Addison’s disease is most commonly an autoimmune disorder affecting the adrenal glands. Each person has two adrenal glands, which are part of the endocrine system (hormone producing) and they sit on top of each kidney in a person’s body. These glands are small and shaped like pyramids about the size of a walnut, measuring about 3 x 5 x 1 cm in size.
The immune system can mistakenly recognized these glands as intruders and begin to attack them (autoimmune response), slowly destroying them with auto-antibodies (killer cells from the immune system). This is the most common cause of Addison’s disease.
Addison’s Disease Results in Hormone Deficiency
When the onset of Addison’s disease occurs, this causes the adrenal glands to become inadequate in supplying the important adrenal hormones needed by the body, the two major hormones being “cortisol” and “DHEA” (dehydroepiandrosterone). Symptoms of Addison’s disease appear once at least 90% of the adrenal cortex (the protective outer layer of the gland) has been destroyed by the autoimmune process known as “autoimmune adrenalitis.”
Addison’s Disease Symptoms
The symptoms of Addison’s disease are those of adrenal hormone deficiency. Addison’s disease causes adrenal insufficiency, meaning a reduction in adrenal hormone production and output. The two major hormones that become low due to this disease process are cortisol and DHEA.
Cortisol is the “stress hormone” and “anti-inflammatory hormone” that gives the body its ability to handle and recover from stressors and inflammation. DHEA is a “sex hormone precursor,” meaning the hormone that converts into testosterone, estrogen and other male and female sex hormones needed by the body.
When the adrenal hormones become low, a person may experience the following symptoms of low adrenal function.
- fatigue
- joint/muscle pain
- weight loss
- diminished appetite
- low blood pressure (hypotension)
- hyper-pigmentation (darkening of the skin)
If left untreated, people with Addison’s disease are at risk of experiencing an adrenal crisis, meaning they can potentially go into shock and possibly coma or death.
Diagnosing Addison’s Disease
Addison’s disease is most often diagnosed through blood testing and MRI (magnetic resonance imaging). Medical blood lab testing can measure the adrenal hormone levels and if they are found to be low, this can indicate adrenal insufficiency due to Addison’s disease.
Patients will then usually be tested for adrenal function via an ACTH Stimulation Test. This test uses the ACTH hormone, which usually comes naturally from a person’s own pituitary gland, to stimulate adrenal-cortisol hormone production but, during the test, it is administered to the patient by injection.
A patient will have a baseline blood draw taken before the test. After the ACTH hormone injection, they will have two or more additional blood draws taken at 30 minute intervals, and these three blood levels will then be compared. If the two or more additional blood levels of cortisol do not significantly increase above the baseline level, a diagnosis of adrenal insufficiency is confirmed.
Other tests that may be ordered would include an MRI to detect the extent of adrenal gland destruction, and a blood test to detect antibodies that the immune system is directing against the adrenal glands.
Treatment for Addison’s Disease
Addison’s disease is treated by replacing the low adrenal hormone levels. Once blood tests reveal which adrenal hormones are low, hormone replacement therapy will begin. One of the major hormones called cortisol, which is most commonly low in adrenal insufficiency states, must be replaced with a steroid cortisol substitute called a "corticosteroid" also referred to as “hydrocortisone.” Patients will need replacement with this synthetic hormone and any others found to be low for the rest of their lives.
Addison’s disease patients are also usually required to wear a medical ID bracelet, so that if they experience an adrenal crisis (sudden, severe drop in adrenal hormones), the person finding them will know that they are treated for Addison’s disease and that, they may need to have an emergency-dose of corticosteroid steroid administered by a doctor.
There are a number of other causes of adrenal insufficiency, but Addison’s disease is the most common, affecting about 1 in 100,000 people according to medical sources. Anyone who suspects they may be experiencing symptoms of adrenal insufficiency should see their doctor for immediate evaluation.
Sources:
Jim Lowrance - James M. (Jim) Lowrance has authored over 100 book and ebook publications since year 2004.
