Addison’s Disease
- mrsaepts
- Dec 7, 2023
- 3 min read
BY Aiyada Ieumwananonthachai, Hargun Champi, Phurinart Suandork
EDITED BY Jittanan Tirawatthanaprapha
What is Addison’s Disease?
Addison’s Disease which is also known as primary adrenal insufficiency,
is a rare autoimmune disease that occurs when the body produces an insufficient amount of cortisol and aldosterone, by the adrenal glands. The adrenal glands, located on top of each kidney, play an essential role in producing hormones that regulate various body functions.
When the adrenal glands fail to produce an adequate amount of cortisol, a hormone needed for managing stress, maintaining blood sugar levels, and regulating metabolism, an imbalance of sodium and potassium is transpired.
An infection or damage to the adrenal gland causes autoimmune diseases, prompting the immune system to attack and destroy the adrenal glands.
Addison’s Disease can affect people of any age, although it is most common between the ages of 30-50 years. It is also more common in women than in men.
Causes and symptoms
Causes: problems with immune system, genetics (vitiligo, diabetes type 1, underactive thyroid / hypothyroidism), tuberculosis, infections, hemorrhage, cancer, amyloidosis, surgical removal of both adrenal glands (adrenalectomy), adrenoleukodystrophy (ALD), certain treatments needed for Cushing's syndrome
Symptoms:
Symptoms of adrenal insufficiency usually appear slowly over time, causing many to confuse them as something else or overlook them. Initial signs of Addison’s Disease include overwhelming exhaustion and lack of energy, chronic fatigue, muscle weakness with cramps, loss of appetite, unintentional weight loss, and abdominal pain.
Other common physical symptoms may include dizziness when standing, low blood pressure (hypotension), hyperpigmentation or patches of skin with darker coloration than normal, abnormal tiredness (lethargy), a frequent need for urination, increased thirst, irregular menstrual cycles, headaches, and fevers
Addison’s disease also highly affects an individual mentally, which may include low mood or mild clinical depression- which is caused by the hormonal imbalances, difficulty concentrating, irritability, and loss of interest in sexual intercourse.
Children who are diagnosed with Addison’s disease may also experience a delay in puberty and growth.
Risk Factors
While Addison’s disease is rare, it is essential to recognize and be aware of various risk factors. In most cases, patients prone to the primary or autoimmune forms often have associated risk factors and other autoimmune diseases such as:
Type I diabetes
Hypoparathyroidism (Insufficient production of parathyroid hormone from parathyroid glands)
Hypopituitarism (Deficiency in hormones production in pituitary gland)
Pernicious anemia (Lack of or insufficient amount of healthy red blood cells)
Testicular dysfunction (Failure to produce sperms and male hormones)
Graves' disease and Hyperthyroidism (Overproduction of thyroid hormones)
Chronic Thyroiditis (Inflammation of thyroid glands which leads to the reduction of thyroid function)
Candidiasis (Fungal infection caused by yeast)
Dermatitis herpetiformis (Skin inflammatory disease that leads to severe itching and blistering of skin)
Vitiligo (Loss of skin pigment)
Myasthenia gravis (When the immune system mistakenly destroys the nerves and muscles)
Treatments
Patients diagnosed with Addison’s Disease, are required to take daily medication to replace the lost hormones which the body has failed to produce. Treatment involves corticosteroid (a steroid which is used to replace aldosterone and cortisol hormones which the body no longer produces) replacement for life. It is usually taken in the form of tablets, 2-3 times a day.
Other possible medications are prednisolone, dexamethasone and hydrocortisone, which is used to replace cortisol.
Usually, the medication used to treat Addison’s disease does not have any side effects unless the dose taken is too high. If a dose higher than necessary is taken for a long time, risks of osteoporosis, insomnia and mood swings rises.
Taking the medications stated above enables patients to continue with their normal diet and exercise. However, fatigues are common and can take time to manage periods of low energy.
It is recommended for patients to carry emergency injections of hydrocortisone in case of severe symptoms. Consultation with an endocrinologist is essential for personalized treatment plans.
References:
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