Endocrinology

Addison’s Disease

Introduction to Addison’s Disease

Addison’s disease is a life long autoimmune disease in which certain steroid hormones are not produced. Hormone supplements should be enough to allow you to lead an active life.

Written by Doctify Team 27/04/2020

What is Addison’s Disease?

Addison’s disease is a life long autoimmune disease in which certain steroid hormones are not produced. Hormone supplements should be enough to allow you to lead an active life but some people feel fatigued easily and this is harder to manage. 1 in 10, 000 people in the UK have the disease with it usually presenting between the ages of 30-50 years.

What causes Addison’s Disease?

The body’s immune system begins to attack the outer layer of your adrenal gland where the steroid hormones, cortisol and aldosterone, are produced. Once 90% of the adrenal cortex is damaged, these steroid hormones will not be produced to a high enough level to work in the body. Tuberculosis (TB) is another cause of Addison’s disease if is spreads to other parts of your body but this is uncommon in the UK.

Addison’s Disease

What are the symptoms of Addison’s Disease?

Initial symptoms include lethargy, fatigue, muscle weakness, mild depression, loss of appetite, increase thirst and urination. These symptoms are common to many other diseases and so it is hard to initially diagnose. Other symptoms develop over months or years and include low blood pressure, vomiting, diarrhoea, back pain. If left untreated, people can go into an adrenal crisis in which you will become severely dehydrated, cold, sweating, dizzy and have severe vomiting and diarrhoea. An adrenal crisis is an emergency and can be fatal so if you suspect it, dial 999.

How is Addison’s Disease treated?

If the underlying cause of Addison’s is TB, then the infection can be treated.
If it is due to an autoimmune condition, this cannot be cured but medication can be given to replace the lost hormones. In most cases hydrocortisone is given to replace cortisol. Others such as prednisolone or dexamethasone might be given but this is less common. Fludrocortisone is given to replace aldosterone. Sometimes you might be asked to eat extra salt but not if you’re taking fludrocortisone. These medications usually allow people to live the life they lived prior to the disease but sometimes people still have episodes of fatigue.
Medication may need to be increased if your body is under additional strain such as infection, operation, accident.
In an emergency you or a family member might have to inject hydrocortisone if you’re suffering an Addisoninan crisis. If this occurs, you must call your GP immediately or out-of-hours service in your area.

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