Addison disease is a disorder of the adrenal glands. The adrenal glands sit on top of the kidneys and make important hormones. Hormones affect systems throughout the body including blood pressure, metabolism, and the immune system.
With Addison disease, the adrenal glands do not make enough of certain hormones. The hormone cortisol is always affected but aldosterone may be low as well. Addison disease may be:
A severe complication of Addison's disease is the Addisonian or adrenal crisis. This is a life threatening crisis.
Primary Addison disease is caused by damage to the outer layer of the adrenal gland. This damage can happen slowly overtime for a number of reasons.
Addison disease is most often caused by an autoimmune disease when the immune system begins to attack healthy tissue. In this case, it attacks tissue of the adrenal gland. The cause of autoimmune diseases is unclear.
Damage may also be caused by infections such as:
Less common causes include:
Secondary Addison disease can be caused by damage to the pituitary gland. The pituitary gland sends hormones that control the adrenal gland. If the pituitary gland is damaged it will affect the adrenal glands.
Adrenal insufficiency may also occur after long term corticosteroids are stopped.
Factors that may increase your chance of Addison's disease include:
Symptoms of Addison disease may include:
Symptoms of an adrenal crisis include:
You will be asked about your symptoms and medical history. A physical exam will be done. If a problem with hormones is suspected your doctor may order:
Imaging tests may be needed to look at the adrenal glands. Tests may include:
Addison disease cannot be cured but can be managed with medication. These medications replace the missing hormones to decrease symptoms. They can also help prevent an adrenal crisis. An adrenal crisis will need immediate medical attention to try to balance the hormones again.
Regular blood tests are needed to monitor your response to medication. Wear a medical alert bracelet that states adrenal insufficiency or Addison disease. This will let others know of your condition if you are unable to communicate.
Cortisol helps the body deal with stress. Those with Addison disease need to take extra care during times of stress. Extra treatment may be needed during physical stress or recovery such as:
Family Doctor—American Academy of Family Physicians
National Adrenal Diseases Foundation
The Canadian Addison Society
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 14, 2014. Accessed June 4, 2014.
Adrenal insufficiency in adults. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T116703/Adrenal-insufficiency-in-adults. Updated December 29, 2015. Accessed September 30, 2016.
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Last reviewed November 2017 by Kim Carmichael, 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.