Addison’s disease, also known as adrenal insufficiency, is a rare and potentially life-threatening condition that occurs when your adrenal glands, which are located on top of your kidneys, produce too little cortisol and, sometimes, an insufficient amount of aldosterone. Cortisol is a hormone that helps your body deal with stress, while aldosterone helps it regulate salt levels and fluid balance.

Causes

The primary cause of Addison’s disease is the damage to the adrenal glands. There are different ways that damage can occur. They include:.

Autoimmune disorders: In about 80% of cases, Addison’s disease is caused by an autoimmune condition called autoimmune adrenalitis. Essentially, your immune system attacks the adrenal glands and damages them.
Adrenal gland destruction: This can be due to infection, such as tuberculosis, or cancer that has spread to the adrenal glands.
Genetic defects: Some rare genetic disorders like X-linked adrenoleukodystrophy and congenital adrenal hyperplasia can result in the adrenal glands being unable to produce enough hormones.
Treatment: In some instances, surgery to remove the adrenal glands can cause adrenal insufficiency.

Symptoms

Addison’s disease symptoms usually develop gradually and may go unnoticed until a stressful event like an illness or injury. When symptoms do occur, they can include:.

Extreme fatigue and weakness
Weight loss and decreased appetite
Nausea and vomiting
Dizziness or fainting
Muscle or joint pain
Change in mood or personality
Darkening of the skin (hyperpigmentation)
Salt craving

Diagnosis

Addison’s disease can be challenging to diagnose, and it may take months or even years to obtain an accurate diagnosis. Your doctor will start by reviewing your medical history and symptoms, then perform a physical exam.

They may also order several diagnostic tests, including:.

Blood tests: Blood tests will check for the levels of cortisol, aldosterone, and potassium in your blood.
ACTH stimulation test: This test involves measuring your cortisol levels before and after receiving a synthetic version of ACTH, a hormone that stimulates cortisol production. A low cortisol level after the ACTH stimulation test indicates adrenal insufficiency.
Insulin-induced hypoglycemia test: This test checks for adrenal insufficiency by measuring how your cortisol levels respond to low blood sugar levels.

Treatment

There is currently no cure for Addison’s disease, and treatment aims to replace the hormone deficiencies. Treatment will usually include:.

Corticosteroid replacement therapy: The main treatment for Addison’s disease is to replace the missing cortisol and aldosterone hormones with synthetic versions, usually in the form of tablets. The dosage will need to be monitored regularly, and it may be adjusted depending on stress levels, illness, and other factors.
Fludrocortisone: This medication is used to replace aldosterone, which regulates salt and fluid balance. Fludrocortisone may be prescribed in addition to corticosteroids.
Emergency treatment: In the case of an adrenal crisis, you may need an injection of hydrocortisone, saline, or glucose. An adrenal crisis is a severe, life-threatening condition that can occur if the body doesn’t have enough cortisol.

Living with Addison’s Disease

Living with Addison’s disease can be challenging, and you’ll need to take steps to manage the condition carefully. Some tips for living with Addison’s disease include:.

Take your medication as prescribed by your doctor.
Avoid physical and emotional stress.
Maintain a healthy diet and regular exercise routine.
Wear a medical alert bracelet that indicates you have Addison’s disease.
Carry an emergency injection kit with you at all times in case of an adrenal crisis.
Regularly monitor for signs of adrenal insufficiency and seek medical attention immediately if you suspect an adrenal crisis.
Work with your doctor to develop a long-term treatment plan.

Conclusion

Addison’s disease is a rare and potentially life-threatening condition caused by damage to the adrenal glands.

It can be challenging to diagnose and treat, but with careful management, people with Addison’s disease can live a full and healthy life. If you suspect you have Addison’s disease or have been diagnosed with the condition, work closely with your doctor to develop a treatment plan that is tailored to your needs.