Addison's Disease | Let's learn about the causes, symptoms and treatment in simple terms

Do you feel increasingly tired and lethargic day by day? Along with stomach pain and nausea, do you sometimes have a strange craving for salty foods? Although these may seem like normal things, perhaps behind this is a condition that we have not heard much about, but which needs to be managed properly. Today we are talking about one such condition, Addison's disease.

What exactly is Addison's Disease?

Simply put, Addison's disease is a chronic condition that occurs when the adrenal glands in our body do not produce enough of two essential hormones, cortisol and aldosterone .

Now you may be wondering what the adrenal glands are. These are two small, triangular glands that sit like a cap on top of our kidneys. They are an important part of our body's endocrine system.

• Cortisol: This hormone is essential to our lives. Imagine when you get sick, have an accident, or undergo surgery, your body feels a lot of stress. At such times, the cortisol hormone helps the body cope with that stress. Not only that, but it also helps control blood pressure, heart function, the immune system, and blood sugar levels.

• Aldosterone: This hormone regulates the balance of sodium (salt) and potassium in our blood. It also controls how much fluid our kidneys excrete as urine. This directly affects our blood volume and blood pressure.

Addison's disease is also known as primary adrenal insufficiency . There is another related condition called secondary adrenal insufficiency . In this condition, the pituitary gland in the brain does not produce enough of a hormone called ACTH . This hormone, ACTH, stimulates the adrenal glands to produce cortisol.

What is the difference between Addison's disease and Cushing's syndrome?

Don't confuse the two. It's very simple.

• Addison's Disease: Insufficient cortisol (and aldosterone) in the body.
• Cushing's Syndrome: Increased cortisol in the body.

Who is most likely to develop this condition?

Although Addison's disease can occur at any age, it is most common between the ages of 30 and 50.Among people. This is a very rare condition.

Also, people with certain autoimmune diseases are at higher risk of developing it. An autoimmune disease is when our body's own immune system mistakenly attacks our own healthy cells. People with the following diseases are at higher risk of developing Addison's disease:

• Type I diabetes
• Pernicious anemia
• Graves' disease
• Chronic thyroiditis
• Dermatitis herpetiformis
• Vitiligo
• Myasthenia gravis

What are the symptoms of Addison's disease?

In this disease, damage to the adrenal glands often occurs slowly, over time. Therefore, symptoms appear gradually. These symptoms can vary from person to person.

If women have this disease, they may also experience symptoms such as irregular menstrual cycles, body hair loss, and decreased sexual desire.

Emergency: What is an Addisonian Crisis?

Sometimes, especially during times of great stress on the body (e.g., a serious illness, an accident), symptoms can suddenly worsen and become life-threatening. This is called an Addisonian crisis , or acute adrenal failure .

If you or someone you know has the following symptoms, take them to the nearest hospital's Emergency Department (ETU) immediately.

What causes Addison's disease?

The main cause of Addison's disease is an autoimmune response . Simply put, our body's own defense system (the immune system) mistakenly attacks our own healthy tissues. In this disease, the immune system attacks the outer part of the adrenal glands (the adrenal cortex). This is where cortisol and aldosterone are produced. Symptoms usually do not appear until about 90% of this damage has occurred. This can take months, or even years. This is the cause of 75% of Addison's patients.

In the past, tuberculosis was a major cause of this, and it is still a major cause in developing countries.

There are other rare reasons:

• Infections such as HIV/AIDS and fungal infections.
• Spread of cancer cells from elsewhere to the adrenal glands.
• Bleeding into the adrenal glands (hemorrhaging).
• Surgical removal of the adrenal glands.
• Diseases such as amyloidosis.

How does a doctor diagnose this disease?

Because the symptoms appear gradually and are common to many other diseases, it can be difficult to accurately diagnose this disease.

Often, a doctor becomes suspicious when a routine blood test shows low sodium levels or high potassium levels in the blood. Dark spots on the skin are another major symptom that makes one suspect this.

If your doctor suspects Addison's disease based on your symptoms, they will order several more tests to confirm the diagnosis.

• Blood tests: These measure the levels of sodium, potassium, cortisol, and ACTH hormones in your blood.
• ACTH stimulation test: This involves injecting a synthetic ACTH hormone and looking at whether your adrenal glands produce cortisol in response. Low cortisol levels may indicate that the glands are underactive.
• Insulin-induced hypoglycemia test: This checks to see if your problem is related to the pituitary gland.
• CT scan: This can check for damage to the adrenal glands or infection.

What are the treatments for this?

Addison's disease is treated by replacing the body's missing hormones with synthetic drugs.

• A drug called hydrocortisone is given instead of cortisol.
• Aldosterone is replaced with a drug called fludrocortisone .

The dosage of this medication varies from person to person. Also, your doctor may increase the dosage of the medication to prevent an Addisonian crisis if you experience stress, such as an infection, accident, or surgery.

If you have Addison's disease, how do you take care of yourself?

If you have this disease, it is very important to take care of yourself.

• Always wear an ID card or medical alert bracelet so that medical professionals can know about your condition in case of an emergency.
• Talk to your doctor about what to do when you are sick or under a lot of stress, as your medication dosage may need to be adjusted at times like these.
• For an emergencyAsk your doctor about keeping a cortisol injection on hand and teaching a family member how to give it to you.

When should you see your doctor?

If you have Addison's disease, you should see your doctor (often an endocrinologist) regularly to make sure your medication dosage is right for you.

If you experience a major stressor, such as an accident, illness, or the death of a loved one, call your doctor because you may need to change the dosage of your medication.

Knowing you have a chronic illness can be emotionally distressing. But the good news is that Addison's disease can be successfully managed with medication. By seeing your doctor regularly, taking the right dose of medication, and taking care of yourself, you can live a healthy, normal life.