Attacking Addison’s Disease
You feel tired much of the time. You have no appetite and you’re losing weight. And you have some skin discoloration. You could have Addison’s disease.
Addison’s disease is when the adrenal glands stop producing much needed hormones in the body. The adrenal gland is a small gland that rests over each kidney. Its outer shell, the cortex, produces important hormones that enable the body to withstand stress. Without its action, the body could become overwhelmed with an infectious disease. Loss of salt and water is common, along with diarrhea and digestive complaints. In one form of adrenal insufficiency, the skin becomes bronzed from increased pigmentation.
The adrenal cortex is stimulated by a hormone from the pituitary gland under the brain. This hormone, adrenal corticotropic hormone (ACTH) was one of the first hormones used in steroid therapy. If the pituitary gland fails to produce this hormone, chronic adrenal insufficiency occurs. These patients can be treated with prednisone. But if the adrenal cortex itself is diseased, which is more common, then you need steroid hormones that also help to control salt and water as well.
The adrenal glands make hormones without which life could not go on. One such hormone is cortisone. It’s involved with blood sugar regulation and inflammation control. Aldosterone is another important adrenal gland hormone. It maintains normal blood levels of sodium and potassium and plays a large role in maintaining normal blood pressure. The glands also produce adrenaline, the hormone that gears the body to combat life’s daily stresses.
There are three types of hormones produced by the adrenal gland:
§ Glucocorticoids. These are steroid hormones. One type is cortisol, which helps regulate blood sugar and the body’s response to infection or stress.
§ Mineralocorticoids. These help regulate sodium, potassium, blood pressure and blood volume.
§ Androgens. These hormones are needed for normal sexual development and ongoing sexual function. Testosterone is the most well-known androgen.
When the glands go on the fritz, the deficiency zaps your strength. You lose weight and your appetite. Blood pressure falls. Brown discoloration often appears in the hands’ creases, on the elbows and on the knuckles.
Addison’s disease usually results from autoimmunity: an attack on a part of the body by the body’s immune system. This shouldn’t happen. Our immune systems were built to attack invaders such as invading viruses and bacteria. They were not built to attack us. But in autoimmune diseases such as Addison’s disease, something goes wrong.
Addison’s disease also can result from other conditions that damage the adrenal glands. This includes infections of the glands, bleeding into the glands or cancer that has spread to the glands.
This illness is rare. Approximately 1 in 100,000 in the United States have Addison’s disease. The disease affects males and females in equal numbers. Addison’s disease is a lifelong problem that requires continued and careful management.
Diagnosing Addison’s disease can be challenging. It usually involves measuring the blood level of adrenal hormones (such as cortisol) and brain hormones that stimulate the adrenal glands to produce adrenal hormones. CT scanning to check the size of the adrenal glands may be used for diagnosis.
Treatment is not a huge problem. The huge problem is arriving at a diagnosis when the signs and symptoms of Addison’s disease are just beginning to emerge. Supplying the deficient hormones in pill form resolves symptoms for almost all patients. You will have to take the hormones for life. These pills replace the hormones that the adrenal gland isn’t making. For example, doctors may prescribe hydrocortisone or prednisone pills for glucocorticoid replacement. Androgens (such as DHEA or testosterone) may need to be taken as well.
Having a chronic condition like Addison’s disease can be pretty stressful. But luckily it is treatable. If you have any questions regarding this illness, please speak to your health care provider.
