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Addison’s disease is a rare disorder of the adrenal gland, which is also referred to as hypoadrenalism or primary adrenal insufficiency.
The adrenal glands are small glands located on top of each kidney’s surface. They are responsible for the production of vital hormones such as cortisol, aldosterone, and sex hormones (androgen in men and oestrogen in women).
In Addison’s disease, the adrenal gland is damaged, causing an insufficient production of cortisol and aldosterone.
The early-stage symptoms of Addison’s disease are similar to those of some other common health conditions, including depression and the flu. Individuals with this condition may encounter:
- Fatigue (lack of energy)
- Muscle weakness
- Low mood
- Appetite loss
- Unintentional weight loss
- Increased thirst
These issues may worsen over time, and the patient may experience additional symptoms including dizziness, fainting, cramps, and exhaustion. Some people may also notice small patches of darkened skin as well as darkened gums or lips.
Although Addison’s disease is not always the cause of these symptoms, one should see a doctor so that these symptoms can be investigated.
What causes Addison’s disease?
It is unclear why Addison’s disease occurs; the condition can be caused by a variety of factors, including autoimmune disorders, infections, and certain medications. Although the condition usually results from an immune system problem that causes the immune system to attack the adrenal cortex (outer layer of the adrenal gland), disrupting the production of the hormones cortisol and aldosterone, other possible causes include diseases that can harm the adrenals, including infections, trauma, haemorrhage, or tumours.
Diagnosis of Addison’s Disease
A doctor will inquire about the patient’s medical history as well as current symptoms. They will conduct a physical examination and may request laboratory tests to determine sodium and potassium levels.
The doctor may also recommend imaging tests and hormone level measurements in order to get the adrenal insufficiency diagnosis.
Treatment of Addison’s Disease
Addison’s disease treatment typically involves the replacement of the missing hormones through medication. One must continue taking the medication for the remainder of their life after the onset of diagnosis of the condition. The cortisol replacement therapy is typically given in the form of hydrocortisone tablets, which are taken twice a day. The dosage and timing of the medication may be adjusted based on the individual’s needs and response to treatment. In addition, mineralocorticoid replacement therapy, typically given in the form of fludrocortisone tablets, is also given to compensate for the lack of aldosterone.
Addison’s disease symptoms can be greatly reduced with treatment. Most individuals who have the disease live a normal life and can lead an active life with few restrictions.
Nevertheless, individuals with Addison’s disease must learn to manage fatigue, and other health issues, such as an underactive thyroid or diabetes, may be associated. In addition to hormone replacement therapy, individuals with Addison’s disease may need to take extra precautions to avoid stress and illness, as these can cause a crisis in adrenal function.
People suffering from Addison’s disease should be aware of the possibility of a sudden deterioration of their symptoms, known as an adrenal crisis. This can occur when the cortisol levels in the body drop significantly as a result of not taking the medications or due to some other illness.
Adrenal crisis is a medical emergency with symptoms such as severe headache, nausea, confusion, fever, and extreme weakness. It can be fatal if left untreated. Consult a doctor right away if one has a known history of Addison’s disease and is experiencing severe symptoms.
Other treatment options for addison’s disease
- keep extra medicines on hand
Even missing a single dose of medicine can be dangerous. So, maintain a small supply of medicines at work and during travel. - Carry a corticosteroid injection kit
This kit includes a needle, a syringe, and injectable corticosteroids for use in an emergency. - Remain in contact with the care-giver
The hormone levels can be monitored by a care provider. If one has problems with their medication, the doctor may have to adjust the doses or the frequency with which the dose is being taken. - Have yearly health checks
Visit a healthcare professional or a doctor specialising in hormone issues a minimum of once a year. The doctor may advise the patient to have an autoimmune disease screening every year.
Adrenal crisis treatment
Adrenal crisis, also known as Addisonian crisis, necessitates immediate medical attention.
If a person has Addison’s disease and is experiencing an adrenal crisis, they will require an immediate hydrocortisone injection, either by themselves or by someone else.
Adrenal crisis symptoms include:
- Significant drowsiness or loss of consciousness
- Extreme dehydration
- Sweating
- Pale, clammy skin
- Shallow breathing
- Dizziness
- Hypotension (low blood pressure)
- Severe vomiting and diarrhoea
- Abdominal or side pain
- Fatigue
- Severe muscle weakness
- Headaches
During the course of hospitalisation, to rehydrate, the patient will be given a lot of fluids through a vein (intravenously), containing a mixture of sugar and salts (sodium, glucose, and dextrose) to replenish the fluids and nutrients the body is lacking. Individuals will also be given hydrocortisone injections to replace the missing cortisol hormone.
Any underlying issues, such as an infection, that caused the adrenal crisis will also be addressed.
When should one contact the physician?
Any illness that stresses the body can have an impact on the amount of medicine an individual requires. If the following symptoms are seen in a person with this condition, they must seek medical attention at once.
- If the person is ill, particularly if they have the flu, vomiting, or diarrhoea
- If the person gets pregnant
- If the patient requires surgery
If individuals experience sudden and severe symptoms(Addisonian crisis), seek medical attention right away.
Takeaway
Addison’s disease is a rare disorder, which occurs when the adrenal glands do not generate adequate levels of the hormones cortisol and aldosterone. Treatment typically involves a hormone replacement therapy in the form of hydrocortisone and fludrocortisone tablets and taking extra precautions to avoid stress and illness. Close monitoring of and adjustments to treatment as needed, along with emergency treatment in cases of acute crisis, are important for managing the condition.
