The National Organization for Rare Diseases (NORD) recognizes Addison’s disease as a lifelong endocrine disorder that affects 1 in 100,000 citizens in the United States. It can happen to people of all ages but is most commonly diagnosed amongst those between 30 to 50 years old of both sexes. Addison’s disease is caused by malfunctioning of the adrenal glands, found right on top of the kidneys. The outer layer of the gland is called the cortex and it produces three key hormones needed for most physiological processes in the body. The disease is spurred on when the adrenal glands are affected by adrenal cancer, infections or bleedings, leading to a drop in the production of hormones (cortisol, aldosterone and androgens). This condition referred to as the primary adrenal insufficiency is only diagnosable at a stage when 90 percent of the cortex is wrecked. For reasons unknown, adrenal glands are destroyed due to pre-existing autoimmune diseases, most commonly tuberculosis and thyroid.The other kind is called secondary adrenal insufficiency, according to Dr Axe. It is a condition when the pituitary gland cannot make adrenocorticotropic hormone (ACTH) to stimulate the cortex due to many reasons; inflammation, benign pituitary tumors and pituitary surgery, to name a few. Cortisol and androgens are produced in very small quantities as a result and this can happen despite not having any adrenal damage whatsoever. Surprisingly, aldosterones remain unaffected. Symptoms Addison's disease is many a time not diagnosed until a physical stressor occurs. Symptoms may takes months to recognize as they develop slowly overtime. The most prominent symptom is usually an extreme sense of fatigue, followed by weight loss and loss of appetite. Gastrointestinal problems such as nausea, vomiting and diarrhea may bring it on. In some rare cases, even dehydration can unintentionally cause weight loss, according to information published by NORD. In some cases, skin discoloration is a symptom. Hyperpigmentation near scars, skin creases and gums are seen clearly contrasting with original skin color. It may take months or even years to form, neatly slipping under the radar. Black freckles and white spots appear in one or two places. Skin changes are less common with secondary adrenal insufficiency. Addison's disease is caused by hormonal imbalances due to malfunctioning of either the adrenal cortex or the pituitary gland. Pixabay The symptoms are all over the body. Muscle pain, spasms and joint pain are more symptoms to take note of and it may be confused with other health issues. Low blood pressure leading to lightheadedness and loss of consciousness in rare cases are also need to be addressed. The mind is not left behind and it can also be affected when hormonal balance is disrupted. Poor concentration, irritability and depression are a few symptoms related to the mind to watch out for. Women lose sexual appetite, decrease period flow and lose body hair too. Furthermore, unexpected salty food cravings and low blood sugar levels are seen in those with Addison's disease sometimes. However, during the event of an injury or when experiecing any physical trauma, it triggers the life threatening Addisonian Crisis. The immediate symptoms are lower back pain, loss of strength in the abdomen and legs. Also, delirium, dehydration and low blood pressure are important symptoms that can lead ultimately to kidney failure. Treatment During an Addisonian Crisis, the first step doctors take to save the patient's life is to intravenously inject hydrocortisone (the common drug used to replace absent cortisols), saline solutions, electrolyte replacement and vasopressors to treat blood pressure. Hormone replacement therapy is given to balance the level of absent steroid hormones, namely cortisol and aldosterone. Oral fludrocortisone acetate is prescribed to set right aldosterone imbalances, while cortisol is replaced by oral hydrocortisone according to Mayo Clinic. The dosages have to be adjusted according to each individual person's needs and it can be increased in an acute adrenal crisis situation by consulting a doctor. Dietary control helps maintain overall good health. Patients should add salt to their diet, consume enough calcium and vitamin D, and eat anti-inflammatory ingredients regularly. Generally, they should be encouraged to reduce stress by taking multivitamins and exercising. For emergencies, carrying an identification card mentioning they have Addison's disease, along with an injection kit of hydrocortisone and oral hormone replacements is needed. It could guide paramedics or others performing first aid. For long-term health, get yourself checked by an endocrinologist and test yourself for as many autoimmune diseases as possible once a year to be safe rather than sorry. Source
