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    Addison’s disease

    • Overview

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      Addison’s disease, also known as adrenal insufficiency, is rare when the body fails to produce enough hormones. This condition results in the adrenal glands producing inadequate cortisol and sometimes aldosterone.

      Addison’s disease can affect anyone and risk one’s life. To manage this condition, hormone replacement therapy is necessary to replace the missing hormones.

    • Symptoms

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      Symptoms of Addison’s disease usually develop gradually, often taking several months. Unfortunately, they can progress so slowly that those affected may not notice the signs. However, stress can exacerbate the symptoms, whether due to sickness or injury.

      Some common symptoms of Addison’s disease are:
      Extreme fatigue
      Weight loss and loss of appetite
      Areas of darkened skin
      Low blood pressure, even fainting
      Salt craving
      Low blood sugar, also called hypoglycemia
      Nausea, diarrhea or vomiting
      Abdominal pain
      Muscle and joint pain
      Irritability
      Depression
      Body hair loss or sexual issues in some people

      Acute adrenal failure, known as Addisonian crisis
      Addison’s disease symptoms may manifest abruptly in some instances, and acute adrenal failure can result in a life-threatening shock. If you encounter any symptoms, seek emergency medical attention immediately: severe weakness, confusion, lower back or leg pain, severe abdominal pain, vomiting, and diarrhea that can lead to dehydration, reduced consciousness, delirium, and low blood pressure.

    • When to see a doctor

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      Suppose you experience any typical symptoms of Addison’s disease, such as darkened skin, extreme dehydration, severe fatigue, unintentional weight loss, nausea, vomiting, belly pain, lightheadedness, fainting, salt cravings, or muscle and joint pains. In that case, seeking medical attention from a healthcare provider is vital.

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    • Causes

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      Addison’s disease occurs when the adrenal glands above the kidneys are damaged. These glands produce hormones that affect various organs and tissues in the body as part of the endocrine system. Damage to the glands leads to insufficient levels of cortisol and sometimes aldosterone. The adrenal glands consist of two parts: the medulla, which produces adrenaline-like hormones, and the cortex, which synthesises corticosteroids, a group of hormones that includes:
      Glucocorticoids. These hormones, including cortisol, affect the body’s ability to turn food into energy. They also play a role in the immune system’s inflammatory response and help the body respond to stress.
      Mineralocorticoids. These hormones, including aldosterone, balance the body’s sodium and potassium to keep blood pressure in a healthy range.
      Androgens. In all people, the adrenal glands make small amounts of these sex hormones. They cause male sexual development. And they affect muscle mass, sex drive, libido, and a sense of well-being in all people.

      Primary adrenal insufficiency
      When the cortex, the outer layer of the adrenal glands, is damaged, it may not be able to produce enough hormones. This condition is called primary adrenal insufficiency and is often caused by an autoimmune disease where the body attacks itself. Those with Addison’s disease are more likely to have another autoimmune disease. Additionally, other causes of adrenal gland failure may include tuberculosis, infections of the adrenal glands, cancer spreading to the glands, or bleeding into the glands.

      Secondary adrenal insufficiency
      The pituitary gland produces the adrenocorticotropic hormone (ACTH), which stimulates the adrenal cortex to have its hormones. However, the pituitary gland can produce insufficient ACTH due to non-cancerous tumours, inflammation, or surgery. This condition is known as secondary adrenal insufficiency.

      When there is insufficient ACTH, the adrenal glands may also produce inadequate glucocorticoids and androgens. Symptoms of secondary adrenal insufficiency are similar to those of primary adrenal insufficiency but without darkened skin or severe dehydration. Instead, low blood sugar is more common.

      Temporary secondary adrenal insufficiency can occur when people suddenly stop taking corticosteroids, such as prednisone, used to treat conditions like asthma or arthritis instead of gradually tapering off.

    • Risk factors

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    • Prevention

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      It’s important to talk to your care provider if you are experiencing constant fatigue or weakness or losing weight unintentionally. Inquire about the possibility of an adrenal shortage.
      If you have already been diagnosed with Addison’s disease, ask your provider about the steps to take when you’re sick. You may need to learn how to adjust your corticosteroid dosage.

      If you become severely ill and cannot take your medication, especially vomiting, it’s best to seek medical attention at an emergency room.

      Some individuals with Addison’s disease may be concerned about the potential severe hydrocortisone effects or prednisone. However, those with Addison’s disease are less likely to experience side effects from high-dose glucocorticoids because the prescribed dose is meant to replace the missing amount.

      If you are taking cortisone, it’s important to regularly follow up with your provider to ensure that your dosage is manageable.

    • *Please note that the information provided in the article is for reference purposes only. It is essential to consult a doctor before applying any of the suggestions mentioned.

    Content Details

    Medical info from Mayo Clinic, for reference only. Visit Hoan My for better advice.

    Last updated on: 07/08/2023