Addison's disease is a disorder that occurs when the adrenal glands do not produce enough of their hormones.
The adrenal glands are small hormone-releasing organs located on top of each kidney. They are made up of the outer portion (called the cortex) and the inner portion (called the medulla).
The cortex produces three types of hormones:
Addison's disease results from damage to the adrenal cortex. The damage causes the cortex to produce less of its hormones.
This damage may be caused by the following:
Risk factors for the autoimmune type of Addison's disease include other autoimmune diseases:
Certain genetic defects may cause these conditions.
Tests may show:
Other tests may include:
This disease may also change the results of the following tests:
Treatment with replacement corticosteroids will control the symptoms of this disease. However, you will usually need to take these drugs for life. People often receive a combination of glucocorticoids (cortisone or hydrocortisone) and mineralocorticoids (fludrocortisone).
Never skip doses of your medication for this condition, because life-threatening reactions may occur.
The health care provider may increase the medication dose because of:
During an extreme form of adrenal insufficiency, called adrenal crisis, you must inject hydrocortisone immediately. Supportive treatment for low blood pressure is usually needed as well.
Some people with Addison's disease are taught to give themselves an emergency injection of hydrocortisone during stressful situations. It is important for you to always carry a medical identification card that states the type of medication and the proper dose you need in case of an emergency. Your health care provider may also tell you to always wear a Medic-Alert tag (such as a bracelet) alerting health care professionals that you have this condition in case of emergency.
With hormone replacement therapy, most people with Addison's disease are able to lead normal lives.
Complications can occur if you take too little or too much adrenal hormone supplement.
Complications also may result from the following related illnesses:
Call your health care provider if:
If you have symptoms of adrenal crisis, give yourself an emergency injection of your prescribed medication. If it is not available, go to the nearest emergency room or call 911.
Symptoms of adrenal crisis include:
Adrenocortical hypofunction; Chronic adrenocortical insufficiency; Primary adrenal insufficiency
Stewart PM, Krone NP. The adrenal cortex. In: Kronenberg H, Melmed S, Polonsky K, Larsen PR, eds. Williams Textbook of Endocrinology. 12th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 15.
Updated by: Nancy J. Rennert, MD, Chief of Endocrinology & Diabetes, Norwalk Hospital, Associate Clinical Professor of Medicine, Yale University School of Medicine, New Haven, CT. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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