Everything You Need To Know About Addison’s Disease

What is Addison’s disease?

Addison’s disease is a rare chronic condition where your adrenal gland does not produce the required amounts of essential hormones like Aldosterone and cortisol. The adrenal glands, also known as suprarenal glands, are small, triangular-looking glands found at the top of each of your kidneys. They are an integral part of your endocrine system.

The hormone cortisol released by this gland is the first response to stress in your body. This includes emphasis due to illness, surgery, or injury. Cortisol also has a vital role in maintaining blood pressure, proper heart function, blood glucose levels, and a healthy immune system, making it an essential hormone for life.

On the other hand, Aldosterone is a hormone released by the adrenal gland that helps to balance sodium and potassium in your blood, which controls how much fluid your kidneys remove as urine.

What’s the difference between Addison’s disease and Cushing’s syndrome?

While both these are diseases of the adrenal glands, Addison’s disease occurs when your body does not produce enough Aldosterone and cortisol. At the same time, Cushing’s syndrome results from too much cortisol.

Who does Addison’s disease affect?

Individuals between the age group of 30 to 50 years are commonly affected by Addison’s disease. Those with autoimmune polyendocrine syndrome, a rare condition in which your immune system attacks most of your organs and tissues, are also more susceptible to Addison’s disease. Your mucous membranes, including your adrenal and parathyroid glands, are commonly affected by this condition.

People with other kinds of autoimmune diseases, as listed below, are also at high risk of developing Addison’s:

• Graves disease
• Pernicious anaemia
• Type I diabetes
• Dermatitis herpetiformis
• Vitiligo
• Chronic thyroiditis
• Myasthenia gravis

How common is Addison’s disease?

If we talk about the number then in India, it is found to affect 1 in 100,000 people.

What are the symptoms of Addison’s disease?

In the case of Addison’s disease, gradual damage to your adrenal glands happens over time. Addison’s disease symptoms also vary from person to person, making it a complex condition to recognise.

The most common Addison’s disease symptoms include:

• Fatigue that steadily gets worse
• Dark patches of skin that can form around scars, skin creases, or on your gums
• Nausea and vomiting
• Abdominal pain
• Muscular pain, spasms, joint pain
• Diarrhoea
• Dehydration
• Low blood pressure that causes dizziness and lightheadedness upon standing
• Constant mood and behavioural changes like poor concentration, depression, and irritability
• Low blood sugar levels
• A craving for salty food

Females with Addison’s disease can also have abnormal menstruation (periods), lose body hair, and have a decreased sexual drive.

In some rare cases, such as at times of intense stress, severe illness, or after an injury, your Addison’s disease symptoms can rapidly develop. It may lead to a condition called Addisonian crisis, which needs immediate medical intervention.

If you experience any of the following symptoms, you should get yourself tested for Addisonian:

• Extreme weakness
• Sudden severe pain in your legs, belly, or lower back
• Feeling confused, restless, afraid, or other kinds of mental changes
• Severe diarrhoea and vomiting that can lead to dehydration
• Loss of consciousness
• Low blood pressure

If you experience any of the symptoms mentioned above, it is best to visit your doctor immediately.

What causes Addison’s disease?

The most common Addison’s disease cause is an autoimmune response due to which your immune system attacks healthy tissues in your body without reason. In this condition, your immune system attacks the adrenal cortex, the outer portion of your adrenal glands that makes Aldosterone and cortisol. As the symptoms do not reveal themselves until your adrenal glands are almost 90% damaged, it can take several months or even years for you to get a proper Addison’s disease diagnosis.

A whopping 75% of Addison’s disease cases are caused because of an autoimmune attack. Another condition known as autoimmune Addison’s disease can be caused by itself or by an inherited syndrome like APS type 1 and Schmidt syndrome.

Recently, tuberculosis was also considered one of Addison’s disease causes and is still a prominent cause in most developing countries.

Other less common causes of Addison’s disease include:

• Repeated infections, including HIV/Aids or fungal infections
• Invasion of cancerous cells from different parts of your body into your adrenal gland
• Haemorrhaging or bleeding into your adrenal gland
• Surgical removal of your adrenal glands
• Amyloidosis is when amyloid proteins build up and damage vital organs.

How is Addison’s disease diagnosed?

Since the symptoms of Addison's disease are slow to develop and can be vague and familiar, among other conditions, it can delay your diagnosis.

Most healthcare providers only discover you have Addison’s disease when you take a routine blood test, like a basic metabolic panel that can identify low levels of sodium or high amounts of potassium.

Another common symptom that helps your healthcare provider identify Addison’s disease is dark patches on your skin. Based on these symptoms, if your doctor or healthcare provider suspects you may have Addison’s disease, they may ask you to get more tests done to confirm whether you have a disease or not.

What tests will be done to diagnose Addison’s disease?

The following tests help healthcare providers diagnose Addison’s disease:

• Blood tests: Tests that measure your levels of sodium, potassium, ACTH, and cortisol are likely to help your healthcare provider diagnose Addison’s disease.
• ACTH stimulation test: This test helps measure the adrenal gland’s response after your doctor or lab technician gives you a shot of artificial ACTH. After this shot, if your test results show low cortisol levels, your adrenal glands may not be functioning effectively.
• Computed Tomography (CT scan): This is an imaging test in which a computer combines many X-ray images of your body into a cross-sectional view. Your healthcare provider then evaluates your adrenal glands and pituitary glands to check for any damage to these glands or if they are infected.
• Insulin-induced hypoglycemia test: This test is usually done if you show symptoms of issues with your pituitary gland instead of the adrenal glands. With this test, your blood sugar levels are measured before and after receiving a shot of fast-acting insulin that is known to cause a rapid drop in blood sugar and a rise in cortisol levels.

How is Addison’s disease treated?

The most effective Addison’s disease treatment is replacing the missing cortisol and aldosterone hormones with synthetic versions.

The Addison’s disease medication that replaces cortisol is known as hydrocortisone, while the replacement for Aldosterone is fludrocortisone. Most people diagnosed with this disease may have to undergo Addison’s disease treatment for the rest of their lives.

The dosage of these medications can differ from person to person. Your healthcare provider can increase the doses if you experience an infection, surgery, trauma, or any other stressful situation to prevent an acute adrenal crisis.

Can Addison’s disease be prevented?

There are no known ways of preventing Addison’s disease. However, even those with this condition can live a long and healthy life and by continuing proper Addison’s disease treatment.

What is the prognosis (outlook) for Addison’s disease?

Most individuals with Addison’s disease receive a good prognosis. Addison’s disease life expectancy is also high as long as they take the necessary medication for the rest of their lives.

Your doctor may closely monitor your medication for an everyday healthy life to prevent over or under-treatment. Over-treatment with glucocorticoids can cause osteoporosis, type 2 diabetes, or obesity. In contrast, fludrocortisone can cause high blood pressure.

About 50% of individuals with this condition are at risk of developing another autoimmune disease.

How do I take care of myself if I have Addison’s disease?

Individuals with Addison’s disease should carry their identification card along with them at all times and wear a medical alert bracelet or necklace. This lets other medical professionals know of their condition in times of emergency.

Keep in touch with your healthcare provider and ask them about the precautions you need to take if you get sick or experience extreme stress. In such cases, you might have to increase your dosage of medications.

You can also keep a shot of cortisol with you for emergencies and ensure someone close to you knows how to administer this shot to you.

When should I see my healthcare provider about Addison’s disease?

In the case of Addison’s disease, you may need to visit your healthcare provider regularly to monitor your medication doses and see what works best for you. If you experience extreme stress like an injury, illness, or the death of a loved one, you may need to revise your medication to suit this need.

If you experience known symptoms of Addisonian crisis, like sudden intense pain or extreme weakness, seek medical attention immediately.

Conclusion

Addison’s disease is a condition that most people learn to live with. With the proper treatment, Addison’s disease can be kept in check. As this condition is usually diagnosed by itself, it is best to undergo testing at least once a year, especially if you are at risk of developing Addison’s disease or already have an autoimmune disease. Contact our experts at Metropolis Labs and get yourself tested in the comfort of your home.