Addison's disease – symptoms, causes, diagnosis and treatment

Adrenal insufficiency is a disorder that occurs when the adrenal glands do not make enough of certain hormones. The adrenal glands are just above the kidneys. Adrenal insufficiency can be primary, secondary or tertiary. Primary adrenal insufficiency is often called Addison disease.

What is Addison & # 39; s Disease (aka adrenal insufficiency)?

Addison's disease (also called primary adrenal insufficiency and hypocorrosion) is a medical condition that occurs when the body's endocrine system fails to produce enough adrenal hormones, especially cortisol and aldosterone. Insufficient adrenal hormone production affects many functions of the body, leading to Addison disease or primary adrenal insufficiency.

Most of the adrenal insufficiency is known as autoimmune disorders. Adrenal nephritis The immune system attacks and damages the cells of the adrenal glands. Adrenal insufficiency can also be caused by tuberculosis, cancer, adrenal injuries, fungal infections and other diseases and infections such as HIV.

Adrenal insufficiency can affect the body's ability to respond to stress and maintain other essential life functions. With treatment, most people with adrenal insufficiency can live a normal active life. 

Addison disease facts

  • Also known as primary adrenal insufficiency or adrenal insufficiency.
  • It is a rare disorder of the adrenal glands.
  • The adrenal glands are two small glands that sit on the kidneys. They produce two essential hormones, cortisol and aldosterone.
  • The adrenal glands are damaged by Addison's disease, which does not produce enough cortisol or aldosterone.
  • The most common between the ages of 30 and 50, but can affect people of all ages.
  • It is more common in women than in men.
  • Addison's disease is rare. In developed countries, it affects about 100 to 140 people per million.
  • Secondary adrenal insufficiency is more common, affecting 150-280 people per million.
Addison's disease is rare. It affects 1-6 people per 100,000 people. And it is impossible to remove it from the body, but hormone replacement allows you to manage the disease. Here are 10 Addison disease symptoms to watch out for:

Addison's disease symptoms

Symptoms of Addison's disease usually progress slowly over several months. Often, the disease progresses so slowly that it ignores the symptoms and makes them worse until stress, such as illness or injury, develops. Signs and symptoms include:

1. Extreme fatigue
2. Weight loss and appetite reduction
3. skin darkening (hyperpigmentation)
4. hypotension, even fainting
5. Salt craving
6. Hypoglycemia (hypoglycemia)
7. Nausea, diarrhea or vomiting (gastrointestinal symptoms)
8. Stomach ache
9. Muscle or joint pain
10. Sensitization
11. Depression or other behavioral symptoms
12. Hair loss or sexual dysfunction in women

1. Fatigue

Fatigue is one of the most common symptoms of Addison's disease. It is understandable considering that the adrenal hormones play a role in energy metabolism. This means that if the adrenal glands do not produce a sufficient amount of adrenal hormones, the body cannot produce all the energy necessary for its various functions.

Some body functions may slow down and become inactive as usual. If this continues for some time, it manifests itself as chronic fatigue, lack of energy and fatigue. Adrenal hormones are also involved in the regulation of electrolytes and fluid balance. Factors affecting blood pressure. Without proper adrenal hormone production, sodium-potassium and fluid balance are weakened, resulting in low blood pressure and a feeling of weakness.

2. Nausea, vomiting and diarrhea

Abdominal problems are a common symptom of Addison's disease, which occurs in most patients with the disease. It is not known how adrenal insufficiency causes these abdominal problems. However, this can happen because the adrenal hormones play a role in the digestion and absorption of fats, proteins and carbohydrates.

If this hormone is missing or present in small amounts, there may be a problem with the digestion and absorption of food. In addition, the stomach may not be suitable for food processing, as hormones that stimulate appetite may not function properly. In case of chronic nausea, vomiting, diarrhea or abdominal pain, consider testing Addison disease.

3. Dizziness

Especially if you get dizzy or dizzy when you stand up, this may be a symptom of Addison's disease. Dizziness occurs as a result of hypotension, poor control of electrolytes and fluids in the body. This can cause the body to lose too much fluid, reduce blood volume and ultimately lead to low blood pressure.

Adrenal insufficiency affects energy metabolism, so available energy is not suitable for all body functions, including brain function. The combination of hypotension and hypoglycemia means that the brain is depleted of energy-producing glucose, and as little as necessary does not reach the brain. This interferes with proper and timely brain function, causing dizziness or fainting.

4. Hyperpigmentation

Hyperpigmentation or darkening of the skin can indicate the presence of Addison's disease. Areas of skin that are susceptible to discoloration are those that are exposed to the sun, including the face, forearms, and elbows. Hyperpigmentation can also affect the skin of other parts of the body, such as gums, nails, and labia.

Hyperpigmentation is caused by the overproduction of melanin, a pigmentation that gives skin color and causes pigmentation. Dark skin patches will be noticed by the doctor as the first symptom of Addison's disease.

5. Salt craving

One of the roles of the adrenal hormones, known as aldosterone, is to regulate the body's electrolytes. This electrolyte contains sodium and potassium, which are important for healthy blood pressure. Without the proper aldosterone hormone, more sodium can be excreted in the urine. Excessive loss of sodium can deprive the body of this important electrolyte and cause hypotension in addition to other effects.

Craving for salt is a way of moving your body to replace lost sodium through your urine. If you are craving for salt, do not add more salt to your food. Talk to your doctor and ask for a test to determine if you have enough adrenal glands.

6. Weight loss

In addition to fatigue Addison's disease can lead to weight loss. This can be due to a number of factors. Loss of appetite. The body needs a certain amount of nutrients to function and maintain a healthy weight. If you have more nutrients than your body eats, you may need to balance your tissues.

Low production of cortisol hormones adversely affects the function of leptin and ghrelin hormones, which play a role in stimulating appetite. This means that this hormone does not stimulate the hunger or appetite necessary to eat food. You may eat less than you need. Loss of appetite leads to weight loss.

7. Hair loss

Adrenal insufficiency associated with Addison disease can lead to hair loss. This is most likely to occur in women. Androgen hormones, including DHEA, regulate hair growth. When this hormone is produced in small amounts as a result of adrenal insufficiency, it is insufficient to stimulate normal hair growth.

The reason women are more likely to lose hair from Addison's disease is because the female androgen hormone is produced only by the adrenal glands. In men, Addison's disease will not cause hair loss, because testosterone, another androgen hormone produced in the testes, stimulates hair growth, among other functions.

8. Depression

Several conditions can cause depression, but they can also indicate the presence of Addison's disease. Nevertheless, depression itself can not rely on the symptoms of Addison's disease. However, if it occurs with other symptoms, such as hyperpigmentation, tests should be carried out to determine the level of adrenal hormones, as well as sodium and potassium.

It is not clear how adrenal insufficiency causes depression. However, there is a theory that electrolytic and metabolic problems caused by low adrenal hormone production can lead to brain dysfunction. These dysfunctions can lead to depression due to excessive excitability of neurons and increased response to sensory input.

9. Increased heart rate

A fast heartbeat accompanied by other signs on this list may be a sign of Addison's disease. As mentioned elsewhere, adrenal insufficiency has low blood pressure, among other symptoms. But the body still needs glucose and oxygen to produce the energy needed for many functions.

Low blood pressure means less blood to carry oxygen and glucose. To compensate for this, the heart beats faster and the available blood circulates faster throughout the body. In addition, there may be shortness of breath and extreme tiredness. If you have an increased heart rate in addition to other symptoms, visit your medical facility.

10. Muscle pain and weakness

There are many conditions that can manifest as muscle pain and weakness. But these may also be symptoms of adrenal insufficiency. Muscle symptoms can be chronic or intermittent and affect other muscles of the body, including the shoulders, hips, arms and legs. Symptoms may affect other muscles at different times. In some cases, the muscles are stiff, which makes it difficult to move or use the affected muscles.

If muscle weakness and pain occur along with other signs such as hyperpigmentation, weight loss and fatigue, you will think it is easy to diagnose Addison's disease. However, because Addison's disease is rare and is also a symptom of other diseases, Addison's disease can remain undiagnosed for months or years. If you find some of these symptoms, ask for adrenal sufficientness tests.

When to see a doctor

Consult your doctor if you have general symptoms and symptoms of Addison's disease.

  • Darkening of the skin (hyperpigmentation)
  • Severe fatigue
  • Unintentional weight loss
  • Gastrointestinal problems such as nausea, vomiting and abdominal pain
  • Dizziness or fainting
  • Salt craving
  • Muscle or joint pain

Causes of Addison's Disease

Addison's disease often results in insufficient hormone cortisol and insufficient aldosterone due to damage to the adrenal glands. The adrenal glands are part of the endocrine system. They produce hormones that give instructions to almost every organ and tissue in the body.

The adrenal gland consists of two parts. Internal (medulla) produces adrenaline-like hormones. The outer layer (cortex) produces a group of hormones called corticosteroids. Corticosteroids include:

Glucocorticoids. These hormones, including cortisol, affect the body's ability to turn food into energy, play a role in the inflammatory response of the immune system, and help the body respond to stress.

Mineral corticoids. These hormones, including aldosterone, maintain the body's sodium and potassium balance to keep blood pressure normal.

Androgen. This male sex hormone is produced in small amounts in both the adrenal glands. They provoke sexual development in men and affect muscle mass, libido (sex drive) and the well-being of both men and women.

Adrenal insufficiency

This condition is called primary adrenal insufficiency if the cortex is damaged and insufficient corticosteroids are not produced. This is most commonly the result of the body attacking itself (autoimmune diseases). For unknown reasons, the immune system is considered an outsider that can attack and destroy the adrenal cortex. People with Addison's disease are more likely to have other autoimmune diseases.

Other causes of adrenal insufficiency include:

  • Tuberculosis
  • Other infections of the adrenal glands
  • Cancer spreads to the adrenal glands
  • Bleeding in the adrenal glands. In this case, there may be an Addisonian crisis without previous symptoms.

Secondary adrenal insufficiency

The pituitary gland makes a hormone called corticosteroids (ACTH). ACTH stimulates the adrenal cortex to produce hormones. Pituitary benign tumors, inflammation, and pituitary surgery are common causes of insufficient production of pituitary hormones.

Too little ACTH can cause too little glucocorticoids and androgens that are normally produced by the adrenal glands, even if they are not damaged. This is called adrenal insufficiency. Mineral corticoid production is not affected by too little ACTH.

Most symptoms of secondary adrenal insufficiency are similar to those of primary adrenal insufficiency. However, people with secondary adrenal insufficiency do not have hyperpigmentation and are less likely to have severe dehydration or hypotension. It is likely to be hypoglycemic.

The transient cause of secondary adrenal insufficiency occurs when people taking corticosteroids (for example, prednisone) stop taking corticosteroids at once, rather than diminishing to treat chronic diseases such as asthma or arthritis.

Tertiary adrenal insufficiency

Tertiary adrenal insufficiency begins in the hypothalamus, a small area of ​​the brain near the pituitary gland. The hypothalamus produces corticotropin-releasing hormone (CRH), a hormone that directs the pituitary gland to make ACTH. If the hypothalamus does not produce enough CRH, the pituitary gland does not produce enough ACTH. In turn, the adrenal glands do not make enough cortisol.

Complications related to Addison's disease

Addison crisis

If you have not treated Addison's disease, physical stress, such as injury, infection, or illness, can cause the Addison crisis. In general, the adrenal glands produce two to three times more cortisol in response to physical stress. If adrenal insufficiency prevents stress from increasing cortisol production, a poisoning crisis can occur.

Addisonian crisis is a life-threatening situation that causes hypotension, hypoglycemia and potassium levels in the blood. Immediate treatment is needed.

Addison's disease patients usually Autoimmune diseases.

Addison disease prevention

Addison disease can not be prevented, but there are steps you can take to avoid the Addison crisis.

  • Always consult your doctor if you are tired, weak or lose weight. Ask if you have an adrenal insufficiency.
  • If you are diagnosed with Addison's disease, ask your doctor what to do when you are sick. You may need to learn how to increase your corticosteroid dose.
  • If you are very vomiting, especially if you are vomiting and can not take medicine, go to the emergency room.

Some people with Addison's disease are worried about the serious side effects of hydrocortisone or prednisone. Because you know that it happens in people who take steroids for other reasons.

But if you have Addison disease, the side effects of high dose glucocorticoids should not occur. Because the prescribed dose replaces the missing amount. Follow up regularly with your doctor to make sure you don't have too much.

What to eat if you have adrenal insufficiency

Adrenal Insufficiency and Diet, Diet and Nutrition in Addison's Disease

Some of Addison's patients with low aldosterone levels High Sodium Diet. It is advisable to consult a nutritionist about the best sources of sodium and how much sodium should be taken daily.

High capacity Corticosteroids Are linked to a higher risk osteoporosis – A condition where bones become less dense and prone to fracture.

If you are taking corticosteroids, you may need to protect your bone health by getting enough dietary calcium and vitamin D. Your health care professional or dietitian can tell you how much calcium you need to get by age. You may need to take calcium supplements.

Addison disease treatment

Addison's disease is treated with drugs to replace the missing hormone. You need to take medicine for life.

Treatment can greatly control the symptoms of Addison's disease. Most people with the condition have a normal life span and can live an active life with almost no restrictions.

However, many people with Addison's disease also need to learn to manage their fatigue symptoms, and they may have a medical condition, such as diabetes or hypothyroidism.

Patients with Addison's disease should be constantly aware of the risk of suddenly worsening a condition called an adrenal crisis. This can happen if the body's cortisol levels drop significantly.

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Reference: NIDDK, Wikipedia, NHS

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