what does addisons disease do to the body?

Definition

Addison illness is a disorder that occurs when the adrenal glands practise not produce plenty hormones.

Alternative Names

Adrenocortical hypofunction; Chronic adrenocortical insufficiency; Primary adrenal insufficiency

Causes

The adrenal glands are pocket-size hormone-releasing organs located on pinnacle of each kidney. They are made up of an outer portion, called the cortex, and an inner portion, called the medulla.

The cortex produces 3 hormones:

• Glucocorticoid hormones (such every bit cortisol) maintain carbohydrate (glucose) control, decrease (suppress) immune response, and help the body respond to stress.
• Mineralocorticoid hormones (such as aldosterone) regulate sodium, water and potassium balance.
• Sexual practice hormones, androgens (male) and estrogens (female), affect sexual development and sexual activity drive.

Addison disease results from damage to the adrenal cortex. The damage causes the cortex to produce hormone levels that are likewise low.

This impairment may be caused past the following:

• The immune organisation mistakenly attacking the adrenal glands (autoimmune disease)
• Infections such as tuberculosis, HIV, or fungal infections
• Hemorrhage into the adrenal glands
• Tumors

Gamble factors for the autoimmune blazon of Addison affliction include other autoimmune diseases:

• Swelling (inflammation) of the thyroid gland that ofttimes results in reduced thyroid role (chronic thyroiditis)
• Thyroid gland produces too much thyroid hormone (overactive thyroid, Graves disease)
• Itchy rash with bumps and blisters (dermatitis herpetiformis)
• Parathyroid glands in the neck do not produce enough parathyroid hormone (hypoparathyroidism)
• Pituitary gland does not produce normal amounts of some or all of its hormones (hypopituitarism)
• Autoimmune disorder that affects the fretfulness and the muscles they control (myasthenia gravis)
• Trunk does non have enough salubrious cerise blood cells (pernicious anemia)
• Testicles cannot produce sperm or male hormones (testicular failure)
• Type I diabetes
• Loss of brown color (pigment) from areas of the skin (vitiligo)

Certain rare genetic defects may also cause adrenal insufficiency.

Symptoms

Symptoms of Addison disease may include any of the following:

• Abdominal pain
• Chronic diarrhea, nausea, and airsickness
  
• Darkening of the skin
• Dehydration
• Dizziness when standing upwards
• Low-class fever
• Depression blood sugar
• Low claret pressure
• Extreme weakness, fatigue, and dull, sluggish move
• Darker pare on the within of the cheeks and lips (buccal mucosa)
• Salt craving (eating food with a lot of added salt)
• Weight loss with reduced ambition

Symptoms may not be present all the time. Many people have some or all of these symptoms when they have an infection or other stress on the torso. Other times, they have no symptoms.

Exams and Tests

The health care provider volition perform a physical exam and enquire about the symptoms.

Claret tests will probable exist ordered and may show:

• Increased potassium
• Low blood pressure, especially with a change in body position
• Low cortisol level
• Low sodium level
• Low pH
• Normal testosterone and estrogen levels, but depression DHEA level
• Loftier eosinophil count

Additional laboratory tests may exist ordered.

Other tests may include:

• Abdominal ten-ray
• Abdominal CT browse
• Cosyntropin (ACTH) stimulation exam

Treatment

Treatment with replacement corticosteroids and mineralocorticoids volition control the symptoms of this disease. These medicines usually demand to be taken for life.

Never skip doses of your medicine for this condition because life-threatening reactions may occur.

Your provider may tell you to increase your dosage for a brusque time considering of:

• Infection
• Injury
• Stress
• Surgery

During an extreme form of adrenal insufficiency, called adrenal crisis, you lot must inject hydrocortisone right away. Handling for low blood pressure is usually needed too.

Some people with Addison disease (or family unit members) are taught to requite themselves an emergency injection of hydrocortisone during stressful situations. Always carry medical ID (card, bracelet, or necklace) that says you lot have adrenal insufficiency. The ID should also say the type of medicine and dosage y'all need in case of an emergency.

Outlook (Prognosis)

With hormone therapy, many people with Addison affliction are able to lead a well-nigh normal life.

Possible Complications

Complications can occur if yous accept too footling or also much adrenal hormone.

When to Contact a Medical Professional

Call your provider if:

• You are unable to keep your medicine downwards due to vomiting.
• Y'all accept stress such as infection, injury, trauma, or aridity. Y'all may need to accept your medicine adjusted.
• Your weight increases over time.
• Your ankles begin to dandy.
• You develop new symptoms.
• On treatment, you develop signs of a disorder chosen Cushing syndrome

If you accept symptoms of adrenal crunch, give yourself an emergency injection of your prescribed medicine. If it is non available, get to the nearest emergency room or call 911 or the local emergency number.

Symptoms of adrenal crunch include:

• Abdominal pain
• Difficulty breathing
• Dizziness or lightheadedness
• Low blood pressure
• Reduced level of consciousness

References

Barthel A, Benker G, Berens Thousand, et al. An update on Addison's disease. Exp Clin Endocrinol Diabetes. 2019;127(two-03):165-175. PMID: 30562824 pubmed.ncbi.nlm.nih.gov/30562824/.

Bornstein SR, Allolio B, Arlt W, et al. Diagnosis and handling of primary adrenal Insufficiency: an Endocrine Society clinical practise guideline. J Clin Endocrinol Metab. 2016;101(ii):364-389. PMID: PMC4880116 www.ncbi.nlm.nih.gov/pmc/articles/PMC4880116/.

Nieman LK. Adrenal cortex. In: Goldman 50, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 214.

Version Info

• Concluding reviewed on v/xiii/2021
• Brent Wisse, MD, Board Certified in Metabolism/Endocrinology, Seattle, WA. Besides reviewed by David Zieve, Medico, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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