About Addison's Disease
Addison's disease (primary adrenal insufficiency) is a rare disorder where the adrenal glands don't produce enough hormones, especially cortisol and often aldosterone.
What are the adrenal glands?
The adrenal glands sit on top of the kidneys and produce hormones essential for life: cortisol (helps manage stress, blood sugar, blood pressure) and aldosterone (manages salt and water balance). In Addison's disease, these glands are damaged, usually by an autoimmune response.
Symptoms
- Extreme fatigue and weakness
- Weight loss and loss of appetite
- Darkening of the skin (hyperpigmentation)
- Low blood pressure, dizziness
- Salt craving
- Nausea, vomiting, diarrhea
- Muscle or joint pains
- Irritability or depression
Diagnosis
Diagnosis involves blood tests to measure cortisol and ACTH levels. An ACTH stimulation test is often used: synthetic ACTH is given and the cortisol response is measured. In Addison's, the adrenal glands do not respond adequately.
Treatment
Treatment is lifelong hormone replacement. Hydrocortisone (cortisol) is taken daily, often in divided doses to mimic natural rhythms. Some patients also need fludrocortisone for aldosterone replacement. Doses may need to be increased during illness, stress, or surgery.
Lifestyle tips
- Take your medication at the same time each day
- Never skip doses
- Carry an emergency hydrocortisone injection and wear medical alert ID
- Learn to "stress dose"—increase hydrocortisone during illness
- Stay in touch with your endocrinologist