April is Adrenal Disease Awareness Month.
You probably don’t think much about your adrenal glands. It is a small hormone-secreting organ located at the top of the kidney. But don’t mistake it for weakness. It plays a big role in your health.
The adrenal glands produce hormones such as cortisol, aldosterone, and sex hormones.
Cortisol is very important because it helps the body respond to stress. It also helps maintain blood sugar levels and regulate blood pressure. Aldosterone helps regulate sodium, water, and potassium balance in the blood. And the sex hormones estrogen and androgen affect sexual desire.
So you can see how damage to the adrenal glands can cause a variety of problems. This is the case for people with Addison’s disease, a rare disease that mainly affects women.
What is Addison’s disease?
Addison’s disease, also called primary adrenal insufficiency, is a chronic condition in which the adrenal glands do not produce enough hormones (mainly cortisol and aldosterone).
Severely low levels of cortisol and aldosterone can lead to life-threatening complications, including a rapid drop in blood pressure and organ failure.
What causes Addison’s disease?
Addison’s disease is caused by damage to the outer layer of the adrenal glands, which are responsible for hormone production.
In most people, the damage occurs when the immune system mistakenly attacks the adrenal glands, meaning it is an autoimmune disease.
However, adrenal damage can also occur due to:
- Infections such as fungal infections, HIV, or tuberculosis
- bleeding into the adrenal glands
- tumor
Symptoms of Addison’s disease
Symptoms of Addison’s disease typically appear slowly over time and can be non-specific, making it more difficult to obtain a proper diagnosis.
Symptoms of Addison’s disease include:
- dehydration
- extreme fatigue
- diarrhea
- nausea and vomiting
- colic
- low blood pressure
- Mild fever
- weight loss
- muscle weakness
- The skin inside your lips, cheeks, and gums becomes darker.
- low blood sugar
- Fainting or dizziness when standing
- craving for salt
- joint pain
- Irregular periods or amenorrhea
Symptoms can come and go, and many people with Addison’s disease often don’t know they have the disease until a stressor, such as an illness or infection, triggers symptoms.
A severe lack of cortisol can lead to sudden, life-threatening complications, including very low blood pressure and heart problems. This is called an adrenal crisis. An adrenal crisis is a medical emergency and must be treated immediately. Patients with Addison’s disease should carry a medical ID bracelet that lists the type and dosage of medication needed during an adrenal crisis.
Risk factors for Addison’s disease
Most adults diagnosed with Addison’s disease are between the ages of 30 and 50, and the disease is more common in women.
Having certain other autoimmune disorders also increases your risk of Addison disease. These may include:
- chronic thyroiditis
- dermatitis herpetiformis
- Graves’ disease
- hypoparathyroidism
- hypopituitarism
- pernicious anemia
- myasthenia gravis
- type 1 diabetes
- vitiligo
How to test for Addison’s disease
There are a variety of tests and imaging that can help your health care provider (HCP) diagnose Addison disease.
- blood test Check your sodium, potassium, cortisol, white blood cell, testosterone, and estrogen levels.
- ACTH stimulation blood test It measures how the adrenal glands respond to adrenocorticotropic hormone (ACTH), a hormone that stimulates the secretion of cortisol.
- CT scan To check the size of the adrenal glands
Treatment Options for Addison’s Disease
Treatment for Addison’s disease usually involves two medications to control symptoms.
- Corticosteroids — synthetic drugs that mimic cortisol
- Mineralocorticoids — synthetic versions of aldosterone
Your health care provider may increase your dose of these medications to prevent an adrenal crisis if you are under stress, such as surgery, or if you have an infection.
Hydrocortisone injections are also prescribed as emergency medication for adrenal crisis.
Be proactive about Addison’s disease
Symptoms of Addison’s disease can be similar to many other health conditions, so if you think you may have Addison’s disease, ask your health care provider about getting tested. Early diagnosis can help check hormone levels and prevent an adrenal crisis.
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