Addison disease is a lifelong condition that can be treated successfully with the replacement of steroid hormones. People with Addison disease can have a normal life span because cases of Addison disease may go undiagnosed, and it is difficult to determine its true frequency in the general population.
The mean ages at death for females (75.7 years) and males (64.8 years) were 3.2 and 11.2 years less than the estimated life expectancy. Conclusion: Addison's disease is still a potentially lethal condition, with excess mortality in acute adrenal failure, infection, and sudden death in patients diagnosed at young age.
Signs & Symptoms. The symptoms of Addison's disease can vary from one individual to another. Symptoms usually develop slowly over time and are usually vague and common to many conditions (nonspecific). This often leads to delays in the proper diagnosis of Addison's disease.
If Addison's disease is left untreated, the levels of hormones produced by the adrenal gland gradually decrease in the body. This causes your symptoms to get progressively worse and eventually lead to a life-threatening situation called an adrenal or Addisonian crisis.
With Addison's disease, your immune system attacks the outer portion of your adrenal glands (the adrenal cortex), where they make cortisol and aldosterone. Symptoms don't usually develop until 90% of the adrenal cortex has been damaged, which can take several months to years.
Most of the patients with Addison's are often initially misdiagnosed or diagnosed with a significant delay. Presenting signs and symptoms in patients with adrenal insufficiency are often non-specific and may comprise of fatigue, weakness, weight loss, nausea, poor appetite, and light headedness.
Gastroenteritis and Syndrome of Inappropriate Secretion of Antidiuretic hormone (SIADH) are the most frequent reported misdiagnosis in patients with adrenal insufficiency (AI).
Symptoms tend to come and go and may include abdominal pain, dizziness, fatigue, weight loss, salt craving, and the darkening of the skin. 1 During periods of extreme stress or poor health, Addison's disease can trigger a rapid drop in cortisol levels and a potentially life-threatening event known as an adrenal crisis.
Men and women of all ages are equally affected by adrenal insufficiency, which may be permanent or temporary and can be treated with medications.
Addison's disease can remain unrecognized until acute crisis and sometimes it may be misdiagnosed.
Regardless of the specific terminology used, it is clear that some patients with Addison's disease have a disturbance in brain function and may develop a range of neuropsychiatric symptoms as a result.
Addison's disease is usually the result of a problem with the immune system, which causes it to attack the outer layer of the adrenal gland (the adrenal cortex), disrupting the production of the steroid hormones aldosterone and cortisol.
In its early stages, adrenal insufficiency can be hard to diagnose since symptoms come on slowly. Your health care professional may suspect it after reviewing your medical history and symptoms. The next step is blood testing to see if your cortisol levels are too low and to help find the cause.
Autoimmune Addison's disease (autoimmune primary hypoadrenalism) is generally regarded as an irreversible, progressive disease. Destruction of the adrenal glands leads to inadequate secretion of glucocorticoid and mineralocorticoid that requires lifelong replacement.
This is called acute adrenal insufficiency, or Addisonian crisis. This can occur when your body is stressed. That can happen for many reasons, such as an illness, fever, surgery, or dehydration. You may also have a crisis if you stop taking your steroids or lower the amount of your steroids suddenly.
Acute adrenal crisis is a medical emergency caused by a lack of cortisol. Patients may experience lightheadedness or dizziness, weakness, sweating, abdominal pain, nausea and vomiting, or even loss of consciousness.
If Addison's disease is suspected, blood tests will be carried out to measure the levels of sodium, potassium and cortisol in your body. A low sodium, high potassium or low cortisol level may indicate Addison's disease.
Autoimmune Addison disease affects the function of the adrenal glands, which are small hormone-producing glands located on top of each kidney. It is classified as an autoimmune disorder because it results from a malfunctioning immune system that attacks the adrenal glands.
Ocular Features: Virtually all patients have visual symptoms. Loss of acuity, hemianopia, visual agnosia, optic atrophy, and strabismus are the most common features.
Women are more likely than men to develop Addison's disease. This condition occurs most often in people between the ages of 30 and 50, 2 although it can occur at any age, even in children. Secondary adrenal insufficiency occurs in people with certain conditions that affect the pituitary.
Addison's disease symptoms usually happen slowly, often over months. The disease can move so slowly that people who have it may ignore the symptoms at first. Then a stress, such as illness or injury, makes symptoms worse.
Addison's disease stages
Stage 0: Normal adrenal function. Stage 1: You may have increased plasma renin with normal or low levels of aldosterone but no other abnormal results. Stage 2: You're likely to have high renin levels and low aldosterone levels. Renin is an enzyme produced in your kidney.
Patients with Addison's disease frequently self-report memory and attention difficulties, even when on standard replacement therapy.
However, replacement medication does not restore the natural circadian rhythm of cortisol and, despite adherence, patients experience sub/supra physiological cortisol concentrations, particularly during the night. Patients with AD report and experience both poor-quality sleep and cognitive difficulties (3–8).
Possible metabolic causes of dementia include: Hormonal disorders, such as Addison disease, Cushing disease. Heavy metal exposure, such as to lead, arsenic, mercury, or manganese.