Addison’s disease is also called adrenal insufficiency, a rare disorder that develops when the body doesn’t procedure an adequate amount of certain hormones. In this disorder, adrenal glands, that is situated above the kidney produce very little cortisol, this hormone helps the body to respond well to stress and holds a significant role in bone health, immunity, and metabolism. This disorder affects people in all age groups, both male and female and can be life-threatening. Generally, treatment involves hormone therapy to replace deficient ones.
Symptoms normally develop slowly and may often take several months. The disease progresses so slowly that symptoms are ignored, until stress, such as illness or injury develops and worsen the symptoms. Signs and symptoms include:
Low blood pressure
Craving for salt
Low blood sugar level
Muscle or joint pains
Sexual dysfunction in women
At times the symptoms of Addison’s disease may appear abruptly. Acute adrenal failure (Addisonian crisis) can lead to life-threatening shock. Seek immediate medical help if you experience the following symptoms:
Pain in your lower back or legs
Severe abdominal pain
Diarrhoea and vomiting leading to dehydration
In an Addisonian crisis a person may have
Low blood pressure
Addison’s disease is caused when the adrenal glands are damaged, resulting in inadequate production of hormones cortisol and aldosterone. The adrenal glands are part of the endocrine system, they produce hormones that provide instructions to every organ and tissue in the human body.
The adrenal glands comprise two sections -the interior (medulla) produces adrenaline-like hormones, and the outer layer (cortex) produces a group of hormones called corticosteroids, which include:
Glucocorticoids: These hormones mainly include cortisol that is responsible for metabolism, triggering immunity, inflammatory response and support the body to react to stress.
Mineralocorticoids: This includes aldosterone, which maintains sodium and potassium balance to keep blood pressure under control.
Androgens: Male sex hormones are produced in minimal amounts by the adrenal glands in both men and women. They support sexual development in men and boost muscle mass, libido and sense of well-being in both men and women.
Primary Adrenal Insufficiency
The cortex is damaged and doesn’t make adequate adrenocortical hormones, this condition is called primary adrenal insufficiency. It is an autoimmune disease, where the immune system views the adrenal cortex as a foreign substance. Some of the other causes of adrenal gland failure include:Tuberculosis
Infections of the adrenal glands
Cancer to the adrenal glands
Bleeding into the adrenal glands
Secondary Adrenal Insufficiency
The pituitary gland makes a hormone called adrenocorticotropic hormone (ACTH) that stimulates the adrenal cortex to produce its hormones. Benign pituitary tumours, inflammation and pituitary surgery are common causes of not making enough pituitary hormone. Too little ACTH can also lead to very minimal production of glucocorticoids and androgens that are usually produced by adrenal glands, even if the adrenal glands are not damaged. This is called secondary adrenal insufficiency. Symptoms are similar to those of primary adrenal insufficiency but don’t have hyperpigmentation and are less likely to have severe dehydration or low blood pressure.
The doctor will completely collect medical history and enquire about signs and symptoms. Some of the tests that are suggested by healthcare providers include:
Blood Test: Certain blood works such as sodium, potassium, cortisol, and adrenocorticotropic hormones levels are measured. While blood test also measures antibodies associated with autoimmune Addison’s disease.
ACTH Stimulation Test: This test determines the level of cortisol in the blood before and after an injection of synthetic ACTH.
Insulin-Induced Hypoglycaemia Test: The healthcare provider may recommend this test if he suspects adrenal insufficiency, and the test involves monitoring blood glucose and cortisol levels after giving a shot of insulin. In normal adults, glucose levels fall, and cortisol levels increase.
Imaging Tests: The doctor may also suggest doing a CT scan of the abdomen to check the size of adrenal glands and look for any other abnormalities. An MRI scan of the pituitary gland is taken, if the tests determine that patient may have secondary adrenal insufficiency.
The main treatment mode for Addison’s disease is hormone replacement therapy to correct the levels of steroid hormones. The patient may also be asked to increase the intake of sodium in the diet, especially post heavy workouts and when the temperature is hot or during episodes of stomach upsets.