Addisons Disease or Adrenal Insufficiency

Lower Back | Endocrinology and Metabolism | Addisons Disease or Adrenal Insufficiency (Disease)


Addison’s disease (also chronic adrenal insufficiency, hypocortisolism, and hypoadrenalism) is a rare, chronic endocrine disorder in which the adrenal glands do not produce sufficient steroid hormones (glucocorticoids and often mineralocorticoids). Addisons disease occurs in all age groups and affects both sexes and can be life-threatening.

The symptoms of Addisons disease appear gradually but become increasingly obvious over a period of several weeks or months. They are: vague feeling of ill health; tiredness and weakness; gradual loss of appetite; low blood sugar weight loss; muscle or joint pains; skin pigmentation similar to suntan, especially in the creases of the palms and on knuckles, elbows, and knees; nausea, diarrhea or vomiting; depression. In suspected cases of Addisons disease, one needs to demonstrate that adrenal hormone levels are low even after appropriate stimulation (called the ACTH stimulation test) with synthetic pituitary ACTH hormone tetracosactide.

Causes and Risk factors

The usual cause of Addisons disease is damage to an adrenal gland by an autoimmune disorder, in which the body attacks its own tissues. Other causes of adrenal gland failure may include: tuberculosis, other infections of the adrenal glands, spread of cancer to the adrenal glands, bleeding into the adrenal glands, HIV infection and AIDS, lack of stimulation from the pituitary gland and sudden, severe low blood pressure.

Diagnosis and Treatment

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.

Any underlying conditions will be treated if possible. In addition, people with Addisons disease usually need long-term treatment with oral corticosteroid drugs. ...

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