Addison's Disease: What Is It, Symptoms, Causes, and How to Treat It?

The proper functioning of the adrenal glands, which are located on top of the kidneys, is essential for the normal functioning of the human body and for a healthy life.

The adrenal glands are two small glands located in the human body, and they produce two hormones that are crucial for life. When these hormones, cortisol and aldosterone, are not produced in adequate amounts, Addison's disease, a rare condition, can develop. Addison's disease can affect individuals of all ages, but it is most commonly diagnosed in people between the ages of 30 and 50. Research has shown that Addison's disease is more prevalent in women.

What Is Addison's Disease?

Addison's disease is a condition that occurs when the adrenal glands, located on top of the kidneys, are unable to produce enough cortisol and aldosterone hormones. Since hormones control the function of tissues and organs, hormonal imbalances can lead to many diseases and disorders in the human body. The human body produces various hormones to fight diseases, injuries, or stress. Cortisol plays a significant role in helping the body respond to stress. It also helps maintain blood pressure, heart function, immune system, and blood sugar levels. Aldosterone is responsible for balancing sodium and potassium levels in the blood. This helps the kidneys regulate fluid output, which affects blood volume and blood pressure.

Addison's disease is also known as primary adrenal insufficiency. A condition called secondary adrenal insufficiency occurs when the pituitary gland, a small gland at the base of the brain, does not produce enough ACTH hormone to activate the adrenal glands to produce cortisol. In short, this is the answer to the question, "What is Addison's disease?"

What Are the Symptoms of Addison's Disease?

The symptoms of Addison's disease are often a source of curiosity. There are many symptoms that can arise due to Addison's disease, but these symptoms usually don't appear suddenly. Instead, they develop gradually as the glands responsible for the disease start to lose their function. The most common symptoms of Addison's disease include:

• Painful abdominal pain,
• Irregular menstrual cycles in women,
• A strong desire to consume excessive amounts of salt,
• Persistent depression and stress,
• Diarrhea caused by disturbed bowel movement,
• Dizziness or nausea when standing up,
• Loss of appetite due to a loss of body balance,
• Low blood sugar and low blood pressure,
• Muscle weakness over time,
• Sensitivity to cold,
• Unexplained weight loss despite no changes in diet,
• Excessive fatigue.

In certain abnormal conditions (such as injury), symptoms can appear very quickly due to the disease or intense stress. In this case, a serious condition known as adrenal insufficiency or an Addisonian crisis can occur. Emergency intervention is necessary in such cases; otherwise, shock or life-threatening situations may develop. The known symptoms of an Addisonian crisis are:

• Confused mental state, with weakened perception,
• Dehydration,
• Severe weakness,
• Difficulty staying awake or complete loss of consciousness,
• High fever,
• Shortness of breath,
• Severe vomiting and diarrhea,
• Sudden and intense pain in the lower back, abdomen, or legs,
• Constant feeling of fainting.

This situation is very serious, and seeking immediate medical help is essential.

What Causes Addison's Disease?

Addison's disease is caused by an autoimmune disorder, where the body's immune system attacks its own tissues and organs. In people with Addison's disease, the immune system attacks the outer part of the adrenal glands that produce cortisol and aldosterone, leading to the onset of the disease. However, the disease's sole cause is not just the immune system attacking these glands.

Other causes of Addison's disease include:

• Injury to the adrenal glands,
• Infections such as tuberculosis, HIV, AIDS, and fungal infections,
• Tumors in other parts of the body that affect the function of the adrenal glands,
• Bleeding in the adrenal glands,
• Surgical removal of the adrenal glands due to other diseases,
• Abnormal accumulation of proteins in tissues and organs,
• Genetic defects.

The exact cause of Addison's disease can only be determined through a detailed diagnostic process.

How is Addison's Disease Diagnosed?

There are several procedures followed in the diagnosis of Addison's disease. Initially, the patient's medical history is reviewed, and symptoms are assessed through a physical examination. Dark spots on the skin may provide a clue for transitioning to the next stage of testing. To obtain a more accurate result, blood tests are conducted. The purpose of the blood test is to measure the levels of sodium, potassium, cortisol, and ACTH in the blood. The levels of these substances in the blood provide clues to the doctor about the disease. A diagnostic method called the ACTH stimulation test may also be used, where artificial ACTH is injected, and the function of the adrenal glands is tested. If the adrenal glands produce low levels of cortisol after the procedure, it indicates that the glands are not functioning properly. Additionally, X-rays may be used to detect calcium deposits in the adrenal glands.

As a final step, computed tomography (CT) scans may be used. CT scans provide imaging of the body using X-rays. A CT scan can be used to visualize the adrenal glands or the pituitary gland. This allows doctors to assess whether the immune system has caused any damage to the adrenal glands.

What Are the Symptoms That Accompany Addison's Disease?

The symptoms that accompany Addison's disease typically do not appear suddenly. They develop gradually due to the immune system attacking the body. This gradual onset can make diagnosing and treating the disease more difficult. However, individuals who are familiar with their own bodies and take even small changes seriously can facilitate early diagnosis. Irregularities in the menstrual cycle in women can be a sign of many diseases, but it may also occur in conjunction with Addison's disease. Periodic fever and blood pressure irregularities are also common symptoms of Addison's disease. Pain in the lower back and near the kidneys, and the spreading of this pain across the body, are also common symptoms. These symptoms should be taken seriously, and timely examination is crucial for treatment.

How Is Addison's Disease Treated?

To properly answer the question of how Addison's disease can be treated, it is essential to understand the treatment methods. Early diagnosis is key to successful treatment. Therefore, any abnormal conditions in the body should be taken seriously, and medical examination should be sought. The most common treatment method for Addison's disease involves supplementing the deficient hormones from external sources. Medications may be prescribed to support the body in producing cortisol, especially if the body has difficulty producing it. If the cause of the disease is aldosterone deficiency, specific medication will be applied for that. Doctors may also recommend that patients with Addison's disease consume more salt after strenuous physical activities. Increased salt intake may also be necessary in hot and humid weather conditions. Furthermore, patients may need to carry injectable corticosteroids for emergencies. The doctor performing the treatment will provide the necessary instructions regarding the use of these injections.

Individuals with Addison's disease should also avoid stress, as high stress levels can worsen the condition or make treatment ineffective. Therefore, psychological support can also be beneficial.