Addison's disease can develop if your immune system attacks your adrenal glands and severely damages your adrenal cortex. When 90% of the adrenal cortex is destroyed, your adrenal glands will not be able to produce enough of the steroid hormones cortisol and aldosterone.
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.
Primary adrenal insufficiency is most often caused when your immune system attacks your healthy adrenal glands by mistake. Other causes may include: Cancer. Fungal infections.
Primary adrenal insufficiency
Sometimes, the outer layer of the adrenal glands, known as the cortex, is damaged. Then it can't make enough hormones, a condition called primary adrenal insufficiency. This is usually the result of an autoimmune disease, in which the body attacks itself.
Risk factors for adrenal crisis include physical stress such as infection, dehydration, trauma, or surgery, adrenal gland or pituitary gland injury, and ending treatment with steroids such as prednisone or hydrocortisone too early.
The most common symptoms are fatigue, muscle weakness, loss of appetite, weight loss, and abdominal pain. Adrenal insufficiency can be caused by autoimmune disease or suddenly stopping steroid medicines used to treat other conditions, among other causes.
Addison's disease is a rare chronic condition in which your adrenal glands don't produce enough of the hormones cortisol and aldosterone. It's most often caused by an autoimmune attack. It's treatable with medication.
What are the complications of adrenal insufficiency? The most serious complication of adrenal insufficiency is called adrenal crisis. If not treated right away, adrenal crisis can cause death. Your body needs much more cortisol than usual during times of physical stress such as illness, serious injury, or surgery.
ACTH Stimulation Test This is the most specific test for diagnosing adrenal insufficiency. Blood cortisol levels are measured before and after a synthetic form of adrenocorticotrophic hormone (ACTH), a hormone secreted from the anterior pituitary, is given by injection.
Although there's no cure, primary adrenal insufficiency can be managed effectively by taking cortisol and aldosterone replacement hormones, with the goal of stabilizing hormone levels and relieving signs and symptoms.
Treatment usually involves corticosteroid (steroid) replacement therapy for life. Corticosteroid medicine is used to replace the hormones cortisol and aldosterone that your body no longer produces. It's usually taken in tablet form 2 or 3 times a day.
Treatment involves taking corticosteroids, a drug that mimics cortisol, for the rest of your life to replace the hormones that your body is not producing. Your endocrinologist will order tests periodically to ensure that your hormone levels are normal.
Typically, the hypothalamic pituitary adrenal axis recovers after cessation of glucocorticoids, but the timing of recovery can be variable and can take anywhere from 6–12 months.
Treatment is tailored to the underlying cause and, in most cases, lifelong treatment is necessary. With appropriate treatment and a few added precautions, people with adrenal insufficiency can lead active lives and have a normal life expectancy.
Too little cortisol may be due to a problem in the pituitary gland or the adrenal gland (Addison's disease). The onset of symptoms is often very gradual. Symptoms may include fatigue, dizziness (especially upon standing), weight loss, muscle weakness, mood changes and the darkening of regions of the skin.
Low cortisol levels, also known as hypocortisolism, can be caused by multiple issues. Some factors that can contribute to low cortisol levels include Addison's disease, an autoimmune disorder which attacks the adrenal glands, impairing cortisol production, an underactive pituitary gland or adrenal fatigue.
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.
Symptoms said to be due to adrenal fatigue include tiredness, trouble falling asleep at night or waking up in the morning, salt and sugar craving, and needing stimulants like caffeine to get through the day. These symptoms are common and non-specific, meaning they can be found in many diseases.
Multiple conditions can mimic one or more symptoms of adrenal insufficiency (chronic fatigue syndrome, depression, hypothyroidism, fibromyalgia, chronic dyspepsia, etc.).
Adrenal insufficiency can be diagnosed by blood tests and special stimulation tests that show inadequate levels of adrenal hormones. Proponents of the adrenal fatigue diagnosis claim this is a mild form of adrenal insufficiency caused by chronic stress.
Hydrocortisone (Cortef), prednisone (Rayos) or methylprednisolone (Medrol) to replace cortisol. These hormones are given on a schedule to act like the changes in cortisol levels the body goes through over 24 hours. Fludrocortisone acetate to replace aldosterone.
Long-term glucocorticoids must be withdrawn slowly to avoid withdrawal reactions, particularly adrenal insufficiency and crisis.