Addison's Disease
Addison's disease is a condition in which the adrenal glands don't produce enough cortisol (and sometimes aldosterone). Without treatment, an adrenal crisis can be life-threatening, but with proper hormone replacement, people lead normal lives.
Table of Contents
Quick Facts
- ICD-10: E27.1
- Type: Primary adrenal insufficiency
- Treatment: Lifelong hormone replacement
Adrenal Crisis Is an Emergency
Call 911 for an adrenal crisis: severe weakness, vomiting and diarrhea, very low blood pressure, confusion, or loss of consciousness — especially during illness or after missed medication.
Symptoms
- Chronic fatigue, muscle weakness
- Weight loss and decreased appetite
- Darkening of the skin (hyperpigmentation), especially in scars and creases
- Low blood pressure, dizziness on standing
- Salt craving
- Low blood sugar
- Nausea, diarrhea, abdominal pain
- Depression, irritability
- Reduced body hair (women)
Causes
- Autoimmune destruction of the adrenal glands (most common in developed countries)
- Tuberculosis or other infections
- Adrenal hemorrhage
- Cancer that has spread to the adrenal glands
- Genetic disorders
Diagnosis
- Morning cortisol level
- ACTH stimulation test
- ACTH level
- Antibodies for autoimmune cause
- Imaging of adrenal glands
Treatment
- Daily oral hydrocortisone (or prednisone)
- Fludrocortisone for mineralocorticoid replacement
- Stress-dose steroids during illness, surgery, or major stress
- Carry an emergency injection kit and wear medical-alert identification
When to See a Doctor
See a doctor for persistent unexplained fatigue, weight loss, skin darkening, or low blood pressure. Seek emergency care for symptoms of adrenal crisis.
Frequently Asked Questions
Will I ever come off the medication?
No — hormone replacement is lifelong because the adrenal glands cannot produce these hormones.
What is a stress dose?
An increased dose of hydrocortisone during illness, injury, or major procedures to mimic the body's normal stress response and prevent adrenal crisis. Your endocrinologist will provide a sick-day plan.
Medical Disclaimer: This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider with questions about a medical condition. If you are experiencing a medical emergency, call your local emergency number immediately.
References
- National Adrenal Diseases Foundation. Patient Resources.
- Endocrine Society. Adrenal Insufficiency Guidelines.