Carl R. Darnall Army Medical Center - Health Library

Addison Disease

(Adrenal Insufficiency; Adrenocortical Hypofunction; Chronic Adrenocortical Insufficiency; Hypoadrenalism)

Definition

Addison disease is problem with the adrenal glands. They make hormones that help the body with blood pressure, metabolism, and the immune system.

With Addison disease, the glands do not make enough of a hormone called cortisol. Aldosterone may also be low.

The disease may be:

  • Primary—the glands can’t make hormones
  • Secondary—other hormones that tell glands what to do are missing or low

A severe problem from this disease is the Addisonian or adrenal crisis. It can result in death.

Adrenal Glands
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Causes  ^

Primary Addison disease is caused by problems with the outer layer of the gland. This can happen slowly over time.

Addison disease is most often caused when the immune system attacks the gland. It is not known why this happens.

Damage may also be caused by infections such as:

Less common causes are:

  • Some cancers
  • Amyloidosis—build up of certain proteins in tissue
  • Bleeding within the glands—may happen because of blood thinning drugs or shock
  • Having the glands removed with surgery
  • Genetic problems or birth defects that make it hard for the glands to work the right way
  • Certain medicines

Secondary Addison disease can be caused by damage to the pituitary gland. This gland sends hormones that control the adrenal gland.

This disease may also happen after long term corticosteroids are stopped.

Risk Factors  ^

This disease is more common in women.

These problems may raise your chances:

Symptoms  ^

You may have:

  • Tiredness
  • Loss of hunger
  • Weight loss
  • Nausea and vomiting
  • Muscle and joint pain
  • Dark freckles, nipples, scars, skin creases, gums, mouth, and nail beds
  • Craving salty foods
  • Mental health issues, such as depression
  • In woman:
    • Dry and itchy skin
    • Lack of sex drive

Diagnosis  ^

You will be asked about your symptoms and health history. An exam will be done.

  • Blood tests
  • Urine tests

Pictures may be taken. This can be done with:

Treatment  ^

Addison disease can’t be cured. Medicines can help replace the missing hormones and ease health problems from it. They can also help stop you from having adrenal crisis. You will need care right away if you have this.

Routine blood tests are needed when you are taking the drugs.

Wear an alert bracelet that states that you have this disease. This will let others know of your health problem if you can’t tell them yourself.

Cortisol helps the body deal with physical stress and sickness. Those with Addison disease need to take extra care during:

  • Surgery
  • Pregnancy
  • Severe sickness or trauma

Prevention  ^

There is no way to prevent this disease.

RESOURCES:

Family Doctor—American Academy of Family Physicians
http://familydoctor.org

National Adrenal Diseases Foundation
http://www.nadf.us

CANADIAN RESOURCES:

Health Canada
https://www.canada.ca

The Canadian Addison Society
http://www.Addisonsociety.ca

REFERENCES:

Adrenal insufficiency and Addison's disease. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: http://www.niddk.nih.gov/health-information/health-topics/endocrine/adrenal-insufficiency-Addisons-disease/Pages/fact-sheet.aspx Updated May 2014. Accessed August 16, 2018.

Adrenal insufficiency in adults. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T116703/Adrenal-insufficiency-in-adults. Updated July 24, 2018. Accessed August 16, 2018.

Arlt W, Allolio B. Adrenal insufficiency. Lancet. 2003;361(9372):1881-1893.

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):167-179.

Salvatori R. Adrenal insufficiency. JAMA. 2005;294(19):2481-2488.

Ten S, New M, Maclaren N. Clinical Review 130: Addison's disease. J Clin Endo Metabol. 2001;86(7):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;419(9):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 2018 by EBSCO Medical Review BoardDaniel A. Ostrovsky, MD  Last Updated: 8/15/2018