Addison’s disease or primary adrenal insufficiency or hypoadrenalism is a rare, chronic condition caused by failure of the adrenal glands. Addison’s disease affects approximately 8,400 people in the UK, and is most common between the aged of 30 and 50 with a higher prevalence in woman then men.
The adrenal glands themselves are two small, pyramid-shaped glands situated just above the kidneys. Each gland has an inner layer or medulla which produces the hormone adrenaline, the typical fight-or-flight hormone, and an outer layer or cortex which produces the hormone cortisol and aldosterone. It is the cortex which is damaged in Addison’s disease, which leads to reduced production of cortisol and aldosterone.
The damage to the cortex seen in Addison’s disease is often caused by an autoimmune condition (accounting for approximately 70-90% of causes of the condition). In Addison’s disease the immune system attacks the adrenal glands, severely damaging the adrenal cortex. When 90% of the cortex is destroyed the adrenal glands are no longer able to produce cortisol and aldosterone effectively, causing the symptoms of the condition.
Within the body cortisol mobilises nutrients, enabling the body to fight inflammation while also stimulating the liver to produce blood sugar and help control the water levels in the body. Aldosterone is involved in the regulation of salt and water in the body, both of which can affect blood volume and pressure. Without these two hormones, the initial symptoms of Addison’s disease can begin. These include can include, fatigue, lethargy, low mood or irritability, increased thirst and frequent need to urinate, craving for salty foods, loss of appetite and unintentional weight loss and muscle weakness.
As the adrenal cortex is also responsible for holding a large functional reserve called upon by the body in times of intense stress or illness, many suffers of Addison’s disease can find that symptoms can become worse during times of additional stress. This can include, low blood pressure, nausea and vomiting, abdominal, joint or back pain, muscle cramps, chronic exhaustion, brownish discolouration of the skin, lips and gums, diarrhoea and reduced libido.
If Addison’s disease is left untreated it can cause the symptoms to get progressively worse leading to adrenal crisis, due insufficient levels of cortisol and aldosterone. An adrenal crisis is a medical emergency and must be treated in hospital immediately. Symptoms of an adrenal crisis include; pale, cold, clammy skin; sweating; rapid, shallow breathing; severe dehydration; headache; severe vomiting and diarrhoea; severe muscle weakness; dizziness and severe drowsiness or loss of consciousness.
However, in the majority of cases the symptoms of Addison’s disease can be treated with hormone replacement oral medication. With medication, many people with Addison’s can lead a normal life with minimal changes to life style and daily routine. Most people with Addison’s disease also carry emergency medication in case of an episode of high stress such as an injury. This is often an emergency injection of hydrocortisone; however after every dose of this a medical professional must be informed. In the case of an adrenal crisis this can only be treated in hospital and is done through a hydrocortisone injection and an IV drip to rehydrate the body and replace to salts and sugars lost.
For more information please visit:
http://www.nhs.uk/Conditions/Addisons-disease/Pages/Treatment.aspx
http://www.addisons.org.uk/info/addisons/page1.html
Gracey's medical blog 