Addison’s disease affects the adrenal glands and is also known as hypoadrenalism or primary adrenal insufficiency. It is a serious, potentially fatal, but uncommon condition caused by a lack of aldosterone or cortisol hormones in a body. These hormones are required to maintain the immune system, blood pressure, as well as other vital functions.
The adrenal glands, which are located on top of the kidneys, produce crucial hormones such as cortisol and aldosterone. To release these hormones, they communicate with the hypothalamus and pituitary gland.
In Addison’s disease, the adrenal glands do not synthesise adequate amounts of these hormones due to the damage to the glands. Also, sometimes, when the pituitary gland is damaged, the adrenals do not release aldosterone or cortisol.
Addison’s disease symptoms
People with Addison’s disease may experience a variety of symptoms. While symptoms differ from individual to individual, the following are among the most common ones:
- Fatigue (chronic)
- Appetite loss
- Weight loss
- Skin darkening—most evident on skin folds and scars, knuckles, lips, and gums
- Muscle weakness
- Pain in the abdomen
Symptoms can also occasionally include:
- Hypoglycaemia (low blood glucose levels)
- Irregular or missing periods
- Low blood pressure
- Joint pain
- Mood symptoms, such as irritability or depression
- Low libido (little interest in sex)
- Craving salts
While there is no specific Addison’s disease diet that can cure Addison’s disease, certain dietary changes can help manage the symptoms and prevent complications.
A high-sodium diet may benefit some of Addison’s disease patients with low aldosterone. Aldosterone, one of the hormones produced by the adrenal glands, helps regulate blood pressure and balance the fluids in the body. When the body does not produce enough aldosterone, blood pressure can drop, which can cause dizziness and fainting. To aid in maintaining blood pressure, people with Addison’s disease may need to consume more sodium than normal. Therefore, salt intake is an important consideration for people with Addison’s disease. This can be done by adding a pinch of salt to food, using saltier seasonings, or eating salty snacks. Also, a doctor or a nutritionist can provide guidance on the proper sodium sources and the amount of sodium one should consume each day.
Other sources containing sodium include:
- Grain products
- Salted nuts
- Canned tuna
- Salted seeds
- Canned beans
One should consume salty foods if they have Addison’s disease and crave salt. Although nutritious foods such as eggs, poultry, cheese, salted seeds, and nuts are the best sources of sodium, people with this condition may also benefit from consuming salted crackers or pretzels as snacks.
The doctor may, however, recommend steroid medications that can help individuals balance their salt intake, thereby allowing them to eat a normal diet.
In Addison’s disease, high doses of corticosteroids are recommended as a part of the treatment. These high doses have been linked to an increased risk of osteoporosis, a disorder where the bones become porous and more prone to fracture. If individuals take corticosteroids, they may need to take supplement with calcium and vitamin D to protect their bone health. A doctor or a nutritionist can advise on the amount of calcium one should consume based on their age.
Corticosteroid users should make sure they get enough vitamin D and calcium. Calcium-rich foods include the following:
- Fruits and vegetables
◦ Collard greens
- Dairy products
◦ Yoghurt (plain, low-fat, or Greek)
◦ Skim milk
◦ Cheese (Mozzarella or cheddar)
◦ Cottage cheese
- Fortified foods
◦ Orange juice and other fruit juices, fortified
◦ Tofu (prepared with calcium)
◦ Plant-based milks (e.g., soy or almond)
Vitamin D-rich foods include the following:
- Meat and poultry products
◦ Liver of beef
◦ Liver of beef
◦ ground beef
◦ White and portabella mushrooms
- Milk and dairy products
◦ Cheddar cheese
◦ Milk with added vitamin D
◦ Cod liver oil
◦ Cereals fortified with vitamin D
◦ Plant-based milks (e.g., soy, almond, and oat), fortified with vitamin D
Sunlight exposure is another source of vitamin D.
Foods to avoid with Addison’s disease
A long-term use of steroid medications makes people with Addison’s disease highly likely to develop obesity and osteoporosis. As a result, some foods should be avoided or consumed with caution. These are some examples of such foods:
- Black tea
- Green tea
- Bananas and oranges
- Salt substitutes
- Foods containing high sugar and fats (e.g., chips)
In studies, some foods have been shown to raise the likelihood of osteoporosis and are advised to be avoided in Addison’s disease. Examples of these foods include:
- Refined grains
- Soft drinks
- Processed meats
- Fried foods
In conclusion, Addison’s disease is a rare, chronic condition that occurs when the adrenal glands do not produce adequate amounts of the hormones, especially aldosterone and cortisol. While there is no specific diet that can cure Addison’s disease, certain dietary changes can help manage the symptoms and prevent complications. Salt intake, protein intake, and hydration as well as eating balanced meals that include a variety of fruits and vegetables are important measures for people with Addison’s disease. It’s important to work with a healthcare professional and a registered dietitian to determine the best dietary approach for an individual’s specific needs.