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).

Addison's disease is also known as primary adrenal insufficiency.

Secondary adrenal insufficiency occurs when the pituitary gland in the brain does not release enough of the hormone that stimulates the adrenal gland to release cortisol.

Addison's disease 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 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:

• loss of appetite
• 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
• loss of hair

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. 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 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.

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 fall sick and how to manage your steroid medication. It is important to take your medication as prescribed; do not suddenly stop taking them without checking with your doctor.