Treatments and Complications of Addison’s Disease | Endocrinology

Addison's Disease

What is Addison’s disease?

Addison’s disease is an illness in which the adrenal glands – which sit on top of the kidneys – do not produce enough of the hormones cortisol and aldosterone. (Hormones are chemicals that control the function of tissues or organs.)

Cortisol reliefs the body respond to stress, including the stress of illness, injury, or surgery. It also helps maintain blood pressure, heart function, the immune system, and blood glucose (sugar) levels. Aldosterone moves the balance of sodium and potassium in the blood. This in turn reins the amount of watery the kidneys remove as urine, which affects blood volume and blood pressure.

Addison’s disease is also called “primary adrenal insufficiency.” A related illness, “secondary adrenal insufficiency,” occurs when the pituitary, a small gland at the base of the brain, does not conceal enough adrenocorticotropic hormone (ACTH), which activates the adrenal glands to produce cortisol.

Addison’s disease causes

Most cases of Addison’s illness result from a problem with the adrenal glands themselves (primary adrenal insufficiency). The autoimmune disease accounts for 70% of Addison’s disease. This happens when the body’s immune system mistakenly attacks the adrenal glands. This autoimmune assault ends the outer layer of the glands.

Long-lasting infections — such as tuberculosis, HIV, and some fungal infections — can damage the adrenal glands. Cancer cells that extend from other parts of the body to the adrenal glands also can cause Addison’s disease. Although rare, the adrenal glands can be injured as a result of a bacterial infection.

Less commonly, adrenal glands can be unnatural by “secondary adrenal insufficiency,” which is caused by a difficulty with the pituitary gland or a problem with the hypothalamus, both located in the center of the brain. These glands produce hormones that act as a change and can turn on or off the production of hormones in the rest of the body. A pituitary hormone called ACTH is the switch that turns on cortisol manufacture in the adrenal gland. If ACTH levels are too low, the adrenal glands stay in the off position.

Another cause of secondary adrenal insufficiency is the prolonged or incorrect use of steroid hormones such as prednisone. Less common causes include pituitary tumors and harm to the pituitary gland during surgery or radiation.

Symptoms of Addison’s disease

Addison’s disease symptoms typically develop slowly, often over several months. Repeatedly, the disease progresses so slowly that symptoms are ignored until stress, such as illness or injury, occurs and makes symptoms worse. Signs and symptoms may include:

  • Extreme fatigue
  • Weight loss and decreased appetite
  • Darkening of your skin (hyperpigmentation)
  • Low blood pressure, even fainting
  • Salt craving
  • Low blood sugar (hypoglycemia)
  • Nausea, diarrhea, or vomiting (gastrointestinal symptoms)
  • Abdominal pain
  • Muscle or joint pains
  • Irritability
  • Depression or other behavioural symptoms
  • Body hair harm or sexual dysfunction in women

Acute adrenal failure (Addisonian crisis)

Occasionally the signs and symptoms of Addison’s disease may aspect suddenly. Acute adrenal failure (Addisonian crisis) can main to life-threatening shock. Seek extra medical treatment if you experience the following signs and symptoms:

  • Severe weakness
  • Confusion
  • Pain in your lower back or legs
  • Severe abdominal pain, vomiting, and diarrhea, important to dehydration
  • Reduced consciousness or delirium

In an Addisonian crisis you will also have:

  • Low blood pressure
  • High potassium (hyperkalemia) and low sodium (hyponatremia)


Addisonian crisis

If you have unprocessed Addison’s disease, you may develop an Addisonian crisis as a result of physical stress, such as an injury, infection, or illness. Generally, the adrenal glands produce two to three times the usual amount of cortisol in response to physical stress. With an adrenal deficiency, the inability to increase cortisol production with stress can lead to an Addisonian crisis.

An Addisonian crisis is a serious situation that results in low blood pressure, low blood levels of sugar, and high blood levels of potassium. You will essential immediate medical care. People with Addison’s disease usually have associated autoimmune diseases.

Prevention of Addison’s disease

Addison’s disease can’t be prohibited, but there are steps you can take to avoid an Addisonian crisis:

  • Talk to your doctor if you always feel tired, weak, or are losing weight. Ask about having an adrenal shortage.
  • If you have been diagnosed with Addison’s disease, ask your doctor about what to do when you’re sick. You may need to learn how to grow your dose of corticosteroids.
  • If you become very sick, especially if you are vomiting and you can’t take your medication, go to the emergency room.

Some people with Addison’s disease concern about serious side effects from hydrocortisone or prednisone because they know these occur in people who take these steroids for other reasons.

However, if you have Addison’s disease, the adverse effects of high-dose glucocorticoids should not occur, since the dose you are agreed is replacing the amount that is missing. Make sure to track up with your doctor regularly to make sure your dose is not too high.

Addison’s disease treatment

Your treatment will rest on what’s causing your condition. Your doctor may recommend medications that regulate your adrenal glands. Following the treatment idea that your physician creates for you is very important. Raw Addison’s disease can lead to an Addisonian crisis.

If your circumstance has gone untreated for too long and has developed to a life-threatening condition called Addisonian crisis, your physician may prescribe medication to treat that first. Addisonian crisis reasons low blood heaviness, high potassium in the blood, and low blood sugar levels.

  • Medications: You may need to take a grouping of glucocorticoid medications (drugs that stop inflammation) to improve your health. These medicines will be taken for the rest of your life and you cannot miss a dose. Hormone replacements may be arranged to replace hormones that your adrenal glands are not created.
  • Home care: Keep an emergency kit that contains your medications on hand at all times. Ask your doctor to write a medicine for an injectable corticosteroid for emergencies. You may also want to keep a medical alert card in your wallet and a bracelet on your wrist to let others know about your disorder.
  • Alternative therapies: It’s important to keep your stress equal down if you Addison’s disease. Major life events, such as the death of a loved one or an injury, can raise your stress level and affect the way you re-join your medications. Talk to your doctor about alternative methods to relieve stress, such as yoga and meditation.

Addison’s disease diagnosis

To regulate if you have Addison’s disease, your doctor might use the following:

  • History and physical: Your physician will review your symptoms and perform a physical exam. Dark coverings on your skin might be a clue for your doctor to consider testing for Addison’s disease.
  • Blood tests: These will be done to quantify the levels of sodium, potassium, cortisol, and ACTH in your blood.
  • ACTH stimulation test: This tests the adrenal glands’ rejoinder after you are given a shot of artificial ACTH. If the adrenal glands produce low levels of cortisol after the shot, they may not be operative properly.
  • X-rays: These may be done to look for calcium bonds on the adrenal glands.
  • Computed tomography (CT scan): Computed tomography uses computers to chain many X-ray images into cross-sectional views. A CT scan might be done to appraise the adrenals and/or pituitary gland. For example, it can show if the immune system has broken the adrenal glands or if the glands are infected.
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