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Addison's disease, also referred to as hypoadrenalism or primary adrenal insufficiency, is a rare disorder of the adrenal glands. These two glands are situated on top of the two kidneys. They produce two essential hormones, namely Cortisol and Aldosterone. The adrenal gland is damaged in Addison's disease which leads to lesser production of Cortisol and Aldosterone. It occurs in both men and women equally and in all age groups, but is most common in the 30-50-year-old age range.
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Overview
Hormones are chemicals that control the functions of tissues and organs. The following happens in Addison's disease when the two adrenal glands do not produce the required hormones.
Cortisol helps the body in responding to stress, which includes the stress of surgery, injury or illness. It also helps maintain blood pressure, heart function, the immune system and the body blood glucose levels.
Aldosterone regulates the balance of sodium and potassium in our blood. This in turn controls the amount of fluid the kidneys remove as urine which regulates the blood volume and blood pressure.
Causes and Symptoms
What causes this disease?
Addison's disease is usually a result of a problem with the immune system, which attacks the outer layer of the adrenal gland, the adrenal cortex, that disrupts the production of steroid hormones - Cortisol and Aldosterone. Another potential cause includes a condition which is able to damage the adrenal glands, such as Tuberculosis (TB).
What are the symptoms of this disease?
Early-stage symptoms of Addison's disease are sometimes similar to Depression or Flu. Some of the symptoms are:
- lack of energy or motivation or fatigue
- acute muscle weakness
- unintentional loss of appetite or weight
- having trouble staying awake or losing total consciousness
- low blood glucose
- low blood pressure
- patches of dark skin around scars, joints and skin folds
- dehydration
- paleness
- severe vomiting and diarrhoea
- sudden, deep in the lower back, legs or belly
- abdominal pain
Diagnosis
- Addison's disease can be treated with the replacement of missing hormones in which case life long medication is needed.
- Blood tests can show the levels of sodium, potassium, cortisol and ACTH in blood and conditions related to diabetes or an underactive thyroid.
- CT scan helps to detect calcium deposits on adrenal glands.
- shots of artificial ACTH are given to the glands for better response and if the cortisol level remains low after the shot, they may not be functioning properly.
- There is a risk of worsening symptoms called adrenal crisis.
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Treatment
Addison's disease can be treated with prescribed hormone supplements such as the Hydrocortisone pill to replace cortisol. Fludrocortisone acetate pills are prescribed for the lack of Aldosterone hormone. With the intake of Fludrocortisone acetate pills, one might be suggested to increase the salt intake in humid weather after exercising During surgeries or emergencies, medication is given intravenously or directly into veins.
Things to Remember
- Having annual check-ups and seeing an Endocrinology specialist once a year is important for the screening of several autoimmune diseases.
- An ongoing relationship with the doctor or keeping in touch is mandatory for the correct dosage of replacement hormones because ongoing problems with medication might demand an adjustment of timing or dosage of medication.
- It is important to carry a medical alert identification card or steroid emergency card for medical personnel to understand what kind of care or treatment one needs in case of an emergency.
- One vital point is to keep extra medication handy, while travelling or to work, as even one day amiss of medication may be dangerous.
- A Glucocorticoid Kit is important to be carried with a syringe and injectable form of corticosteroid to use in case of emergency.
Sample Questions
Ques: How is Addison's disease treated?
Answer: Addison's disease is treated with prescribed medicines that make up for the reduced hormone production. These medicines are to be taken regularly and frequent visits to the doctor are also important to maintain proper regulation of the medication being taken. Increased medication can be a fatal result otherwise. Along with Addison's disease's treatment, the associated diseases, such as Diabetes and Thyroid disorder, with Addison's disease should be treated separately. Every treatment of Addison's disease is crucial to prevent it from turning fatal.
Ques: For how long someone having Addison's disease should be on medication?
Answer: Some of the medications for Addison's disease may be required to be taken for a lifetime. Hence, regular testing and monitoring of the medicines being taken are vital. Visiting the doctor after every 4-6 months is necessary because the dosage of medication is subjected to change in circumstances of injury, stress and surgery.
Ques: What is supposed to be done when a person is faced with an Adrenal Crisis?
Answer: No one must be allowed to reach this position. However, if one does suddenly reach this stage, it has to be made sure that anybody in the family injects the person in Adrenal crisis with a corticosteroid dose after a doctor's consultation. This makes the disease less life-threatening and after which the patient should be taken to the hospital for further proper medication and care.
Ques: Can children suffer from Addison's disease?
Answer: Yes. Children can suffer from Addison's disease too. Addison's disease in children usually brings about a slow growth process and late puberty in children who are diagnosed with this Adrenal insufficiency. However, steps can be taken to control the adverse effect.
Ques: Can Addison's disease be a birth defect?
Answer: Yes. Addison's disease can be a birth defect when the child acquires the wrong genes from their parents. Nevertheless, studies are still in the process of knowing more about this condition and how it can be prevented.
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