What is Addison’s Disease?
Addison’s disease is a rare condition that happens when the adrenal glands do not produce enough cortisol and aldosterone hormones.
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 the body. These hormones are required to maintain the immune system, blood pressure, as well as other vital functions of the body.
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
Addison’s Disease : Occasional Symptoms
- Hypoglycaemia (low blood glucose levels)
- Diarrhoea
- Vomiting
- Nausea
- Irregular or missing periods
- Low blood pressure
- Joint pain
- Mood symptoms, such as irritability or depression
- Low libido (little interest in sex)
- Craving salts
Addison’s Disease Causes
Addison’s disease or primary adrenal insufficiency is caused by damaged adrenal glands not producing enough cortisol and aldosterone. Common causes for addison’s disease are – autoimmune response, infections like tuberculosis, cancer spreading to the adrenal glands, bleeding into the adrenal glands and genetic factors like adrenoleukodystrophy.
Secondary adrenal insufficiency can occur when the pituitary gland is damaged, often due to tumors, surgery or radiation. This condition affects hormone production and can have many underlying causes like autoimmune reactions, infections, cancer, bleeding, genetic conditions and damage to the pituitary gland.
Other than these, some other addison’s disease causes are –
- Fungal infection
- Surgically removing a part of the pituitary glands, hypothalamus or the adrenal glands.
- Tumour in the Pituitary glands
- Pituitary glands radition therapy.
Addison’s Disease Diet : Foods to Eat
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. In order to maintain their blood pressure, people with Addison’s disease may need to consume more sodium than normal. Therefore, it is important for people with Addison’s disease to consume more salt. 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:
- Eggs
- Chicken
- Grain products
- Cheese
- Salted nuts
- Canned tuna
- Salted seeds
- Canned beans
- Soups
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.
Addison’s Disease Treatment
In Addison’s disease, doctors suggest taking high doses of corticosteroids as a part of the treatment for Addison’s disease. These high doses of corticosteroids might lead to an increased risk of osteoporosis, a disorder where the bones become porous and more prone to fracture. So patients who take corticosteroids may need to take calcium and vitamin D supplements to protect their bones. 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:
- Seafood
◦ Shrimp
◦ Sardines
◦ Salmon - Fruits and vegetables
◦ Soybeans
◦ Broccoli
◦ Collard greens
◦ Kale
◦ Oranges - Dairy products
◦ Yoghurt (plain, low-fat, or Greek)
◦ Ricotta
◦ Skim milk
◦ Cheese (Mozzarella or cheddar)
◦ Cottage cheese - Fortified foods
◦ Orange juice and other fruit juices, fortified
◦ Tofu (prepared with calcium)
◦ Cereal
◦ Oatmeal
◦ Plant-based milks (e.g., soy or almond)
Vitamin D-rich foods include the following:
- Seafood
◦ Sardines
◦ Tuna
◦ Salmon - Meat and poultry products
◦ Liver of beef
◦ Liver of beef
◦ ground beef - Vegetables
◦ White and portabella mushrooms - Milk and dairy products
◦ Cheddar cheese
◦ Milk with added vitamin D - Other
◦ Cod liver oil
◦ Eggs
◦ 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.
Also Read : All about Addison’s disease medications
Addison’s Disease Diet Plan / Chart
Here’s a sample diet for someone with Addison’s disease. It’s balanced nutrition with adequate sodium and nutrients for adrenal health. Always consult a healthcare provider or dietitian before making big changes.
Sample Diet for Addison’s
Day 1:
Breakfast:
- Oatmeal with sliced banana and cinnamon
- 1 cup low-fat yogurt
- Herbal tea or water
Mid-Morning Snack:
- Handful of mixed nuts (almonds, walnuts)
Lunch:
- Grilled chicken salad with mixed greens, cherry tomatoes, cucumbers and olive oil dressing
- 1 slice whole grain bread
Afternoon Snack:
- Apple with almond butter
Dinner:
- Baked salmon with lemon and herbs
- Steamed broccoli and quinoa
- 1 side of roasted sweet potatoes
Evening Snack:
- Low-fat cheese and whole grain crackers
Day 2:
Breakfast:
- Scrambled eggs with spinach and feta
- 1 slice whole grain toast
- Fresh orange juice
Mid-Morning Snack:
- Carrot sticks with hummus
Lunch:
- Turkey and avocado wrap in whole grain tortilla
- 1 side of mixed fruit
Afternoon Snack:
- Greek yogurt with honey and berries
Dinner:
- Stir-fried tofu with veggies (bell peppers, broccoli, carrots) over brown rice
- 1 side salad with olive oil dressing
Evening Snack:
- 1 dark chocolate square and 1 handful of pumpkin seeds
Hydration:
- 8-10 cups of water a day.
- Electrolyte drinks if advised by your healthcare provider.
Notes:
- Adjust sodium as recommended by your doctor.
- Include a variety of colorful fruits and veggies for vitamins and minerals.
- See how your body reacts to different foods and adjust as needed.
This can be rotated or modified to your liking.
Addison’s Disease Diet : Foods to avoid
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
- Coffee
- Bananas and oranges
- Salt substitutes
- Alcohol
- 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 are:
- Refined grains
- Soft drinks
- Processed meats
- Fried foods
- Desserts
Addison’s Disease Diet : Takeaway
Addison’s disease is a rare and chronic health condition that occurs when the adrenal glands do not produce enough amount of aldosterone and cortisol hormones. 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.
Addison’s Disease Diet FAQs
What foods should you avoid with Addison’s disease?
Individuals with Addison's disease should generally avoid or limit tea, coffee, alcohol, meat that has been processed, refined cereals, soft drinks, and fried foods along with foods that are high in saturated fat and sugar. However, it is best to consult a healthcare professional or registered dietitian for personalised dietary recommendations.
What foods are good for Addison’s disease?
There are no specific foods that are considered ‘good’ for Addison's disease. However, individuals with Addison's disease can benefit from a well-balanced diet that includes a variety of nutrient-rich foods. Some foods that can be beneficial include vegetables, fruits, sources of lean protein and edibles that are high in vitamin D and calcium. Patients might also be required to increase their salt consumption.
What should I eat with Addison’s disease?
Individuals with Addison's disease should consider the following dietary recommendations:
- High-sodium diet: Talk to your doctor or dietitian to determine the proper levels of sodium intake.
- Adequate calcium intake: Include calcium-rich foods like leafy greens, soybeans, seafood, dairy products, and fortified foods in your diet.
- Vitamin D: Taking vitamin D-rich foods is one of the best ways to treat Addison’s disease. You can choose to consume seafood, dairy products, mushrooms, and many other foods. It is also quite important to get more exposure to sunlight. You need to consult a doctor to get dietary advice suitable for your health condition.
What foods reduce cortisol levels?
While there are no specific foods that directly reduce cortisol levels in the body, making certain dietary changes can help support overall hormonal balance and stress reduction. These dietary changes include avoiding high added sugar intake and focusing on whole grains, fruits, vegetables, legumes, dark chocolate, green tea, and healthy fats. Consuming probiotics and prebiotics helps support the gut. Consume more water to stay hydrated.
What foods are good for the pituitary gland?
No particular foods are available to directly strengthen your pituitary gland. But you can manage a balanced as well as nutrient-rich diet for easily gaining adequate endocrine health. You can also consume whole foods such as fruits, vegetables, lean proteins, and more. Take a high amount of iron and iodine to promote optimal pituitary gland function. Consult a doctor for personalised dietary recommendations.
How do I lose weight with Addison’s disease?
Losing weight with Addison's disease can be challenging, but here are a few strategies: • Limit sugar intake
- Minimise stress
- Have a light exercises routine
- Follow the doctor's recommendations Remember, individualised guidance from healthcare professionals is crucial to managing weight effectively with Addison's disease.
What are medications to avoid with Addison's disease?
If you have Addison’s disease, there are certain medications you should avoid or be cautious with. Here are some to watch out for:
- Medications that block glucocorticoid production: Ketoconazole and etomidate
- Medications that block glucocorticoid action: Mifepristone (Mifeprex, Korlym)
- Certain cancer treatments: Checkpoint inhibitors used in cancer therapy can affect adrenal function
- Diuretics and acetazolamide: These can affect electrolyte levels and blood pressure and may require adjustments to your fludrocortisone dose
- Nonsteroidal anti-inflammatory drugs (NSAIDs): Some NSAIDs can affect electrolyte levels and blood pressure
- Some antidepressants and antibiotics: These may require adjustments to your medication regimen
Before starting any medicine, it is important to talk to your doctor to rule out any drug interactions.
What is the best drink for Addison's disease?
Patients suffering from Addison’s disease are required to drink water to completely stay hydrated all through the day. Drinking soda water is also suitable for the patients to stay hydrated. Adding more salt can lead to diarrhoea, so it is best to avoid Salty food. It is best to drink non-sugar-laden liquids to avoid potato chips.
What vitamin is good for Addison's disease?
People affected with Addison's disease must not be adding a high content of sodium to the food. Vitamin D is quite beneficial for people suffering from Addison's disease. These are suitable options for regulating the immune response even without any hassle. Vitamin D therapy also helps to regulate the immune responses. People with Addison's disease can also take food rich in vitamin D.
What deficiency causes Addison’s disease?
A deficiency of the hormone cortisol can cause Addison's disease. Aldosterone is also one of the reasons for producing adrenal glands: Addison's disease will cause damage to adrenal glands. Damages in adrenal glands can lead to the immune system attacking adrenal glands mistakenly. Hormones cortisol deficiency can be causing Addison's disease. The adrenal glands do not make enough of the hormone cortisol.
Can Addison’s go away?
Yes, Addison's disease is an irreversible condition, as these are completely rare cases for recovery. These diseases can occur when adrenal glands located above the kidney are damaged. It can also lead to a deficiency in glucocorticoids, so these need to be treated immediately. This deficiency also requires lifelong replacement therapy along with medication.
What foods increase aldosterone?
Patients suffering from Addison's disease need to avoid taking too much salt in the food. High frequency of aldosteronism also involves chronic stimulation from across fructose. Eating massive amounts of liquorice is the main cause of hyperaldosteronism. The main reason is that liquorice involves glycyrrhizin; Aldosterone is the steroid hormone for regulating blood pressure with increasing sodium reabsorbed amount in the bloodstream.
References:
- Eating, Diet, & Nutrition for Adrenal Insufficiency & Addison’s Disease. National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) [Internet]. https://www.niddk.nih.gov/health-information/endocrine-diseases/adrenal-insufficiency-addisons-disease/eating-diet-nutrition. Accessed Jan 20, 2023.
- What Diet Is Best for Addison’s Disease?. HealthCentral [Internet]. https://www.healthcentral.com/condition/addisons-disease/addisons-disease-diet. Accessed Jan 15, 2023.
- The Diet in Addison’s Disease. Journal of the American Dietetic Association [Internet]. https://www.sciencedirect.com/science/article/abs/pii/S0002822321429330?via%3Dihub. Accessed Jan 10, 2023.
- 10 Foods to Eat If You Have Addison’s Disease. MedicineNet[Internet]. https://www.medicinenet.com/10_foods_to_eat_if_you_have_addisons_disease/article.htm. Accessed Jan 12, 2023.
- What Should I Eat If I Have Addison’s Disease?. eMedicineHealth. https://www.emedicinehealth.com/what_should_i_eat_if_i_have_addisons_disease/article_em.htm . Accessed Jan 15, 2023.
