What Is Addison Disease? Symptoms, Causes and Diagnosis

What is Addison disease?

Addison disease is a form of primary adrenal insufficiency that occurs when the adrenal glands do not produce enough of the hormones the body needs. The adrenal glands sit above the kidneys, and their outer layer, the adrenal cortex, produces important hormones including cortisol and aldosterone. Cortisol helps the body respond to stress and supports several body functions, while aldosterone helps regulate sodium, water, potassium, and blood pressure. [1] [2]

In Addison disease, the adrenal cortex is damaged, so cortisol production falls and aldosterone production may also be reduced. The most common cause is an autoimmune reaction in which the immune system mistakenly attacks adrenal tissue, although other causes include certain infections and some cancers. Having a risk factor does not necessarily mean that a person will develop the disease. [1] [2]

What symptoms can occur?

Symptoms may develop gradually, so they may not be obvious at first. They can include fatigue that becomes worse over time, muscle weakness, weight loss, and low blood pressure. Changes in skin color may also occur, with the skin becoming darker or developing darker areas. Other problems related to insufficient adrenal hormones may occur as well. [1]

Because these symptoms can occur with many other conditions, Addison disease cannot be diagnosed from symptoms alone. Persistent unusual fatigue, muscle weakness, unintentional weight loss, or low blood pressure should prompt medical assessment to determine the underlying cause. [2]

How is it diagnosed?

Diagnosis relies on medical assessment and laboratory testing that evaluates adrenal function and relevant hormone levels. Additional testing may be used to determine the underlying cause of adrenal insufficiency, such as an autoimmune cause or another condition, depending on the circumstances. Compatible symptoms alone are therefore not enough to confirm the diagnosis without appropriate testing. [1] [2]

Can it be dangerous?

Yes. Untreated adrenal insufficiency can lead to a potentially life-threatening condition called adrenal crisis. Call emergency services or go to an emergency department immediately for confusion, loss of consciousness, or severe weakness with low blood pressure or severe vomiting, especially in someone with known adrenal insufficiency. Do not wait for a routine appointment when adrenal crisis is suspected. [6] [1] [2]

People with Addison disease generally require long-term adrenal hormone replacement under medical supervision. Medical sources also recommend carrying medical identification that states the diagnosis and the medicines needed in an emergency. [1]

Discuss a plan for fever, illness, and surgery with your clinician in advance, because hormone requirements may change during physical stress. If vomiting prevents you from keeping replacement tablets down, seek immediate medical help. Follow the emergency plan provided by your care team; do not stop replacement treatment or change doses arbitrarily. [5]

For further reading: Addison Disease: Hidden Danger and Serious Symptoms article (Arabic article).

What is Addison disease?