Addison's disease : worse at times of stress, infection, or injury

Addison's disease is a hormone deficiency caused by damage to the outer layer of the adrenal gland (adrenal cortex). The cortex produces three types of hormones. The adrenal glands are located on top of each kidney. They consist of the outer portion (called the cortex) and the inner portion (called the medulla). The cortex produces three types of hormones: sex hormones, glucocorticoid hormones, and mineralocorticoid hormones.

The sex hormones, androgens (male) and estrogens (female) affect sexual development and reproduction. The glucocorticoid hormones (such as cortisol) maintain glucose (sugar) regulation, suppress the immune response, and help the body respond to stress. The mineralocorticoid hormones (such as aldosterone) regulate sodium and potassium balance.

Addison's disease results from damage to the adrenal cortex, which causes decreased production of adrenocortical hormones. This damage may be caused by the following:

  • The immune system mistakenly attacking the gland (autoimmune disease)
  • Infections such as tuberculosis, HIV, or fungal infections
  • Hemorrhage
  • Tumors
  • Use of blood-thinning drugs (anticoagulants)

The common symptoms of Addison's disease are :

  • Weakness - extreme
  • Fatigue - muscle weakness
  • Unintentional weight loss
  • Nausea
  • Vomiting
  • Chronic diarrhea
  • Loss of appetite
  • Darkening of the skin - skin color, patchy
  • Unnaturally dark color in some locations
  • Paleness may also occur
  • Mouth lesions on the inside of a cheek (buccal mucosa) - pigmentation
  • Slow, sluggish, lethargic movement
  • Changes in the blood pressure or heart rate
  • Salt craving

Replacement therapy with corticosteroids will control the symptoms of the Addison's disease. However, these drugs must usually be continued for life. Usually a combination of glucocorticoids (cortisone or hydrocortisone) and mineralocorticoids (fludrocortisone) are given.

Medication may need to be increased during times of stress, infection, or injury.

Adrenal crisis is an extreme manifestation of symptoms of adrenal insufficiency precipiated by physical stress. Intravenous or intramuscular injection of hydrocortisone must be given immediately to sustain life. Supportive treatment for low blood pressure is usually necessary as well.

Our personal approach to stress relief, to help control the symptoms of the Addison's disease


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