The adrenal glands are small organs located above the kidneys. They produce various hormones that perform several functions, such as maintaining blood pressure and blood sugar levels within the normal range. In people with Addison’s disease, adrenal gland function is impaired, resulting in an insufficient production of these hormones. This leads to symptoms that can sometimes become severe and even life-threatening.
The most common symptoms experienced by people with Addison’s disease are:
- Loss of appetite and weight loss
- Feeling of weakness or fatigue
- Nausea and vomiting
- Dark skin coloration (pigmentation), primarily on the face, neck, and the backs of the hands.
- Muscle and joint pain.
- Intense craving for salty foods.
- Feeling of dizziness while standing or sitting.
- Loss of underarm and pubic hair (in women)
Sometimes, a person’s symptoms can become severe and life-threatening. This condition is known as “adrenal crisis” and manifests during periods of heightened stress, such as an infection or an injury. It can also occur if a patient does not take their medication consistently.
Symptoms of an adrenal crisis are:
- Fever and severe weakness
- Nausea, vomiting, and abdominal pain
- Confusion
- Loss of consciousness
DIAGNOSIS
Addison’s disease is diagnosed through a clinical examination and by measuring blood levels of cortisol, a hormone normally produced by the adrenal glands. In individuals with Addison’s disease, the production of this hormone is insufficient.
Sometimes, to accurately diagnose the disease, a specialized test known as the Synacthen stimulation test is required; during this test, a hormone (synthetic ACTH) is administered intravenously, and blood cortisol levels are subsequently measured 30 and 60 minutes after administration.
MANAGEMENT
Addison’s disease is treated with hormone replacement therapy to replace the missing hormones. Patients usually require two different medications, which must be taken daily for the rest of their lives.
In the event of an illness, such as a cold, it is safe to take a double or even triple dose for a few days. If symptoms do not subside or worsen after the first three to four days, contact your doctor immediately.
Your doctor may also prescribe an injectable medication that you should always carry with you for emergencies. If you believe you are experiencing an adrenal crisis, use this medication and then call an ambulance.
In the event that you experience a fainting episode or a serious injury, suffer from persistent vomiting or diarrhea, or are about to undergo surgery, you must immediately inform your doctor.
Women with Addison’s disease can become pregnant. In such cases, close monitoring by your doctor is required. Medication adjustments may be necessary, particularly during the third trimester of pregnancy. The majority of patients with Addison’s disease lead normal lives. As a patient, you must follow your doctor’s instructions. It is important to recognize the symptoms of an adrenal crisis and to carry an emergency injection with you, especially if traveling to areas where access to a hospital is difficult.