Endocrinology Health Guide

Underactive Adrenal Glands / Addison's Disease

F A C T :

Lack of corticosteroids in the blood may cause the pituitary gland to produce more corticotropin hormones to stimulate the adrenal glands. Since corticotrophin affects melanin production, excess levels of corticotropins may cause dark pigmentation of the skin and lining of the mouth.

What is Addison's disease?
Addison's disease is the result of an underactive adrenal gland. An underactive adrenal gland produces insufficient amounts of corticosteroid hormones. Four in every 100,000 people have Addison's disease.

What causes Addison's disease?
Most of the time, the cause of the disease is unknown. About one-third of Addison's disease cases are caused by the actual destruction of the adrenal glands through cancer, infection, or other diseases. Other causes may include:

Use of corticosteroids as a treatment (such as prednisone) causes a slow down in production of natural corticosteroids by the adrenal glands.
Certain drugs used to treat fungal infections may block production of corticosteroids in the adrenal glands.

Results of inadequate corticosteroid production:
Lack of corticosteroids has several health repercussions:

Lack of corticosteroids can cause elevated levels of sodium and retention of potassium. This leads to the inability to produce concentrated urine by the kidneys, which in turn can lead to excessive urination. Ultimately, a patient becomes dehydrated.
Lack of corticosteroids can also lead to extreme sensitivity to the hormone insulin, which normally is present in the bloodstream. This sensitivity may lead to low blood sugar levels.
Lack of corticosteroids means the patient is at increased risk during stressful periods, such as surgery, infection, or injury. Corticosteroids play an important role in helping the body fight infection and promote healing during physical stress.

What are the symptoms of Addison's disease?
Mild Addison's disease symptoms may only be apparent when the patient is under physical stress. The following are the most common symptoms. However, each individual may experience symptoms differently:

weakness
fatigue
dizziness
dark skin
black freckles
bluish-black discoloration around the nipples, mouth, rectum, scrotum, or vagina
weight loss
dehydration
lack of appetite
muscle aches
nausea
vomiting
diarrhea
intolerance to cold

If not treated, Addison's disease may lead to severe abdominal pain, extreme weakness, low blood pressure, kidney failure, and shock -- especially when the patient is experiencing physical stress.

The symptoms of Addison's disease may resemble other conditions or medical problems. Consult a physician for diagnosis.

How is Addison's disease diagnosed?
In addition to a complete medical history and medical examination, diagnostic procedures for Addison's disease may include:

blood tests to measure corticosteroid hormone levels
kidney function tests to determine if urine is concentrated

Treatment of Addison's disease:
The goal of treatment is to restore the adrenal glands to normal function, producing normal levels of corticosteroid hormones. Specific treatment for Addison's disease will be determined by your physician based on:

your overall health and medical history
extent of the disease
your tolerance for specific medications, procedures, or therapies
expectations for the course of the disease
your opinion or preference

Since Addison's disease can be life threatening, treatment often begins with administration of corticosteroids. Corticosteroids, such as prednisone, may be taken orally or intravenously, depending on the patient's condition. Usually the patient has to continue taking the corticosteroid the rest of his/her life. Treatment may also include taking fludrocortisone, a drug that helps restore the body's level of sodium and potassium.

This page was last updated on: May 23, 2006.

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