What is Addison's disease?

Addison's disease develops when the adrenal glands, which are above the kidneys, are not able to make enough of the hormones cortisol and, sometimes, aldosterone.

Cortisol affects almost every organ in the body and is needed for your body to work as it should. The adrenal glands release cortisol to help the body cope with stress from illness, injury, surgery, childbirth, or other reasons. Aldosterone helps the body hold on to the salt it needs, and it keeps your blood pressure steady.

The brain’s hypothalamus and the pituitary gland control the adrenal glands, which in turn make cortisol. The hypothalamus tells the pituitary gland to make a hormone called adrenocorticotropic hormone (ACTH). This hormone tells the adrenal glands to make cortisol. When your adrenal gland cannot make enough cortisol, you have Addison’s disease.

What causes Addison's disease?

Addison's disease most often occurs when the body's immune system kills off the part of the adrenal glands that makes cortisol and aldosterone. It can also form when the adrenal glands are harmed by:

• Cancer that has spread to the adrenal glands. This is mostly seen in lung cancer.
• Bleeding into the adrenal glands as a side effect of using blood thinners.
• Infections, such as tuberculosis, HIV, and some bacterial infections.
• Some types of surgery or radiation treatments.
• The use of certain medicines, such as high doses of ketoconazole.
• Injury to the adrenal glands in the late stages of pregnancy or during childbirth, but this is rare.

People can get Addison's disease at any age. When it is caused by the immune system killing off the adrenal gland, the disease is more common in women, but men are more likely to have Addison’s disease caused by tuberculosis. ¹ Addison’s disease can also form if you take a steroid medicine for a long time and then suddenly stop using it.

What are the symptoms?

The most common symptoms are:

• Extreme tiredness ( fatigue).
• Weakness.
• Losing weight without trying.

You may also have other symptoms, such as:

• Skin that looks darker than normal.
• Loss of appetite.
• Diarrhea.
• Feeling lightheaded.
• Feeling sick to your stomach or vomiting.
• Craving salt.

And if you have diabetes, you may have low blood sugar more often, and it may be more severe than usual.

Symptoms usually start slowly. You may not even notice them until a stressful event such as a severe infection, trauma, surgery, or dehydration causes an adrenal crisis. An adrenal crisis means that your body can't make enough cortisol to cope with the stress.

In a few cases, Addison's disease gets worse quickly. These people may already be in an adrenal crisis when they see a doctor.

Symptoms of an adrenal crisis include:

• Severe vomiting and diarrhea.
• Sudden pain in the belly, low back, or legs.
• A high fever.
• Feeling very weak or lightheaded.
• Feeling restless, confused, or fearful.
• Having trouble staying awake.