Addison's disease is a rare health condition, arising when the body is unable to produce sufficient levels of certain hormones. Also referred to as adrenal insufficiency, Addison's disease occurs when an individual's adrenal glands - located just above the kidneys - produce less cortisol and aldosterone than necessary. This condition can affect people of all ages and genders, posing potential threats to life if not managed appropriately. Treatment generally involves supplementing the deficient hormones.

Causes Why Does Addison's Disease Occur? The disease typically manifests when adrenal glands incur damage, leading to deficient cortisol levels and sometimes insufficient aldosterone in the body. The adrenal glands are part of the endocrine system, which produces hormones that instruct almost every organ and tissue in the body.

The adrenal glands consist of two parts. The inner part, the medulla, produces hormones similar to adrenaline, while the outer layer, the cortex, produces corticosteroids, a group of hormones including glucocorticoids, mineralocorticoids, and androgens.

Glucocorticoids like cortisol affect an individual's ability to convert food into energy, play a role in the immune system's response to inflammation, and help the body respond to stress. Mineralocorticoids like aldosterone maintain blood pressure by balancing sodium and potassium in the body.

Androgens, a type of sex hormone, are produced in small quantities by the adrenal glands in both men and women. These hormones foster sexual development in males and affect muscle mass development, libido, and the sense of well-being in both genders.

Primary Adrenal Insufficiency Primary adrenal insufficiency arises when the adrenal cortex is damaged and fails to produce adequate adrenocortical hormones. This condition is often due to an autoimmune disease wherein the immune system mistakenly attacks the adrenal cortex. Individuals with Addison's disease have a higher likelihood of having another autoimmune disease.

Other causes of adrenal insufficiency include infections that can affect the adrenal glands, cancer spreading to the adrenal glands, tuberculosis, and bleeding into these glands. Notably, an Addisonian crisis can develop abruptly without any prior symptoms if there is bleeding in the adrenal glands.

Secondary Adrenal Insufficiency The pituitary gland produces a hormone called adrenocorticotropic hormone (ACTH), which stimulates the adrenal cortex to produce hormones. Secondary adrenal insufficiency arises when insufficient ACTH is produced, leading to a lack of glucocorticoids and androgens, even if the adrenal glands aren't damaged.

The symptoms of secondary adrenal insufficiency largely mirror those of primary adrenal insufficiency, but without hyperpigmentation or severe dehydration or low blood pressure. However, individuals with secondary adrenal insufficiency are more likely to develop low blood sugar or hypoglycemia.

Patients taking corticosteroids to treat chronic conditions like asthma or arthritis who suddenly stop these medications can temporarily trigger secondary adrenal insufficiency. Therefore, discontinuing any medication should be done under medical supervision to prevent adverse effects.

Complications What Complications Can Arise From Addison's Disease? Untreated individuals with Addison's disease may develop an Addisonian crisis due to physical stress resulting from injury, infection, or illness. Normally, the adrenal glands respond to physical stress by producing extra cortisol. However, the inability of the adrenal glands to increase cortisol production due to insufficiency can lead to an Addisonian crisis.

An Addisonian crisis is a life-threatening situation presenting symptoms such as low blood pressure, low blood sugar levels, and high levels of potassium in the blood. Emergency medical care is required in such situations. Individuals with Addison's disease often have associated autoimmune diseases.

Prevention How Can We Prevent Addison's Disease? Addison's disease cannot be prevented. However, steps can be taken to avoid a crisis related to the disease.

Those constantly feeling fatigued, weak, or losing weight should consult their doctors to check for adrenal insufficiency. Individuals diagnosed with Addison's disease should ask their doctors about necessary precautions to take when symptoms worsen or during a crisis. Learning how to increase the dose of corticosteroids can be useful in such scenarios. Patients who cannot take their medication due to vomiting attacks should consult their physicians and find appropriate solutions.

Symptoms What Are The Symptoms of Addison's Disease? Symptoms of Addison's disease usually progress slowly over time. Initial signs include extreme fatigue, weight loss, and decreased appetite. Other symptoms can involve hyperpigmentation or darkening of the skin, behavioral symptoms such as depression, hypoglycemia or low blood sugar, fainting due to low blood pressure, loss of body hair or sexual dysfunction in women, abdominal pain, muscle or joint pains, nausea, diarrhea or vomiting, irritability, and a craving for salt.