What is Addison's disease?

Addison's disease is a rare condition where the adrenal glands do not make enough of the hormones cortisol and aldosterone (both of these are known as corticosteroid hormones).

Addison's disease is also sometimes called primary adrenal insufficiency.

Secondary adrenal insufficiency is a different condition to Addison’s disease. It occurs when the pituitary gland in the brain does not release enough of a particular hormone that stimulates the adrenal gland to release cortisol. Sometimes people use the term “Addison’s disease” to refer to both primary and secondary adrenal insufficiency.

What are the symptoms of Addison's disease?

The main symptoms are weight loss, muscle weakness, fatigue, low blood pressure, and sometimes darkening of the skin in both exposed and non-exposed parts of the body.

Other symptoms include:

• loss of appetite and salt cravings
• low blood sugar
• abdominal pain and muscle or joint pains
• nausea, vomiting and diarrhoea
• irritability and depression
• menstrual periods that become irregular or stop
• hair loss

Addison's disease develops slowly, usually over months.

What causes Addison's disease?

Addison's disease may be caused by anything that damages the adrenal glands, such as:

• autoimmune disease, where the immune system attacks some of the body's own tissues
• infection
• cancer
• bleeding
• tuberculosis
• type 1 diabetes
• genetic defects

Secondary adrenal insufficiency can be caused by anything that affects the pituitary gland in the brain, such as a tumour, surgery or radiation to the area. It can also be caused if you suddenly stop long-term steroid treatment for other conditions such as asthma or arthritis.

What is an Addisonian crisis?

Sometimes the symptoms of Addison's disease can appear suddenly. An Addisonian crisis occurs when a stressful event like an accident, illness or surgery causes symptoms to worsen quickly.

Symptoms of an Addisonian crisis include:

• sudden pain in the lower back
• sudden pain in the legs or abdomen
• low blood pressure
• severe vomiting and diarrhoea
• loss of consciousness.

An untreated Addisonian crisis can be fatal.

If you have Addison’s disease, you should have clear plan of action from your doctor as to what to do during a stressful event like illness or injury to prevent an Addisonian crisis.

In the case of a stressful event, you will need to take a “stress dose” (higher dose) of your corticosteroid medicine and may require an injection of a medicine called hydrocortisone.

When should I see my doctor?

If you are experiencing any of the symptoms of Addison’s disease you should see your doctor. If you are experiencing any of the symptoms of an Addisonian crisis, you should go to your nearest emergency department immediately.

How is Addison's disease diagnosed?

Addison's disease can be diagnosed in a number of ways, including:

• blood tests to check hormone and electrolyte levels in your blood
• a blood sugar test
• x-ray, MRI or CT scan to look at the structure of the adrenal or pituitary glands
• medical and family history

How is Addison's disease treated?

Treatment for Addison's disease needs life-long steroid replacement therapy. This includes corticosteroid tablets, corticosteroid injections, androgen replacement and sometimes increased sodium (salt) intake.

If you have Addison's disease, consider wearing a medical alert bracelet or carrying an emergency card. You will usually need a plan from your doctor about what to do if you get sick and how to manage your steroid medicine. It is important to take your medicines as prescribed. Do not suddenly stop taking them without checking with your doctor.

Resources and support

For information and resources for people with Addison’s disease and their carers see the Australian Addison's Disease Association website.

Call healthdirect on 1800 022 222 at any time to speak to a registered nurse (known as NURSE-ON-CALL in Victoria) for more information and advice.