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Addison's Disease - Topic Overview

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.

Your body needs both of these hormones to work as it should. Cortisol helps the body cope with extreme physical 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.

Normally, the level of these hormones increases through a chain reaction. First, the hypothalamus in the brain makes a hormone that the pituitary gland needs to make another hormone called ACTH. ACTH then tells the adrenal glands to make cortisol or aldosterone. But with Addison's disease, the adrenal glands can't make enough of the hormones.

If you have Addison's disease, you need to take medicine for the rest of your life to replace the hormones your body can't make. If you don't treat the disease, an adrenal crisis may occur that can lead to death because of a steep drop in blood pressure.

What causes Addison's disease?

Addison's disease can occur:

  • When the body's immune system kills off the part of the adrenal glands that makes cortisol and aldosterone. This is the most common cause.
  • When the adrenal glands are harmed by:
    • Infections, such as tuberculosis, HIV, and other bacterial or fungal infections.
    • 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.
    • Some types of surgery or radiation treatments.
    • The use of certain medicines, such as high doses of ketoconazole.
  • If you take a steroid medicine for a long time and then suddenly stop using it.

People can get Addison's disease at any age.

What are the symptoms?

The most common symptoms are:

  • Extreme tiredness.
  • 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.

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 your body is under extreme stress, such as when 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.

What happens during an adrenal crisis?

During an adrenal crisis, the body can't make enough cortisol to deal with extreme physical stress. This can cause:

  • 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.
  • Trouble staying awake.

Call your doctor right away if you have these symptoms. If an adrenal crisis isn't treated, you could die of shock from a steep drop in blood pressure.

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