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Addison's Disease

Addison's disease is a rare endocrine disorder which results in the body not producing sufficient amounts of certain adrenal hormones. Your adrenal glands are located just above each of your two kidneys. The adrenal glands are really two endocrine ( ductless or hormone producing ) glands in one. The inner part of the adrenal ( called the medulla ) produces epinephrine ( also called adrenaline ) which is produced at times of stress and helps the body respond to "fight or flight" situations by raising the pulse rate, adjusting blood flow, and raising blood sugar. Cortisol mobilizes nutrients, modifies the body's response to inflammation, stimulates the liver to raise the blood sugar, and also helps to control the amount of water in the body. They include cortisol, aldosterone and supplementary sex hormones. In a person with Addison's disease, only the adrenal cortex is affected. Cortisol production is regulated by another hormone, adrenocorticotrophic hormone (ACTH), made in the pituitary gland which is located just below the brain. This condition is also called primary adrenal insufficiency. Also called adrenal insufficiency or hypocortisolism, Addison's disease can occur at any age, but is most common in people ages 30 to 50. Treatment for Addison's disease involves taking hormones to replace the insufficient amounts being made by your adrenal glands.

Addison's disease (chronic adrenal insufficiency) is a rare and progressive disorder that affects between one and six in every 100,000 people. It occurs in all age groups and afflicts men and women equally. Addison's disease is caused by the inability of the adrenal glands to make sufficient amounts of regulating hormones. The adrenal cortex (the outer part) also produces important hormones, the corticosteroids. Classical Addison's disease results from a loss of both cortisol and aldosterone secretion due to the near total or total destruction of both adrenal glands. These glands form part of the endocrine system, which works with the nervous system and the immune system to help the body cope with different events and stresses. It helps maintain blood pressure and water and salt balance in the body by helping the kidney retain sodium and excrete potassium. When aldosterone production falls too low, the kidneys are not able to regulate salt and water balance, causing blood volume and blood pressure to drop. If ACTH is deficient, there will not be enough cortisol produced, although aldosterone may remain adequate. This is secondary adrenal insufficiency, which is distinctly different, but similar to Addison's disease, since both include a loss of cortisol secretion.

Causes of Addison's Disease

The common Causes of Addison's Disease :

  • The immune system mistakenly attacking the gland (autoimmune disease)
  • Use of blood-thinning drugs (anticoagulants) .
  • Infections such as tuberculosis , HIV, or fungal infections.
  • Invasion of the adrenal glands by cancer cells from another part of the body.
  • Tumors.
  • Chronic infections, such as fungal infections.
  • Hemorrhage, blood loss.
  • The symptoms of Addison's disease are caused by the failure of the adrenal glands, seated above the kidneys , to produce enough of the hormone cortisol and, in some cases, the hormone aldosterone .

Symptoms of Addison's Disease

Some Symptoms of Addison's Disease :

  • Muscle weakness.
  • Depression .
  • Irritability .
  • Chronic fatigue that gradually worsens.
  • Weight loss and loss of appetite .
  • Nausea , diarrhea , or vomiting .
  • Dehydration.
  • Dysphagia (difficulty swallowing) .
  • Polyuria .
  • Increased number of eosinophils.
  • Restlessness .

Treatment of Addison's Disease

  • Medications to replace the hormones cortisol and aldosterone. Hydrocortisone is often used because it can function like both of these hormones. If another medication is used instead of hydrocortisone (such as prednisolone, methylprednisolone, or dexamethasone), you also will need a medication that can function like aldosterone (usually fludrocortisone). You will need a higher dose of medication during childbirth; when you have an injury, surgery, or a serious infection; or during severe stress, such as the death of a loved one.
  • Increasing salt in the diet. Because people with adrenal failure tend to lose sodium , you will need extra salt (sodium chloride) in your diet, especially during hot and humid weather and vigorous exercise. However, because people with Addison's disease retain potassium , you need to avoid salt substitutes, which usually contain potassium chloride salts.
  • Regular medical checkups to monitor symptoms and blood pressure. Your health professional also may need to do lab tests to evaluate and monitor blood levels of potassium, sodium, and cortisol.

 

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