Do you also feel tired all the time? Has your skin changed color? Could it be Addison's Disease?

Do you also feel unusually tired and exhausted all day long for no reason? Do you feel like you have no energy? Or are you losing weight along with a loss of appetite? Although we often think of these things as normal fatigue, sometimes this can be a symptom of something more serious. That is the condition we are talking about today, Addison's Disease. Don't worry, we will talk about everything in simple terms.

Simply put, what is Addison's Disease?

Imagine that our body is a very complex, amazing factory. In this factory, there are a group of chemical messengers that keep everything balanced and running smoothly. We call them hormones . Just above our kidneys, there are two small glands, we call them the adrenal glands . These two small glands produce several types of hormones that are essential for our lives. So, if for some reason these adrenal glands cannot produce the required amount of hormones, that is what we call Addison's Disease or Primary Adrenal Insufficiency. This is a very rare condition. It affects about one in a million people. But the best thing is that if you are diagnosed correctly and take the treatment prescribed by a doctor, you can live a normal life without any problems.

Let's learn about two of the most important hormones.

There are two main types of hormones that are reduced in the body in Addison's disease. 1. Cortisol: This is also called the 'stress hormone'. This hormone is used to prepare the body to deal with stress, whether mental or physical. In addition, it helps control blood pressure and how the body uses protein, carbohydrates, and fat. 2. Aldosterone: This hormone controls the salt (sodium) and potassium levels in the body through our kidneys. If this is not done properly, the salt levels in the body decrease and blood pressure begins to drop.

What are the symptoms of Addison's disease?

The symptoms of this disease appear gradually, very slowly. Therefore, it sometimes takes time to diagnose the disease. Since many of these symptoms are similar to other diseases, it is very important to see a doctor to make an accurate diagnosis .

What are the causes of Addison's disease?

The main and most common cause of this is an autoimmune disease . Simply put, our body's defense system (immune system) mistakenly attacks and destroys our own adrenal glands. This is the cause of about 70% of cases. In addition, there may be other causes.

• Infections: Tuberculosis ,Severe, long-term infections, such as HIV and some fungal infections, can damage the adrenal glands .
• Cancer: Cancer cells from elsewhere can spread to the adrenal glands (this is very rare).
• Internal bleeding: Bleeding within the adrenal glands.
• Genetic factors: There is also a risk of developing this disease due to some genetic conditions.
• Surgery: Things like surgery to remove the adrenal glands.

How does a doctor diagnose this disease?

When you go to see a doctor, he or she will listen carefully to your symptoms and examine your body, especially looking for any dark discolorations on your skin and gums. Then, they will run several tests to confirm the diagnosis.

• Blood tests: These check the levels of sodium (salt), potassium, and cortisol hormones in the body. In Addison's disease, sodium levels may be low and potassium levels may be high.
• ACTH stimulation test: This is the main test used to diagnose the disease. In this test, a hormone called ACTH, which is released from the brain, is given as an injection, and then the cortisol level in the blood is measured. In a healthy person, cortisol levels are high. However, in a person with Addison's disease, the adrenal glands are not working, so cortisol levels remain low.
• Other tests: Sometimes a CT scan may be done to check for infection, cancer, or bleeding in the adrenal glands.

Treatment and management

Addison's disease is a hormone deficiency in the body, and the treatment is to give the deficient hormones externally. This is something that must be done throughout life.

• Hydrocortisone tablets: These must be taken daily to replace the cortisol hormone.
• Fludrocortisone tablets: These must be taken daily to replace the hormone aldosterone.

If you are under stress, such as an infection, surgery, or an accident, your dose of this medication may need to be increased. Your doctor will inform you about this.

The most dangerous complication: Addisonian Crisis

This is the most serious and life-threatening emergency that can occur in Addison's disease.When the body is under severe stress (e.g., a severe infection, an accident, surgery), the body is unable to cope due to low hormone levels. Symptoms then suddenly become severe. Symptoms of an Addisonian crisis:

• Sudden , severe pain in the back, abdomen, or legs
• Severe vomiting and diarrhea, resulting in dehydration
• Shock caused by a very low blood pressure
• Loss of consciousness
• High fever and weakness

If any of these symptoms occur, it is a medical emergency. The patient should be taken to the nearest hospital's Emergency Treatment Unit (ETU) immediately.