What is Addison's Disease? Symptoms, Causes, & Treatment

Addison's disease happens when your adrenal glands don't produce enough of certain hormones your body needs to function properly. These small glands sit on top of your kidneys and make hormones like cortisol and aldosterone that help regulate your blood pressure, blood sugar, and response to stress.

Also called primary adrenal insufficiency, this condition affects about 1 in 100,000 people. While it's serious, you can live a full, healthy life with proper treatment and management.

What are the symptoms of Addison's disease?

The symptoms of Addison's disease often develop slowly over months or years, which can make them easy to miss at first. Your body gradually struggles to maintain normal functions without enough adrenal hormones.

Here are the most common symptoms you might experience:

• Extreme fatigue and weakness that doesn't improve with rest
• Weight loss and decreased appetite
• Darkening of skin, especially in scars, skin folds, and gums
• Low blood pressure that may cause dizziness when standing
• Salt cravings
• Nausea, vomiting, or diarrhea
• Muscle or joint pains
• Irritability and mood changes

Some people also experience less common symptoms like low blood sugar, especially in children, or irregular menstrual periods in women. These symptoms can feel vague and similar to many other conditions, which is why diagnosis sometimes takes time.

What causes Addison's disease?

Addison's disease occurs when your adrenal glands become damaged and can't produce enough hormones. The most common cause is an autoimmune reaction where your body's immune system mistakenly attacks your own adrenal glands.

Let's look at the main causes, starting with the most common:

• Autoimmune destruction - your immune system attacks the adrenal glands (causes about 80% of cases)
• Tuberculosis infection affecting the adrenal glands
• Other infections like fungal infections or HIV
• Cancer that spreads to the adrenal glands
• Bleeding into the adrenal glands
• Genetic disorders affecting adrenal function
• Surgical removal of adrenal glands

In rare cases, certain medications or treatments can also affect adrenal function. Sometimes, doctors can't identify the exact cause, but this doesn't change how effectively the condition can be treated.

When to see a doctor for Addison's disease?

You should see a doctor if you're experiencing persistent fatigue, unexplained weight loss, or skin darkening that doesn't seem related to sun exposure. These symptoms, especially when combined, warrant medical evaluation.

Seek immediate medical attention if you develop severe symptoms like intense weakness, confusion, severe nausea and vomiting, or very low blood pressure. These could signal an adrenal crisis, which is a medical emergency that requires immediate treatment.

Don't wait if you notice multiple symptoms together, even if they seem mild. Early diagnosis and treatment can prevent serious complications and help you feel much better.

What are the risk factors for Addison's disease?

Certain factors can increase your likelihood of developing Addison's disease. Understanding these risk factors can help you and your doctor stay alert for early signs.

The main risk factors include:

• Having other autoimmune conditions like type 1 diabetes, thyroid disease, or vitiligo
• Family history of autoimmune diseases
• Being between ages 30-50 (though it can occur at any age)
• Having had tuberculosis or other serious infections
• Taking blood-thinning medications that might increase bleeding risk
• Having certain genetic conditions

Women are slightly more likely to develop the autoimmune form of Addison's disease. However, having risk factors doesn't mean you'll definitely develop the condition - many people with these factors never experience adrenal problems.

What are the possible complications of Addison's disease?

The most serious complication of Addison's disease is an adrenal crisis, also called Addisonian crisis. This life-threatening emergency happens when your body doesn't have enough adrenal hormones to handle stress, illness, or injury.

Signs of an adrenal crisis include:

• Severe weakness and confusion
• Sharp drop in blood pressure
• Severe nausea, vomiting, and diarrhea
• High fever
• Loss of consciousness
• Severe dehydration

Other complications can include dangerously low blood sugar, high potassium levels that affect heart rhythm, and severe dehydration. The good news is that these complications are largely preventable with proper treatment and emergency preparedness.

With appropriate hormone replacement therapy and stress management, most people with Addison's disease avoid these serious complications entirely.

How is Addison's disease diagnosed?

Diagnosing Addison's disease typically involves blood tests that measure your hormone levels and how your adrenal glands respond to stimulation. Your doctor will start with a detailed discussion of your symptoms and medical history.

The main diagnostic tests include:

• ACTH stimulation test - measures how your adrenal glands respond to a hormone injection
• Blood tests for cortisol levels, especially early morning cortisol
• Tests for electrolytes like sodium and potassium
• ACTH level measurement
• Tests for antibodies that attack adrenal glands
• Sometimes imaging tests like CT scans of the adrenal glands

Your doctor might also test for other autoimmune conditions since they often occur together. The diagnostic process can take some time, but getting an accurate diagnosis is crucial for proper treatment.

What is the treatment for Addison's disease?

Treatment for Addison's disease involves replacing the hormones your adrenal glands can't make. This hormone replacement therapy is highly effective and allows most people to live normal, active lives.

Your treatment plan will typically include:

• Hydrocortisone or prednisone to replace cortisol
• Fludrocortisone to replace aldosterone
• Emergency injection kit (hydrocortisone) for crisis situations
• Regular monitoring and dose adjustments
• Increased medication during illness or stress

You'll need to take these medications daily for life. Your doctor will work with you to find the right doses and teach you when to adjust them. During times of physical stress, illness, or surgery, you may need higher doses to prevent complications.

Most people feel significantly better within weeks of starting treatment. The key is taking your medications consistently and following your doctor's guidance about dose adjustments.

How to manage Addison's disease at home?

Managing Addison's disease at home centers around taking your medications consistently and being prepared for emergencies. With good self-care habits, you can maintain excellent health and energy levels.

Here are the essential home management strategies:

• Take medications at the same times every day, never skip doses
• Keep emergency hydrocortisone injection kit with you always
• Increase medication doses during illness as your doctor instructs
• Eat regular meals and stay well-hydrated
• Wear medical alert jewelry identifying your condition
• Keep extra medication supplies when traveling
• Learn to recognize early signs of adrenal crisis

It's also important to maintain a healthy lifestyle with regular exercise, adequate sleep, and stress management. Many people find it helpful to connect with support groups or online communities for people with Addison's disease.

How can Addison's disease be prevented?

Unfortunately, you can't prevent the autoimmune form of Addison's disease, which is the most common type. Since it involves your immune system mistakenly attacking your adrenal glands, there's no known way to stop this process from starting.

However, you can take steps to prevent some infections that might damage your adrenal glands. This includes getting recommended vaccinations, practicing good hygiene, and seeking prompt treatment for infections like tuberculosis.

If you have other autoimmune conditions or a family history of them, staying alert for early symptoms can help ensure quick diagnosis and treatment if Addison's disease does develop.

How should you prepare for your doctor appointment?

Preparing for your appointment can help you get the most accurate diagnosis and best care possible. Start by writing down all your symptoms, even ones that seem unrelated or minor.

Bring this information to your appointment:

• Complete list of symptoms and when they started
• All medications and supplements you're taking
• Family history of autoimmune diseases
• Recent illnesses, surgeries, or major stressors
• Questions about diagnosis, treatment, and daily management
• List of other doctors you're seeing

Consider bringing a family member or friend to help you remember important information. Don't hesitate to ask your doctor to explain anything you don't understand - managing Addison's disease successfully requires good communication with your healthcare team.

What's the key takeaway about Addison's disease?

Addison's disease is a serious but very manageable condition when properly treated. While your adrenal glands can't be fixed, hormone replacement therapy effectively replaces what your body needs to function normally.

The most important things to remember are taking your medications consistently, being prepared for emergencies, and working closely with your healthcare team. With proper management, you can expect to live a full, active life with energy levels that feel normal to you.

Early diagnosis and treatment make a huge difference in how you feel and your long-term health. If you're experiencing symptoms that concern you, don't hesitate to discuss them with your doctor.