What is Addison's disease?

Addison’s disease is a disorder in which the adrenal glands – which sit on top of the kidneys – do not produce enough of the hormones cortisol and aldosterone. (Hormones are chemicals that control the function of tissues or organs.)

Cortisol helps the body respond to stress, including the stress of illness, injury, or surgery. It also helps maintain blood pressure, heart function, the immune system and blood glucose (sugar) levels.

Aldosterone affects the balance of sodium and potassium in the blood. This in turn controls the amount of fluid the kidneys remove as urine, which affects blood volume and blood pressure.

Addison’s disease is also called “primary adrenal insufficiency.” A related disorder, “secondary adrenal insufficiency,” occurs when the pituitary, a small gland at the base of the brain, does not secrete enough adrenocorticotropic hormone (ACTH), which activates the adrenal glands to produce cortisol.

How common is Addison’s disease?

In the United States, Addison’s disease affects 1 in 100,000 people. It occurs in both men and women equally and in all age groups, but is most common in the 30-50 year-old age range.

What causes Addison’s disease?

Addison’s disease is caused by an autoimmune response, which occurs when the body’s immune system (which protects it from infection) assaults its own organs and tissues. With Addison’s disease, the immune system attacks the outer portion of the adrenal glands (the cortex), where cortisol and aldosterone are made.

Other causes of Addison’s disease include:

  • Injury to the adrenal glands
  • Infection, including tuberculosis, HIV/AIDS-related infections, and fungal infections
  • Cancer cells from another part of the body that have invaded the adrenal glands
  • Bleeding into the adrenal glands
  • Surgical removal of the adrenal glands
  • Amyloidosis (abnormal buildup of certain proteins in the organs)
  • Genetic defects

What are the symptoms of Addison’s disease?

The damage to the adrenal glands happens slowly over time, and symptoms occur gradually. The most common symptoms include:

In some cases – such as an injury, illness, or time of intense stress – symptoms can come on quickly and cause a serious event called an Addisonian crisis, or acute adrenal insufficiency. An Addisonian crisis is a medical emergency. If it is not treated, it can lead to shock and death. Symptoms of an Addisonian crisis include:

  • Feeling restless, confused, or afraid, or other mental changes
  • Dehydration
  • Extreme weakness
  • Having trouble staying awake, or a total loss of consciousness
  • High fever
  • Lightheadedness or feeling faint
  • Paleness
  • Severe vomiting and diarrhea
  • Sudden, deep pain in the lower back, belly or legs

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