Addison’s Disease
Addison’s disease is a rare endocrine or hormonal disorder that occurs in all age groups and afflicts men and women equally. It occurs when the adrenal glands do not produce enough of the hormone cortisol and, in some cases, the hormone aldosterone. The disease is also known as adrenal insufficiency, or hypocortisolism.
Formerly, the cause of this disease was often tuberculosis or a fungal infection. However, in recent years, the disease is more likely to be idiopathic (of unknown cause).
The symptoms of adrenal insufficiency usually begin gradually. Characteristics of the disease are chronic, worsening fatigue, muscle weakness, loss of appetite and weight loss. About 50 percent of the time, one will notice nausea, vomiting and diarrhea. Other symptoms include low blood pressure that falls further when standing, causing dizziness or fainting, and skin changes with areas of hyperpigmentation, or dark tanning, covering exposed and nonexposed parts of the body. Addison’s disease can cause irritability and depression. Because of salt loss, a craving for salty foods also is common. Hypoglycemia, or low blood glucose, is more severe in children than in adults. In women, menstrual periods may become irregular or stop.
Treatment of Addison’s disease involves replacing, or substituting, the hormones that the adrenal glands are not making. An additional steroid drug may be prescribed to promote retention of salt, and thereby water, so that the low blood pressure of severe Addison’s disease can be avoided.
The outlook for patients receiving hormone treatment is excellent. Continued medical supervision is necessary to prevent emergencies caused by a sudden withdrawal of treatment or by an increased need for hormones because of infection, injury, surgery, pregnancy, or other stress on the body. It is important to avoid infection, but should infection occur, it is necessary to treat it as soon as possible. At all times, patients should carry a card or wear a bracelet describing the condition and the need for cortisone. It is also critical to take the medication exactly as prescribed and to be monitored by a physician who can adjust the dosage as the need arises.