Addison's disease (adrenal insufficiency)
About Addison's disease (adrenal insufficiency)
The adrenal gland does not make enough of the hormones cortisol and aldosterone. Cortisol is essential and helps maintain blood pressure, normal heart function, glucose metabolism, carbohydrate metabolism, protein metabolism, fat metabolism, and normal emotional well-being. Aldosterone helps the body maintain normal blood pressure, water and salt levels. The adrenal gland is located on top of the kidneys in the abdomen. There are two types of Addison's disease (adrenal insufficiency), primary and secondary. In primary the adrenal gland is damaged usually from an autoimmune disease, other causes include infections, cancer and bleeding into the gland. Secondary adrenal insufficiency occurs when the pituitary gland in the brain does not produce enough adrenocorticotropic hormone (ACTH). ACTH tells the adrenal gland to produce cortisol. In secondary adrenal insufficiency the adrenal gland itself is normal. The most common cause of secondary disease is taking steroids. Any other problem that damages the pituitary gland such as cancer, infection or surgery can also cause the secondary form of the disease. If left untreated an Addisonian crisis can occur which can be life threatening. The most common causes of this crisis are physical stresses such as an infection, trauma, or surgery.Symptoms
The symptoms can vary and develop gradually. They include: muscle weakness, lack of energy, darkening of the skin, craving salty foods, nausea, vomiting, diarrhea, weight loss, poor appetite, muscle cramps, muscle pain, depression, low blood sugar (hypoglycemia), low blood pressure, fainting when standing, light headed when standing. The symptoms of Addisonian crisis can occur suddenly and include: fainting, severe back pain, low blood pressure, faint pulse, and dehydration.Tests & Diagnostics
A history and physical will be done. Blood tests to measure the sodium, potassium, glucose, cortisol and ACTH levels will be done. CT scans and/or MRIs may be performed to look for damage to the adrenal or pituitary gland. An ACTH stimulation test is sometimes performed to measure the functioning of the adrenal gland.Common tests: Comprehensive metabolic panel (CMP), CT Scan, MRI.
Prescription medications
Conventional treatment summary
Therapy is aimed at replacing the low levels of hormones and include: oral steroids, steroid injections, and androgen replacement. Addisonian crisis is a life threatening condition requiring admission to the hospital and intravenous fluids, intravenous hydrocortisone, and glucose. For more information contact the National Adrenal Diseases Foundation at www.nadf.us.Medical specialties
Internal Medicine · Pediatrics · Family Practice · Diabetes, Endocrinology and Metabolism · Pediatric Endocrinology
This page is educational content, not medical advice. Always consult a qualified clinician for diagnosis and treatment of Addison's disease (adrenal insufficiency).