What is Addison’s disease?

Addison’s disease is a rare condition where the adrenal glands do not produce enough of the hormones cortisol and aldosterone (both corticosteroids).

It is also known as chronic adrenal insufficiency. It can make people feel weak and tired, but it can also be effectively treated with hormones to replace those that are missing.

What are the types of Addison’s disease?

There are 2 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 are the symptoms of Addison’s disease?

Addison’s disease develops slowly, usually over months. 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:

• a darkening of the skin, with or without sun exposure
• loss of appetite
• salt cravings
• low blood sugar
• abdominal pain and muscle or joint pains
• poor growth in children
• nausea, vomiting and diarrhoea
• irritability and depression
• menstrual periods that become irregular or stop
• loss of hair
• sexual problems in women

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 of the adrenal glands
• blood loss, blood-thinning drugs
• cancer in the adrenal glands
• bleeding in the adrenal glands
• tuberculosis
• conditions such as type 1 diabetes
• genetic defects
• disease in the pituitary glands
• sudden stopping of taking corticosteroids for conditions like asthma or arthritis

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

What is an Addisonian crisis?

Sometimes the symptoms of Addison’s disease can appear suddenly. 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.

How is Addison’s disease diagnosed?

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

• blood tests to determine hormone levels
• 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 requires life-long steroid replacement therapy. This includes corticosteroid tablets, 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.