Addison's Disease

Addison's disease is a uncommon disorder in which the adrenal gland produces insufficient amounts of steroid hormones. Addison's disease is also called chronic adrenal insufficiency, hypocortisolism or hypocorticism. The disease is characterized by weight loss, muscle weakness, fatigue, low blood pressure, and sometimes darkening of the skin in both exposed and nonexposed parts of the body. In Addison's disease, your adrenal glands produce too little cortisol, which is one of the hormones in a group called the glucocorticoids. Addison's disease occurs when the adrenal glands do not produce enough of the hormone cortisol and, in some cases, the hormone aldosterone. It may develop in children as well as adults, and may occur as the result of a large number of underlying causes(Munver 80-85).

Addison's disease can be life-threatening. This is an extremely serious disorder and it must be treated as such. Sometimes, the disease also involves insufficient production of aldosterone, one of the mineralocorticoid hormones. The disorder can occur at any age, but is most common in people ages 30 to 50. Most cases are caused by the gradual destruction of the adrenal cortex, the outer layer of the adrenal glands, by the body's own immune system. Addison's disease affects about 1 in 100,000 people. About 70 percent of reported cases of Addison's disease are caused by autoimmune disorders, in which the immune system makes antibodies that attack the body's own tissues or organs and slowly destroy them.

Symptoms of Addison's disease

Addison's disease can cause irritability and depression. Because of salt loss, a craving for salty foods also is common. Hypoglycemia, or low blood glucose, is more severe in children than in adults. In women, menstrual periods may become irregular or stop. The slowly progressive loss of cortisol and aldosterone secretion usually produces a chronic, steadily worsening fatigue, a loss of appetite, and some weight loss. Blood pressure is low and falls further when a person is standing, producing lightheadedness. Nausea, sometimes with vomiting, and diarrhea are common. The muscles are weak and often go into spasm. There are often emotional changes, particularly irritability and depression. Because of salt loss, a craving for salty foods is common. Finally, the increase in ACTH due to the loss of cortisol will usually produce a darkening of the skin that may look like an inappropriate tan on a person who feels very sick(Chrousos 609-632). Unfortunately, the slowly progressive chronic symptoms are usually missed or ignored until a sudden event like a flu virus, an accident, or the need for surgery suddenly precipitates a dramatic change for the worse because of the deficient response from the adrenals to one of these stresses. This is referred to as an Addisonian crisis and is a medical emergency.

Because the symptoms progress slowly, they are usually ignored until a stressful event like an illness or an accident causes them to become worse. This is called an addisonian crisis, or acute adrenal insufficiency. In most cases, symptoms are severe enough that patients seek medical treatment before a crisis ...