What is Addison's disease?

Addison's disease is a rare condition meaning your adrenal glands (small glands above your kidneys) do not make enough cortisol and aldosterone. These are hormones that help your body function normally.

Addison's disease is sometimes called primary adrenal insufficiency.

Secondary adrenal insufficiency is a different condition to Addison's disease. It' s when the pituitary gland in your brain does not release enough adrenocorticotropic hormone (ACTH). Secondary adrenal insufficiency can cause symptoms similar to Addison's disease.

Addison's disease is most common in adults aged from 30 to 50 years, but can happen at any age.

What are the symptoms of Addison's disease?

The most common symptoms of Addison's disease are:

• weight loss
• muscle weakness
• fatigue (feeling very tired for a long time)
• hypotension (low blood pressure)
• darker skin in parts of your body

Other symptoms of Addison's disease include:

• loss of appetite
• abdominal (tummy) pain and joint pain
• nausea and vomiting
• difficulty concentrating
• depression
• menstrual periods that become irregular or stop
• dizziness when standing

The symptoms of Addison's disease usually develop slowly.

What causes Addison's disease?

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

• autoimmune disease (when your immune system mistakenly attacks your own tissues)
• infection such as tuberculosis or meningitis
• cancer
• an injury to your adrenal gland

It can also be caused by birth differences such as your adrenal glands being bigger than usual at birth.

Secondary adrenal insufficiency can be caused by anything that affects your pituitary gland, such as:

• a tumour
• an injury to your brain
• infection
• radiation

Symptoms of adrenal insufficiency can also be caused by suddenly stopping long-term corticosteroid treatment for conditions such as asthma or arthritis.

When should I see my doctor?

If you are experiencing any symptoms of Addison's disease, see your doctor.

When to seek urgent care

An Addisonian crisis, also known as adrenal crisis, is when your Addison's disease symptoms rapidly get worse.

Symptoms of an Addisonian crisis include:

• sudden pain in your abdomen (tummy)
• feeling very dizzy or lightheaded
• vomiting or nausea
• loss of consciousness
• muscle weakness or pain
• a headache that does not go away

If you have Addison's disease, an Addisonian crisis may be triggered by a stressful event, such as:

• an accident
• illness
• infection
• surgery
• missing doses of your usual medicine

If it's not treated quickly, an Addisonian crisis can be fatal (lead to death).

If you think you are having an Addisonian crisis, you should take a “stress dose” (higher dose) of your corticosteroid medicine. You may also need an injection of a medicine called hydrocortisone. Follow the instructions provided by your doctor.

It's important to get urgent medical help even if you have given yourself an emergency dose of your medicine.

How is Addison's disease diagnosed?

Your doctor can diagnose Addison's disease. Your doctor will ask about your symptoms as well as your medical history and family history.

Your doctor may refer you for further tests, including:

• blood tests to check your hormone levels and electrolyte levels
• a blood sugar test
• CT scan to look at the structure of your adrenal glands

How is Addison's disease treated?

Treatment for Addison's disease involves replacing the hormones your adrenal glands do not produce enough of. This includes taking medicines such as:

• hydrocortisone
• fludrocortisone
• prednisolone

You will need to take your medicines for the rest of your life.

You will also need a treatment plan from your doctor. The plan tells you how to manage your medicines and what to do if you get sick.

It's important to take your medicines as prescribed. Do not stop taking your medicines before checking with your doctor.

Living with Addison's disease

If you have Addison's disease you will need to manage your condition for the rest of your life.

Here are some tips that might help:

• Wear a medical alert bracelet or carry an emergency card. This let's others know you have Addison's disease in an emergency.
• Keep your medicines organised and take them regularly. Do not stop taking your medicines before checking with your doctor.
• Have a plan for what to do if you have an adrenal crisis. It's recommended that you carry an emergency injection kit with you.
• Have regular check-ups with your specialist to ensure your treatment is working.

If you have Addison's disease or secondary adrenal insufficiency, you may need to take extra medicines during stressful times, including:

• when you are taking exams
• after having surgery
• when you are sick
• if you get injured

Ask your doctor if this is right for you.

What are the complications of Addison's disease?

Complications of Addison's disease might be side effects from the medicines used to treat Addison's disease. Complications can include:

• fatigue
• Cushing's syndrome
• osteoporosis (low bone density)
• hypertension (high blood pressure)

Can Addison's disease be prevented?

Addison's disease can't be prevented. You can help keep your condition under control by:

• taking your medicines regularly
• eating a healthy diet
• exercising regularly

Resources and support

Visit the Australian Addison's Disease Association website for resources for people with Addison's disease and their carers.

Visit the Hormones Australia website for more information on the causes and diagnosis of adrenal insufficiency,

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with you 24 hours a day, 7 days a week.