(Adrenal Insufficiency; Adrenocortical Hypofunction; Chronic Adrenocortical Insufficiency; Hypoadrenalism)En Español (Spanish Version)
| Risk Factors
Addison's disease is a rare disorder of the adrenal glands. With Addison's, the adrenal glands do not produce enough of the hormones cortisol and aldosterone.
Addison's occurs because of damage to the cortex.
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Addison's disease is the result of gradual damage to the outer layer of the adrenal gland.
This damage may be caused by:
- The body's own immune system attacking the gland—known as an autoimmune disease.
Bleeding within the adrenal glands—related to the use of anticoagulant medications and
- Surgical complication
- Conditions that are present at birth or due to genetic factors such as enzyme defects and familial glucocorticoid insufficiency
- Cytomegalovirus (CMV)
Fungal infections, including:
Cancer including metastases from:
- Medications such as
Chronic illness, including:
Factors that increase your chance of getting Addison's disease include:
Having the following autoimmune diseases:
- Anticoagulant medications
- Abdominal injury
- Family members with autoimmune-caused Addison's disease
Long-term steroid medication treatment, followed by:
- Severe stress
- Previous surgery on adrenal glands
- Hereditary disorders, such as Prader-Willi syndrome and congenital adrenal hyperplasia
Symptoms may include:
- Extreme weakness, fatigue
- Weight loss
- Nausea or vomiting
- Muscle weakness
- Darkening of freckles, nipples, scars, skin creases, gums, mouth, nail beds, and vaginal lining
Emotional changes, especially
- Cognitive impairment or confusion
- Craving salty foods
- Abdominal pain
A severe complication of Addison's disease is the Addisonian or
adrenal crisis. Adrenal crisis is a life threatening disorder, its symptoms include:
- Severe abdominal, back, or leg pain
- Severe low blood pressure
- Severe dehydration
- Severe nausea, vomiting, and diarrhea
- Low blood sugar
- Generalized muscle weakness
The doctor will ask about your symptoms and medical history. A physical exam will be done.
Your bodily fluids may be tested. This can be done with:
- Blood tests
- Urine tests
- ACTH stimulation test
Your doctor may also need images of your bodily structures.
This can be done with:
Symptoms of Addison's disease can be controlled with medications. These drugs replace the missing hormones. Medication needs to be taken for the rest of your life. They may need to be increased during times of stress.
Immediate treatment of adrenal crisis includes:
- Self-injection of dexamethasone
- Hydrocortisone by IV
- Normal saline by IV
Surgery may also be needed for adrenal tumors or brain tumors causing the disease.
Regular blood tests are needed to monitor your response to medicine. Wear a medical alert bracelet that states adrenal insufficiency or Addison's disease. This will let others know of your condition if you are unable to communicate.
There are no guidelines for preventing Addison's disease. If you think you are at risk, talk to your doctor.
Addison's disease. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at:
http://www.niddk.nih.gov/health/endo/pubs/addison/addison.htm. Updated April 6, 2012. Accessed June 25, 2013.
Adrenocortical insufficiency. EBSCO DynaMed website. Available at:
http://www.ebscohost.com/dynamed/what.php. Updated May 29, 2013. Accessed June 25, 2013.
Arlt W, Allolio B. Adrenal insufficiency.
Dorin RI, Qualls CR, Crapo LM. Diagnosis of adrenal insufficiency.
Ann Int Med. 2003;138:3:194-214.
Hahner S, Allolio B. Therapeutic management of adrenal insufficiency.
Best Pract Res Clin Endocrinol Metab. 2009;23(2):167-79.
Salvatori R. Adrenal insufficiency.
Ten S, New M, Maclaren N. Clinical Review 130: Addison's disease.
J Clin Endo Metabol. 2001;86:2909-2922.
Thomas Z, Fraser GL. An update on the diagnosis of adrenal insufficiency and the use of corticotherapy in critical illness.
Ann Pharmather. 2007;41:1456-65.
Wallace I, Cunningham S, Lindsay J. The diagnosis and investigation of adrenal insufficiency in adults.
Ann Clin Biochem. 2009;46(Pt 5):351-367.
Last reviewed June 2013 by Kim Carmichael, MD; Michael Woods, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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