ACTH and cortisol production reumes.
Polyendocrine Deficiency Syndrome
Tuberculosis, an infection which can destroy adrenal glands
Less common causes are: Chronic infection, mainly fungal infections
Cancer cells that spread from other parts of the body to the adrenal glands
Amyloidosis
Surgical removal of the adrenal glands
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Diagnosis
Addison’s disease may be difficult to diagnose in its early stages. The doctor will likely review the patient’s medical history based on the symptoms. In addition, the dark tanning of the skin may lead a doctor to suspect Addison’s disease.
The diagnosis of Addison’s disease is made by laboratory tests, such as ACTH stimulation test and the CRH stimulation test. Imaging tests may also be ordered by the doctor to help establish the cause of the condition.
Top of Page
Treatment
Treatment of Addison’s disease involves replacing the hormones that the adrenal glands are not making. For example, the hormone cortisol is replaced orally with a certain synthetic glucocorticoid. The doctor will determine which particular medication is best for individual patients.
For more information about the treatment of Addison’s disease, you can visit the National Endocrine and Metabolic Diseases Information Service website, which is an information dissemination service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).
Must Reads:
Reference:
National Endocrine and Metabolic Diseases Information Service (July 2004). Addison’s Disease (NIH Publication No. 04-3054). National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), National Institutes of Health (NIH), Bethesda, MD. Web URL: http://www.endocrine.niddk.nih.gov/pubs/addison/addison.htm. Accessed: November 5, 2008
Page Last Revised: November 27, 2010
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