Addison's Disease

Addison’s disease or adrenal insufficiency is a rare disorder in which the adrenal glands are unable to produce adequate amounts of steroid hormones; cortisol and aldosterone.

Cortisol regulates the body’s response to stress, while aldosterone plays an important role in regulating the salt content of the body. This life-threatening situation can occur in both sexes, and in all age groups.

Continuous treatment with steroid replacement is needed to control the symptoms.

Early and appropriate treatment of the condition is very important.

Addison’s disease is caused by the inadequate production of steroid hormones.

The hormones cortisol and aldosterone play an important role in regulating many functions of the body.

Primary insufficiency – In this condition, the adrenal cortex is damaged and this results in low production of adrenal gland hormones.

Autoimmune diseases in which the immune system attacks the body’s own cells are the most common causes of primary adrenal insufficiency.

It may also be caused by:

• Tuberculosis
• Infections of the adrenal glands
• Adrenal cancer
• Bleeding into adrenal glands

Secondary insufficiency – this form of adrenal insufficiency is caused by damage to the pituitary gland or hypothalamus. These organs produce hormones that regulate the functioning of adrenal glands.

Pituitary glands produce the adrenocorticotropic hormone (ACTH) that stimulates the adrenal glands to produce steroid hormones. Reduced production of ACTH leads to inadequate amounts of cortisol and aldosterone.

Secondary insufficiency may also result from abrupt cessation of corticosteroid drugs, often prescribed for conditions like asthma and arthritis.

Addison’s disease is diagnosed based on medical history and physical symptoms. Some of the tests used in confirming the disorder are:

• Blood tests – levels of sodium, potassium, and cortisol in the blood indicate adrenal insufficiency. Addison’s disease is characterized by low levels of sodium and cortisol. Potassium levels remain high. Levels of antibodies are also measured to confirm the disease.
• ACTH test – levels of cortisol in the blood are measured before and after administering ACTH. ACTH stimulates adrenal glands to produce cortisol. If adrenal glands are damaged, cortisol levels remain low in blood. This helps to differentiate between primary and secondary adrenal insufficiency.
• Insulin-induced hypoglycemia test – levels of blood glucose and hormone cortisol are measured at intervals after introducing insulin. Blood glucose levels fall while cortisol levels increase in a healthy individual.
• Imaging techniques – images help to assess size, damage, and other abnormalities in the adrenal glands. If the condition is caused by secondary insufficiency, images of pituitary glands help in diagnosis.

Treatment is based on the actual cause of Addison's disease.

As levels of cortisol and aldosterone are low, hormone replacement therapy is essential. Oral corticosteroids are given to replace cortisol, while fludrocortisone is used to improve levels of aldosterone.

Corticosteroids may also be given in the form of injections, if vomiting increases. The dosage is increased in case of injury, infection, or stress.

Medications are given to control low blood pressure. Sodium supplementation is given for persistent diarrhea and heavy physical exercise.

Addison’s crisis is characterized by low blood pressure, low blood sugar, and high levels of potassium which are treated with injections of hydrocortisone, sugar, and saline.

Limiting the major risk factors of the disease is the best way to prevent Addison’s disease.

Patients should try to control diabetes, fungal infections, treat the spreading of cancer, treat tuberculosis, and control autoimmune diseases for preventing adrenal insufficiency.

There are seeral alternative and homeopathic remedies used for Addison's disease

Arsenic, belladonna, Calcarea carb, Iodine, Phos, and tuberculin are used to arrest the progress of the disease in homeopathy.

These medicines help to improve body functions and alleviate symptoms of this disorder.

Herbal formulas containing Ashwagandha, Eleutherococcus, and Schizandra are used as natural remedies for controlling the disease, but the efficacy of this treatment method is yet to be proven.

Dietary supplements such vitamin C, thiamin, vitamin B6, L-carnitine, and licorice are also beneficial.

There are different ways to adapt your lifestyle in coping with 

Medications for adrenal insufficiency should be handy at all times.

Patients should carry a medical alert card regarding the disease with them. This will help during emergencies.

Also, try to relieve stress through relaxations techniques.

The most risky complication of Addison’s disease that can occur is Addison’s crisis.

It can cause stroke, cardiac arrest, shock and hypoxia.

The disorder may also lead to salt loss, irritability, depression, and amenorrhea.