Tuberculosis (TB) is the most common cause of Addison's disease worldwide, but it's rare in the UK. TB is a bacterial infection that mostly affects the lungs but can also spread to other parts of your body.
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.
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.
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.
In some cases, symptoms of Addison's disease may appear suddenly, a condition called acute adrenal failure or an addisonian crisis.
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.
See a health care provider if you have common symptoms of Addison's disease, such as: Darkened areas of skin. Extreme loss of body water, also known as dehydration. Severe fatigue.
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 can be a life-threatening condition, but it is often not diagnosed until weeks or even months after the first vague symptoms present themselves.
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. Otherwise, the prognosis is excellent for patients with Addison's disease.
Individuals with autoimmune Addison disease or their family members can have another autoimmune disorder, most commonly autoimmune thyroid disease or type 1 diabetes.
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.
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.
It is frequently mistaken for psychiatric disorders, such as depression, apathy, anxiety or even psychosis, and already in the originally described cases by Addison it is obvious that these traits often precede other symptoms.
Blood test.
This test can measure blood levels of sodium, potassium, cortisol and adrenocorticotropic hormone (ACTH). A blood test also can measure antibodies related to autoimmune 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.
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).
Loss of acuity, hemianopia, visual agnosia, optic atrophy, and strabismus are the most common features. Neuropathy may cause a decrease in corneal sensation. Gaze abnormalities due to ocular apraxia are sometimes seen. Ocular symptoms often occur after the systemic abnormalities are noted.
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.
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.
This is most commonly associated with lung, breast, stomach, or colon cancer; melanoma; and lymphoma.
Risk factors for the autoimmune type of Addison disease include other autoimmune diseases: Swelling (inflammation) of the thyroid gland that often results in reduced thyroid function (chronic thyroiditis) Thyroid gland produces too much thyroid hormone (overactive thyroid, Graves disease)