What is Addison’s disease?

It is also known as chronic adrenal insufficiency, or hypocortisolism. Addison’s disease usually gets worse with time, but it can also be effectively treated with replacement steroids.

Types of Addison’s disease

There are two main types of Addison’s disease.

• Primary adrenal insufficiency: the adrenal glands do not produce enough cortisol and aldosterone
• Secondary adrenal insufficiency: the pituitary gland in the brain does not release enough of the hormone that stimulates the adrenal gland to release cortisol.

What causes Addison’s disease?

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

• autoimmune disease
• infection
• blood loss, blood thinning drugs
• a tumour
• conditions such as type 1 diabetes
• genetic defects.

It can also be caused by anything that affects the pituitary gland, such as a tumour.

Addison’s disease symptoms

The symptoms of Addison’s disease start gradually and can include:

• a darkening of the skin, with or without sun exposure
• weight loss
• low blood pressure
• fatigue and muscle weakness
• loss of appetite
• salt cravings
• poor growth in children
• nausea, vomiting and diarrhoea
• irritability and depression
• menstrual periods that become irregular or stop.

What is an Addisonian crisis?

An Addisonian crisis can occur when an accident or illness causes symptoms to worsen. These can include sudden pain in the lower back, legs or abdomen, low blood pressure, severe vomiting and diarrhoea and loss of consciousness. An untreated Addisonian crisis can be fatal.

In the case of accident, illness, vomiting or diarrhoea people with Addison’s disease must have their medication adjusted according to their specific needs.

Addison’s disease diagnosis

Addison’s disease can be diagnosed in a variety of ways, including:

• blood tests to determine hormone levels
• X-ray, MRI or CT scan to look at the structure of the adrenal or pituitary glands
• medical and family history.

Addison’s disease treatment

Treatment for Addison’s disease requires life-long steroid replacement therapy. This includes oral corticosteroids, corticosteroid injections, androgen replacement and sometimes increased sodium (salt) intake.

People with Addison’s disease are advised to wear an identification disc or bracelet noting treatment in an emergency.