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- What is Addison’s Disease?
- Diagnosis of Addison’s Disease
- What Causes Addison’s Disease?
- Help for Addison’s Disease
- More Infomation on Addison’s Disease
What is Addison’s Disease?
Many people ask themselves "What is Addison's disease?" Addison's disease is a rare endocrine disorder characterized by a severe deficiency of hormones produced in the adrenal cortex.
Addison's affects between 1 and 4 in 100,000 people, including both men and women, and all age groups. The disease tends to become clinically apparent during periods of metabolic stress or trauma.
Major disruption and illness can occur if the adrenal glands do not function properly. Cortisol is a glucocorticoid hormone that plays a vital role in the body. It mobilizes nutrients, regulates the metabolism of proteins, fats and carbohydrates, stimulates the liver to raise blood sugar levels, acts as an anti-inflammatory agent and helps the body respond to stress.
Addison's Disease can have a severe effect on all of these bodily systems.
Diagnosis of Addison’s Disease
The diagnosis of Addison’s disease is based on the patient’s medical history, physical symptoms such as hyperpigmentation of the skin or gums, and a series of routine tests.
Symptoms of Addison’s Disease
- Abdominal pain
- Weight loss
- Muscle weakness
- Lightheadedness and dizziness when standing
As the disease progresses:
- The skin appears more tanned with a darkening of the lining of the mouth, vagina (in women), rectum and the area around the nipples (areola).
- Dehydration worsens
- Blood pressure drops
- Increased weakness and lightheadedness
- Depression and irritability
- Women stop having their periods
Often the symptoms of Addison’s disease are overlooked until an individual becomes ill with an acute infection, is involved in an accident or requires surgery causing the disease to advance quickly and become extremely critical. When Addison’s reaches this stage, it is referred to as an Addisonian crisis and symptoms are characterized by:
- Abnormal heart rhythms
- Severe pain in the back and abdomen
- Uncontrollable nausea and vomiting
- Extreme drop in blood pressure and peripheral vascular shut down.
- Kidney failure
Basic Tests used to Diagnose Addison’s Disease
- Blood Tests - The blood levels of potassium and sodium, and the ratio of certain white blood cells are determined through blood tests.
- Biochemical Tests - These tests measure cortisol and aldosterone levels in the blood and urine. Synthetic injections of ACTH (short synacthen test and long synacthen test) are administered to indicate the amount of cortisol in the body and the adrenal glands’ response to stimulation.
- X-ray - A chest X-ray will help to determine changes caused by low blood volume or high potassium.
- Ultrasound and CAT Scans - These tests will be able to check the size of and any damage done to the adrenal glands.
- Blood Electrolyte and Plasma Renin Tests - These tests will determine if mineralocorticoid replacement is required.
- Anti-adrenal Antibody Tests - If this test result is positive, Primary Adrenocortical Insufficiency may diagnosed.
Consult an endocrinologist (a specialist in endocrine or hormonal diseases) for the diagnosis and treatment of Addison’s disease
What Causes Addison’s Disease?
Approximately 70% of cases of Addison’s disease are as a result of an auto-immune process. The body’s immune system produces antibodies against the cells of the adrenal cortex, and slowly destroys the healthy cells. This is a slow process evolving over a long period and can take months, even years, to become clinically apparent.
Other Factors in the Development of Addison's Disease
There are several other factors that can cause damage to or destruction of the adrenal glands. They include:
- Chronic infections such as systemic fungal infections
- Invasion of the adrenal glands by cancer cells that have spread from another part of the body, especially the breast
- CMV virus in association with AIDS
- Hemorrhage into the adrenals during shock
- Surgical removal of both adrenals
- Rare hereditary conditions such as Amyloidosis (protein deposits) or Adrenoleukodystrophy (a neurological disorder)
Help for Addison’s Disease
Addison’s disease is a chronic condition and life-long steroid replacement therapy is required. The primary objective of treatment for Addison’s disease is to replace the lack of cortisol and aldosterone.
Treatment for Addison's disease include medications which are adjusted to suit the needs of each individual and co-existing medical conditions are taken into consideration-
- Cortisol is replaced orally with hydrocortisone or cortisone acetate tablets taken once or twice a day.
- Aldosterone is replaced orally with a mineralocorticoid called fludrocortisone acetate (Florinef) tablets taken once a day. It is usually recommended that patients receiving aldosterone replacement therapy should increase their salt intake.
- Hydrocortisone, saline (salt water) and dextrose (sugar) are administered intravenously during emergencies like an Addisonian crisis or surgery.
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More Information on Addison’s Disease
Tips for Coping with Addison’s Disease
People suffering from Addison’s disease can live a productive life but there are certain measures that can be taken to ensure that they cope better. These preventative measures include:
- Administer medication daily according to the dosage and directions
- Carry a medical identification card or bracelet which will be able to inform medical personnel of your condition and the type of treatment you may need should you be involved in an accident or become acutely ill.
- Treat minor illnesses with extra salt and fluid
- If you experience fever, vomiting and diarrhea, you need to seek emergency treatment - intravenous saline and hydrocortisone is commonly administered
- Increase the intake of salt in your diet
- Monitor your weight regularly if you have been vomiting frequently and your appetite has been poor
- Monitor your blood pressure regularly because high blood pressure may indicate that your medication needs to be adjusted. If you are feeling lightheaded, your blood pressure may be low
- Maintain an open, honest relationship with your doctor where you can freely discuss your symptoms and learn to adjust your medication dosage during times of stress
- Join a support group where you can gain information and support from others who have the same condition