Addison's Disease (Adrenal Insufficiency; Adrenocortical Hypofunction; Chronic Adrenocortical Insufficiency; Hypoadrenalism)
Addison's disease is a rare disorder of the adrenal glands. In the case of Addision's, the glands do not produce enough of the hormones cortisol and aldosterone.
Addison's occurs because of damage to the cortex.
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Addison's disease is the result of gradual damage to the adrenal cortex, the outer layer of the adrenal gland. This damage may be caused by:
The body's immune system attacking the gland (autoimmune disease), which accounts for 85% of cases in developed countries Tuberculosis
(major cause in the Third World countries)
Bleeding within the adrenal glands (related to use of anticoagulant medications and
shock Surgical complication Congenital (present at birth) or genetic factors (enzyme defects, familial glucocorticoid insufficiency)
(CMV) associated with
Fungal infections, including:
Cancer including metastases from:
Long-term corticosteroid treatment
Medications (such as
Chronic illness, including:
Symptoms may include:
Extreme weakness, fatigue Weight loss Nausea or vomiting
diarrhea Muscle weakness Darkening of freckles, nipples, scars, skin creases, gums, mouth, nail beds, and vaginal lining
Emotional changes, especially
depression Craving for salty foods Abdominal pain Anorexia Amenorrhea
A severe complication of Addison's disease is the Addisonian or
Severe abdominal, back, or leg pain Fainting or semicomatose state Severe low blood pressure Severe dehydration Severe nausea, vomiting, and diarrhea Low blood sugar Generalized muscle weakness
The doctor will ask about your symptoms and medical history. A physical exam will be performed.
Tests may include:
Blood and urine tests—to see if you have low levels of cortisol and aldosterone, high level of ACTH (ACTH is a hormone that stimulates the adrenal glands), and to measure levels of:
Anti-adrenal antibody Sodium Chloride Calcium Potassium Bicarbonate Blood urea nitrogen levels ACTH stimulation test
—measures cortisol in the blood and/or urine before and after an injection of ACTH
—pictures of the abdomen to see if the adrenal glands have signs of calcium deposits
of the abdomen—a type of x-ray that uses a computer to make pictures of structures inside the body, in this case the adrenal glands
Symptoms of Addison's disease can be controlled with medications. These drugs can replace the missing hormones. Medication needs to be taken for the rest of your life. They may be increased in times of stress.
Medications may include:
Immediate treatment of adrenal crisis includes:
Hydrocortisone Salt water Sugar
Regular blood tests are needed to monitor your response to medication. Wear a medical alert bracelet in case of an emergency.
There are no guidelines for preventing Addison's disease. If you think you are at risk, talk to your doctor.
Addison's disease. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at:
. Accessed June 13, 2008.
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Salvatori R. Adrenal Insufficiency.
Ten S, New M, Maclaren N. Clinical Review 130: Addison's disease.
J Clin Endo Metabol
Thomas Z, Fraser GL. An update on the diagnosis of adrenal insufficiency and the use of corticotherapy in critical illness.
Last reviewed November 2008 by
David Juan, MD
Please be aware that this information is provided to supplement the care
provided by your physician. It is neither intended nor implied to be a
substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER
IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the
advice of your physician or other qualified health provider prior to
starting any new treatment or with any questions you may have regarding a
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