Addison’s disease affects your body’s adrenal glands. The adrenal glands are part of the endocrine system. The endocrine system is a group of glands all over your body that produce and secrete hormones to regulate your body’s processes, including your body’s moods, growth, metabolism and tissue function. The adrenal glands are located just above your kidneys. They produce adrenaline-like hormones and a class of hormones called corticosteroids.
Some of the corticosteroid hormones that your adrenal glands produce include glucocorticoids and mineralocorticoids. These hormones are essential for life. Glucocorticoids affect how your body responds to stress, your body’s ability to convert food into energy and the immune system’s inflammatory response. Mineralocorticoids maintain your body’s balance of sodium, potassium and water.
In people who have Addison’s disease, the adrenal glands do not produce enough cortisol, one of the glucocorticoids. Sometimes, the adrenal glands also fail to produce enough aldosterone, one of the mineralocorticoids.
Addison’s disease is most common among people 30 to 50 years of age, but it can occur at any age and affects men and women equally. It is also called adrenal insufficiency or hypocortisolism.
The symptoms of Addison’s disease usually develop over a period of several months and may include:
Sometimes, the symptoms of Addison’s disease appear suddenly. This is called acute adrenal failure or an Addisonian crisis. It can be fatal if it isn't treated. The symptoms may include:
Addison’s disease is also called “adrenal insufficiency.” There are 2 types of adrenal insufficiency:
Primary adrenal insufficiency occurs when the outer layer of the adrenal gland (the part that produces corticosteroids) is damaged and doesn’t produce enough hormones. This damage is usually caused by an autoimmune disease. Normally, your immune system produces antibodies to help protect the body against viruses, bacteria and other foreign substances. An autoimmune disease is when your immune system produces antibodies that attack your body's adrenal glands, or other tissues and/or organs.
Other causes of adrenal gland failure include:
Secondary adrenal insufficiency occurs when you have another condition that causes the adrenal gland to fail to produce enough hormones. For example, secondary insufficiency can be caused by a diseased pituitary gland. The pituitary gland is a gland in your brain that makes a hormone called adrenocorticotropic hormone (ACTH), which stimulates the adrenal glands to produce their hormones. If the pituitary gland is unable to produce enough ACTH, the adrenal glands will not produce enough of their hormones either.
You can also develop temporary secondary adrenal insufficiency if you suddenly stop taking a corticosteroid medicine (such as prednisone). Corticosteroids are prescribed for treatment of conditions such as asthma and arthritis.
Your doctor will ask you about your medical history and your symptoms. He or she may also perform laboratory tests to determine whether you have Addison’s disease:
Treating Addison’s disease usually involves taking prescription corticosteroids to replace the hormones your body is not making. If your body is not making enough cortisol, your doctor may prescribe hydrocortisone, prednisone or cortisone acetate. If your body is not making enough aldosterone, your doctor may prescribe fludrocortisone. These medicines are taken every day by mouth (in pill form).
Your doctor may also recommend you take an androgen replacement called dehydroepiandrosterone. Some women who have Addison’s disease find that taking an androgen replacement improves their mood and sex drive.
If you are experiencing an Addisonian crisis, you need immediate medical care. The treatment typically consists of intravenous (IV) injections of hydrocortisone, saline (salt water) and dextrose (sugar). These injections help restore blood pressure, sugar and potassium levels to normal.
You should prepare yourself to handle a medical emergency if you have Addison’s disease:
Written by familydoctor.org editorial staff