Adrenal insufficiency, commonly known as Addison’s disease, is a rare ailment that develops when your body doesn’t generate enough specific hormones. Your adrenal glands, which are right above your kidneys, generate too little cortisol and frequently too little aldosterone when you have Addison’s disease.
All ages and both sexes can develop Addison’s disease, which can be fatal. Taking hormones to make up for those that are absent is part of the treatment.
The symptoms of Addison’s disease often appear gradually, frequently over several months. Frequently, the condition advances so slowly that symptoms go unnoticed until stress, such as a sickness or accident, happens and exacerbates the symptoms. Some warning signs and symptoms include:
- Extreme fatigue
- Darkening of your skin (hyperpigmentation)
- Weight loss and decreased appetite
- Salt craving
- Low blood pressure, even fainting
- Nausea, diarrhea, or vomiting (gastrointestinal symptoms)
- Low blood sugar (hypoglycemia)
- Body hair loss or sexual dysfunction in women
- Abdominal pain
- Muscle or joint pains
- Depression or other behavioral symptoms
Acute Adrenal Failure (Addisonian crisis)
The symptoms and indications of Addison’s disease might occasionally strike out of nowhere. Shock with a high risk of death can result from acute adrenal insufficiency (Addisonian crisis). If you suffer any of the following symptoms, get emergency medical help right away:
- severe sensitivity
- Discomfort in your legs or lower back
- Dehydration is caused by severe stomach discomfort, vomiting, and diarrhea.
- lowered awareness or delirium
During an Addisonian Crisis, you Will Also Have:
- Reduced blood pressure
- Low sodium and high potassium (hyperkalemia) (hyponatremia)
THE BOTTOM LINE: WHEN TO SEE A DOCTOR
Immediately get yourself checked by a doctor if you have any of the typical symptoms of Addison’s disease, including:
- Skin spots getting darker (hyperpigmentation)
- extreme tiredness
- unintentional loss of weight
- digestive issues include nausea, vomiting, and discomfort in the abdomen
- Feeling dizzy or faint
- yearning for salt
- joint or muscle discomfort
Your adrenal glands are damaged by Addison’s disease, which leaves you with insufficient levels of the hormones cortisol and, frequently, aldosterone. The endocrine system includes your adrenal glands. Almost every organ and tissue in your body receives instructions from the hormones that they make.
There are two parts to your adrenal glands. Hormones similar to adrenaline are produced in the interior (medulla). Corticosteroids are a class of hormones that are produced by the cortex, the outer layer. Corticosteroids include:
These hormones, which include cortisol, affect your body’s capacity to turn food into energy, contribute to the inflammatory response of your immune system, and aid your body’s reaction to stress.
These hormones, which include aldosterone, manage the salt and potassium balance in your body to maintain a normal blood pressure level.
Both men’s and women’s adrenal glands generate trace quantities of these male sex hormones. They affect muscular mass, sex desire (libido), and a sense of well-being in both men and women, as well as causing sexual development in males.
Primary Adrenal Insufficiency
Primary adrenal insufficiency is the term used to describe the situation where the cortex is injured and not producing adequate adrenocortical hormones. This most frequently happens when the body attacks itself (autoimmune disease). Your immune system perceives the adrenal cortex as alien and something to attack and kill for unidentified reasons. A second autoimmune illness is more common in Addison’s disease patients than in the general population.
Adrenal gland insufficiency can also result from:
- Spread of cancer to the adrenal glands
- Other infections of the adrenal glands
- Bleeding into the adrenal glands.
Secondary Adrenal Insufficiency
Adrenocorticotropic hormone is a hormone produced by the pituitary gland (ACTH). The adrenal cortex is subsequently stimulated by ACTH to create its hormones. Common reasons for insufficient pituitary hormone production include benign pituitary tumors, inflammation, and previous pituitary surgery.
Even if your adrenal glands themselves are unharmed, too little ACTH can result in too little of the glucocorticoids and androgens that your adrenal glands typically generate. Secondary adrenal insufficiency is what this is. Too little ACTH does not influence mineralocorticoid production.
Most secondary adrenal insufficiency symptoms are interchangeable with basic adrenal insufficiency symptoms. However, those with secondary adrenal insufficiency don’t have hyperpigmentation and have a lower risk of having low blood pressure or severe dehydration. They are more susceptible to low blood sugar.
When persons who take corticosteroids (like prednisone) to treat long-term diseases like arthritis or asthma quit taking them abruptly rather than weaning off, it might temporarily result in secondary adrenal insufficiency.
Autoimmune illnesses are frequently co-occurring in people with Addison’s disease.
Although it is impossible to prevent Addison’s illness, there are things you may do to avert an Addisonian crisis:
- If you consistently feel weak or exhausted or if you’re losing weight, consult your doctor. Inquire about your adrenal fatigue.
- Ask your doctor for advice on what to do while you’re ill if you have Addison’s disease. You might need to figure out how to up your corticosteroid dosage.
- Go to the emergency hospital if you feel unwell, especially if you are vomiting and unable to take your prescription.
Because they are aware that similar adverse effects happen in patients who use hydrocortisone or prednisone for other conditions, some Addison’s disease sufferers worry about major side effects from these medications.
The negative effects of high-dosage glucocorticoids should, however, be avoided if you have Addison’s disease because the dose you are administered is making up for the lost quantity. To ensure that your dose is appropriate, follow up with your doctor frequently.
Medication is used in every aspect of Addison’s disease treatment. To restore the levels of steroid hormones your body isn’t making, hormone replacement therapy will be administered to you. Moreover, medications can be easily accessed through free medication delivery. Among the therapy, possibilities are oral corticosteroids like:
- To replace cortisol, use hydrocortisone (Cortef), prednisone, or methylprednisolone. To replicate the natural 24-hour fluctuation of cortisol levels, these hormones are administered on a timetable.
- Fludrocortisone acetate to replace aldosterone.
You should consume a lot of salt (sodium) in your diet, particularly while engaging in strenuous activity, when the temperature is high, or if you are experiencing digestive issues like diarrhea.
Additional suggestions for therapy include:
- Always keep a medical alert card and bracelet on you. Emergency medical staff will be informed about the type of care you require if you have a medical alert identity card and a steroid emergency card. Have a documented action plan as well.
- Have additional medicine on hand. Keep a little supply of your medication on hand at work and whenever you travel because skipping even one day of treatment might be harmful.
- Carry an injectable kit for glucocorticoids. A needle, syringe, and injectable corticosteroid form are included in the package for usage in an emergency.
- Keep in touch with your physician. Maintain a regular line of communication with your physician to ensure that the doses of replacement hormones are sufficient but not excessive. You might need to change the dosage or timing of your drugs if you’re experiencing persistent issues with them.
- Have yearly examinations. At least once a year, visit your physician or an endocrinology expert. Annual screening for a variety of autoimmune illnesses may be advised by your doctor.
As a medical emergency, an Addisonian crisis is often treated with intravenous injections of:
- Saline solution
- Sugar (dextrose)