Thomas Addison was the researcher who first identified the disease that now bears his name. He was working at Guy’s Hospital in London when he began examining the symptoms, which were believed to be a result of tuberculosis at the time. He realized that he was dealing with something that was unique and not merely a symptom of the other disease.
While Addison’s is a side effect of tuberculosis, particularly in Third World countries, AIDS is now fast coming up as the most frequent cause of the disease, particularly in less affluent nations.
In the United States, the frequency of Addison’s is blamed on what’s called “destructive atrophy,” in which the immune system begins to attack vital organs like the adrenal glands. This accounts for approximately 70 percent of all cases and affects men and women equally.
The Effects of Addison's Disease
Autoimmune diseases are still somewhat unknown territory for researchers, so there is currently no known cause for Addison’s Disease. Researchers believe it can manifest if the adrenal glands are injured or infected, bleeding, sustain an abnormal buildup of proteins, and potentially by invasion of cancer cells that have migrated from elsewhere in the body. Genetics play a role as well.
Although we can’t be certain of the cause, we do understand how Addison's Disease affects the body. The hormone cortisol is a stress management tool, helping the body respond when injured, stressed or undergoing surgery. It maintains blood pressure, the immune system, heart strength and blood sugar levels. Aldosterone helps to balance sodium and potassium in the blood. Those minerals control the kidneys' removal of waste as urine, which in turn can affect blood pressure and volume. Addison’s works against the outer portion of the adrenal glands (known as the cortex), which is where cortisol and aldosterone are made.
A secondary disorder related to Addison's occurs when the pituitary gland is attacked. That gland, located at the base of the brain, starts to lessen production of adrenocorticotropic hormone (ACTH), which works with the adrenal glands in the production of cortisol.
Addison's Disease Symptoms
Because the adrenal glands play such a vital role in the body, a long list of symptoms can be present and related to Addison’s Disease. These include abnormal menstrual periods, cravings for salty foods, abdominal pain, depression, dehydration, diarrhea, irritability, loss of appetite and unexplained weight loss, dizziness, lightheadedness when standing, low blood sugar, muscle weakness, low blood pressure, nausea, sensitivity to cold, vomiting, and extreme fatigue.
The tell-tale sign of Addison’s seems to be patches of dark skin, usually located around joints, skin folds and scars. Unfortunately, Addison’s Disease is usually not diagnosed until its late stages, and much of the adrenal cortexes are destroyed.
Because Addison’s Disease can be caused by unexpected events like injury, its symptoms can arrive quickly and without much warning. This results in what’s known as an Addisonian crisis, also known as acute adrenal insufficiency. If not recognized and quickly treated, this crisis can be fatal.
The symptoms of the crisis version of Addison’s Disease include dehydration, extreme fatigue, mental changes like confusion or extreme anxiety, total loss of consciousness or sleeplessness, lightheadedness, high fever, vomiting, paleness, diarrhea, and excruciating pain in the lower back, legs or stomach areas.
A doctor will diagnose Addison’s Disease with a physical exam; a blood test to determine current levels of cortisol and other hormones, as well as potassium, sodium and other minerals; a test whereby the adrenal glands are given a shot of ACTH hormone to see how much cortisol they can produce after the stimulation; X-rays to determine whether calcium deposits on the glands are present and affecting production; and a CT scan to examine the glands and determine the presence of any infection or damage to the adrenal glands.
After these tests, doctors then will be able to determine the best course of treatment, which is usually medication and watchfulness on the part of the patient in conjunction with a medical professional.
Treatments for Addison’s Disease
Fortunately, treatments can restore sufferers to good health and normal lives, but Addison’s Disease is a lifelong issue that needs constant monitoring.
Hydrocortisone pills may be prescribed to replace the missing cortisol no longer produced by glands. Fludrocortisone acetate may be needed in the event of an aldosterone deficiency. In a rare move, the doctor may request that you ingest more salt, particularly if you live in a hot and humid climate or exercise frequently.
The burden of Addison’s Disease is lifelong vigilance. Sufferers should carry medical emergency cards and perhaps wear another form of medical identification, such as a bracelet to help people quickly identify the condition should a crisis strike.
Sufferers also should carry medications in case of an attack. Some patients keep an emergency shot of cortisol handy. Closely monitor symptoms if a high-stress situation arrives suddenly, like the death of a loved one or an injury or illness. These can trigger a crisis and need to be managed carefully.
Fortunately, most of these issues are overcome with medication, and most Addison’s Disease sufferers can manage the condition without much outside intervention or severe consequences, living a normal life much as they were before their problems started.