Adrenal glands are located above the kidneys and are responsible for producing certain hormones that are essential for the normal functioning of the body.
Addison's disease is a hormonal disorder which is caused by an insufficient level of hormones produced by the adrenal glands. There is a hormone called cortisol that is produced by the adrenal glands. In the case of people suffering from Addison’s disease, there is very little cortisol or aldosterone produced by the adrenal glands in the body. Addison’s disease normally occurs due to damage of the adrenal cortex, which causes a lack of secretion of the steroid hormone cortisol. The cortisol hormone helps the body deal with stressful situations and also produces the sex hormones.
Addison’s disease is also described as adrenal insufficiency. It affects people of varied age groups, and is particularly common in the age group of 30 to 50 years. It can occur in both men and women. In some cases, Addison’s disease can also be fatal.
The main treatment for Addison's disease revolves around taking hormone replacement therapy to replace the insufficient amount of hormones that are secreted by the adrenal glands.
What triggers Addison’s disease in a person?
Addison's disease mainly occurs in a person when the layer covering the adrenal glands, also known as the adrenal cortex, undergoes some form of damage which reduces the levels of the hormones produced by the gland. There are several factors associated with this damage including:
- Problems with the immune system: A problem with the immunity function of a person is the most common factor resulting in Addison’s disease. The immune system is a defense mechanism of the body against germs, infections and diseases. When you are ill with an infection, the body’s immune function produces antibodies, which are a kind of protein that is responsible for destroying disease-carrying germs and toxins. These antibodies mainly attack the root cause of the illness. However, there are times when the immune system goes against its own body. When it begins to attack the healthy tissues and organs of the body, it causes a condition known as an autoimmune disorder. Addison’s disease is normally caused when the immune system of the body begins to attack the adrenal glands, causing severe damage to the adrenal cortex. When about 90 percent of the cortex gets damaged, the adrenal glands are unable to produce adequate steroid hormones which eventually leads to Addison’s disease.
- Genetics: According to some research that has been conducted around Addison’s disease, it has been observed that some people with a genetic predisposition can develop autoimmune disorders that could result in Addison’s disease. However, it is not clear what genes result in Addison’s disease. Chances of the disease increase if any of your family members are suffering from conditions like vitiligo, type 1 diabetes or hypothyroidism.
- Other factors: Tuberculosis or TB is one of the leading causes of Addison’s disease across the world. TB is an infection impacting the lungs, however the condition can also affect other parts of the body. It can result in Addison’s disease if the disease infects your adrenal glands.
- Some of the other factors that could result in Addison’s disease include:
- Infections – Infections such as those linked to AIDS, or fungal infections can cause the disease.
- Hemorrhage – When there is intense or heavy bleeding in the adrenal glands or sepsis, Addison’s disease can be developed.
- Cancer – Addison’s disease can occur if cancer cells from other parts of the body spread to the adrenal glands.
- Amyloidosis – This is a medical condition wherein a protein called amyloid, which is secreted by the bone marrow cells, builds up in the adrenal glands and causes severe damage to them.
What are the signs and symptoms of Addison’s disease?
There are some signs and symptoms that can help identify Addison’s disease early on in a person. Some of these symptoms include:
- Muscular weakness
- Sudden tiredness and fatigue
- Skin darkening and pigmentation
- Sudden weight loss or loss of appetite
- A slowed down heart rate or decreased blood pressure
- Lower sugar levels
- Sudden sensation of fainting or actual fainting spells
- Mouth sores and the need to consume salt
- Nausea or vomiting
- Signs of irritation or depression
If this disease is left untreated for long, it can go on to become a serious health concern requiring medical attention since it could even become life-threatening. If you notice any of the above symptoms, even if they overlap with symptoms of other diseases, you should still bring them to the attention of a doctor as soon as possible. It is a medical emergency if the person is also experiencing:
- Changes in mental health including fear, confusion and anxiety
- Loss of consciousness
- High spikes of fever
- Shooting pain suddenly appearing in the lower back, belly or legs
Is craving salt a sign of Addison’s disease?
Craving salt can often be a sign of a serious underlying disease or medical condition like adrenal insufficiency or another condition known as Bartter syndrome. Adrenal insufficiency, also known as Addison’s disease, can cause a serious salt craving in a person, which may seem unusual or persistent. When this symptom is accompanied by the signs and symptoms mentioned above, it could become concerning and require serious medical intervention.
Diagnosing Addison’s disease in a person
Addison’s disease is diagnosed in a person by the treating doctor after first taking down the medical history of the patient and checking his or her symptoms. A physical examination is also necessary to check what can be traced externally as the next step would be to conduct certain lab tests in order to complete a more detailed diagnosis including checking the potassium and sodium levels. The doctor may also do a few scans and imaging tests to see the position of the adrenal glands as well as check the hormonal levels in a blood test.
Treating Addison’s disease
There are a few ways that Addison’s disease is treated, which include oral corticosteroids as well as corticosteroid injections. Primarily the treatment is centered around a hormonal treatment in which the balance of the hormones is corrected.
Oral corticosteroids include medicines like hydrocortisone, prednisone or cortisone acetate which are used to replenish the levels of cortisol. The doctor may even recommend fludrocortisone which mainly replenishes the levels of aldosterone in the body.
Corticosteroid injections are another way of hormone replacement therapy suggested for patients who are severely ill with symptoms like vomiting and who can’t consume the oral corticosteroid medications.
Doctors also suggest an increase in sodium intake, particularly during exercise, when the weather is extremely hot or cold, or in case a person is suffering from gastrointestinal conditions like diarrhea. The doctor also suggests an increase in the doses if you are scheduled to undergo a severe operation or in case you are undergoing a secondary illness or an infection.
Addisonian crisis is a medical condition that can be fatal. It could result in lowered blood pressure levels, sugar levels and severely high levels of potassium in the body. This situation is usually a medical emergency, requiring immediate care and attention. The treatment normally includes IV injections of hydrocortisone, saline and glucose.