April is Adrenal Disease Awareness Month.
You probably don’t think much about your adrenal glands. They are small hormone-releasing organs located at the top of the kidneys. But don’t mistake their smallness for weakness: they play a huge role in your health.
The adrenal glands produce hormones such as cortisol, aldosterone and sex hormones.
Cortisol is crucial because it helps the body respond to stress. It also helps maintain blood sugar levels and regulate blood pressure, among other things. Aldosterone helps regulate sodium, water and potassium levels in the blood. And sex hormones—estrogens and androgens—affect your sex drive.
So you can see how damage to the adrenal glands can cause a variety of different problems. This is the case for people suffering from Addison’s disease, a rare condition that primarily affects women.
What is Addison’s disease?
Addison’s disease, also called primary adrenal insufficiency, is a chronic disease in which the adrenal glands do not produce enough hormones – mainly cortisol and aldosterone.
Severely low levels of cortisol and aldosterone can cause life-threatening complications, including sudden drops 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 is responsible for hormone production.
For most people, the damage is caused by the immune system mistakenly attacking the adrenal glands, meaning it is an autoimmune disease.
However, damage to the adrenal glands can also be caused by:
- Infections such as fungal infections, HIV or tuberculosis
- A hemorrhage into the adrenal glands
- tumor
Symptoms of Addison’s disease
Symptoms of Addison’s disease usually develop slowly over time and can be nonspecific, which can make a correct diagnosis difficult.
Symptoms of Addison’s disease may include:
- Dehydration
- Extreme fatigue
- Diarrhea
- Nausea and vomiting
- stomach pain
- Low blood pressure
- Mild fever
- weight loss
- Muscle weakness
- Darker skin on the inside of your lips, cheeks, or gums
- Low blood sugar
- Fainting or dizziness when standing
- Craving salt
- Joint pain
- Irregular or no periods
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 the symptoms.
Severe cortisol deficiency can lead to sudden, life-threatening complications, including very low blood pressure and heart problems called adrenal crisis. An adrenal crisis is a medical emergency and should be treated immediately. People with Addison’s disease should wear a medical ID bracelet with the type of medication and dosage they need 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.
The presence of certain other autoimmune diseases also increases the risk of Addison’s disease. These can 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 several tests and imaging tests that can help your doctor diagnose Addison’s disease.
- Blood tests to check sodium, potassium, cortisol, white blood cell, testosterone and estrogen levels
- Blood test with ACTH stimulation to measure how the adrenal glands respond to adrenocorticotropic hormone (ACTH) – the hormone that stimulates the release of cortisol
- A 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 doctor may increase the dosage of these medications to prevent adrenal crisis during stress such as surgery or an infection.
Hydrocortisone injections are also prescribed as emergency medication for an adrenal crisis.
Be proactive about Addison’s disease
The symptoms of Addison’s disease can be similar to those of many other health conditions. So if you suspect you may have the disease, talk to your doctor about getting tested. Early diagnosis can help you get your hormone levels under control and keep adrenal crisis at bay.
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