Addison’s Disease

Addison’s disease can cause symptoms that are easy to brush off at first. You may feel tired, weak or dizzy. You might lose weight without trying or suddenly find yourself craving salty foods.

Because these symptoms can have many causes, it may take time to figure out what’s going on.

Addison’s disease happens when your adrenal glands don’t make enough of certain hormones your body needs. Diabetes & Glandular Disease Clinic provides diagnosis and treatment for Addison’s disease in San Antonio.

Your adrenal glands sit just above your kidneys. They make hormones that help control:

• Blood pressure
• Blood sugar
• Fluid balance
• Your body’s response to illness and physical stress

Two of these hormones are cortisol and aldosterone. Cortisol plays a role in metabolism and helps your body respond to stress. Aldosterone helps your kidneys balance sodium, potassium, and water.

Addison’s disease is also called primary adrenal insufficiency. It develops when the adrenal glands don’t make enough cortisol. They usually make too little aldosterone as well.

An autoimmune condition is the most common cause of Addison’s disease. The immune system attacks the adrenal glands and damages their ability to make hormones.

Less common causes include:

• Infections such as tuberculosis
• Bleeding into both adrenal glands
• Cancer that has spread to the adrenal glands
• Certain inherited conditions
• Surgery to remove the adrenal glands

Addison’s disease can also occur along with other autoimmune conditions, including Hashimoto’s thyroiditis, Graves’ disease, and type 1 diabetes.

Addison’s disease often develops slowly. At first, you may simply feel tired, weak or a little sick to your stomach. Over time, you may notice other changes.

Symptoms can include:

• Ongoing fatigue
• Muscle weakness
• Unexplained weight loss
• Nausea, vomiting or diarrhea
• Stomach pain
• Low blood pressure
• Dizziness when standing
• Muscle or joint pain
• Low blood sugar, especially in children
• Cravings for salty foods

Some people also develop darker areas of skin, called hyperpigmentation. You may notice these changes:

• In skin creases
• Around scars
• Across the knuckles
• On the elbows and knees
• On the lips
• Inside the mouth

Addison’s disease can also affect sodium and potassium levels in your blood.

Your doctor may start with blood tests to check your cortisol level. This is often done in the morning, when cortisol levels are normally highest.

Your doctor may also check ACTH, a hormone that tells your adrenal glands to make cortisol. Low cortisol along with a high ACTH level can point to Addison’s disease.

An ACTH stimulation test can show how well your adrenal glands respond when they’re told to make cortisol. Other blood tests may check aldosterone, renin, or antibodies linked to autoimmune Addison’s disease.

If the cause isn’t clear, your doctor may order a CT scan to look at your adrenal glands.

Treatment replaces the hormones your adrenal glands can no longer make.

Hydrocortisone is commonly used to replace cortisol. Some people may take prednisone or another steroid instead.

If your body isn’t making enough aldosterone, your doctor may prescribe fludrocortisone. This medication helps your body maintain healthy:

• Sodium levels
• Fluid balance
• Blood pressure

Most people with Addison’s disease need hormone replacement for life.

Your body may need more cortisol when you’re sick, injured, or having surgery. Your doctor will give you instructions for temporarily increasing your steroid dose when needed.

This may be necessary during:

• A high fever
• An infection
• Surgery
• An injury

Following your sick-day plan is an important part of managing Addison’s disease.

An adrenal crisis happens when your body doesn’t have enough cortisol to meet its needs. It is a medical emergency.

A severe infection, injury, surgery, or missed medication can trigger a crisis. Repeated vomiting or diarrhea can also be dangerous because your body may not absorb your oral steroid medication.

Signs of an adrenal crisis can include:

• Severe weakness
• Ongoing vomiting
• Severe stomach or back pain
• Confusion
• Fainting
• A dangerous drop in blood pressure

An adrenal crisis needs emergency medical treatment. Treatment usually includes hydrocortisone and IV fluids.

People with Addison’s disease may also be advised to carry emergency hydrocortisone and wear medical identification that says they have adrenal insufficiency.

Addison’s disease requires lifelong care, but treatment can replace the hormones your body is missing. Regular follow-up also gives your doctor a chance to make sure your medication dose is right for you.

If you have symptoms of Addison’s disease or need ongoing care for adrenal insufficiency, schedule an appointment with Diabetes & Glandular Disease Clinic in San Antonio.

1. Is Addison’s disease curable?

There isn’t currently a cure for Addison’s disease. Treatment replaces the cortisol and aldosterone your adrenal glands can no longer make. Most people need hormone replacement for life.

2. What should someone with Addison’s disease do when they get sick?

Follow the sick-day plan your doctor or endocrinologist gives you. Your body needs more cortisol during illness, so you may need to temporarily increase your steroid dose.

Vomiting or severe diarrhea can be more serious because your body may not absorb oral medication. If you can’t keep your medication down, you may need an emergency hydrocortisone injection and immediate medical care.