Addison's disease, also known as primary adrenal insufficiency, is a rare disorder that occurs when your adrenal glands do not produce enough of certain hormones. Here's a detailed look:
Causes
- Autoimmune Disease: The most common cause, where the immune system mistakenly attacks the adrenal glands.
- Infections: Tuberculosis, HIV, and fungal infections can damage the adrenal glands.
- Cancer: Cancer cells from other parts of the body can spread to the adrenal glands.
- Genetic Disorders: Some genetic diseases, like adrenoleukodystrophy, affect adrenal gland function.
- Surgical Removal of the Adrenal Glands: Due to other medical conditions.
Signs and Symptoms
- Fatigue and Weakness: Persistent and gradually worsening tiredness.
- Weight Loss and Decreased Appetite: Often significant and unexplained.
- Hyperpigmentation: Darkening of the skin, especially in areas like scars, skin folds, and the lips.
- Low Blood Pressure: Can lead to fainting or dizziness upon standing.
- Salt Craving: Due to the loss of sodium through urine.
- Low Blood Sugar Levels (Hypoglycemia).
- Gastrointestinal Symptoms: Like nausea, vomiting, and diarrhea.
- Mood Changes: Depression or irritability.
- In Women: Irregular or absent menstrual periods.
Treatment
The treatment for Addison's disease involves hormone replacement therapy to correct the levels of steroid hormones the body isn't producing. The treatment is usually lifelong and often involves:
- Corticosteroids:
- Hydrocortisone: Most commonly used, it replaces cortisol.
- Prednisone or Dexamethasone: Alternatives to hydrocortisone.
- Mineralocorticoids:
- Fludrocortisone Acetate: Used to replace aldosterone, which helps regulate sodium and potassium levels.
Medication
- Hydrocortisone, Prednisone, or Dexamethasone: For cortisol replacement.
- Fludrocortisone: For aldosterone replacement.
Additional Management
- Stress Management: Patients may need increased medication during times of stress, such as surgery or severe illness.
- Regular Monitoring: Regular check-ups to monitor hormone levels and adjust medication as needed.
- Emergency Treatment: Wearing a medical alert bracelet and carrying an emergency hydrocortisone injection kit.
It's essential for individuals with Addison's disease to work closely with their healthcare provider to manage the condition and to be educated about handling potential adrenal crises, which are medical emergencies. Regular follow-up care is critical to monitor the effectiveness of treatment and manage any side effects.