Addison's disease Dr Rob Hicks Addison's disease is a rare condition of the adrenal glands.

In this article

What is it? What causes it?

What are the symptoms? What's the treatment?

Addison's disease occurs when something upsets the production of the corticosteroid hormones in the adrenal glands. Consequently, insufficient amounts of these hormones are available, which results in disturbances in body chemistry.

These corticosteroids are:

• Aldosterone - regulates salt and water loss through the kidneys and so helps control blood pressure
• Cortisol (or hydrocortisone) and corticosterone - involved in the metabolism of fats, carbohydrates and proteins, the control of inflammation and recovery from stress
• Male and female sex hormones - testosterone and oestrogen are produced in small amounts by the adrenal glands

In around 70 per cent of cases, Addison's disease is believed to occur when the body attacks its own adrenal glands for some unknown reason. This is called an autoimmune reaction.

Other causes include tuberculosis, HIV, cancer and other diseases of the adrenal glands.

People with Addison's disease feel weak, lethargic, lose their appetite and weight, and may suffer recurrent abdominal pain and vomiting.

Other symptoms include falling blood pressure, rising blood potassium levels and falling sodium levels in the blood.

These problems develop over time, usually weeks or months, and often it takes a while before the diagnosis is made.

A characteristic feature of Addison's disease is a change in pigmentation on certain parts of the body. Skin creases of the palms, knuckles, elbows and knees may darken, becoming brownish in colour. The inside of the mouth may also darken.

If the demand for corticosteroid hormone outstrips the ability of the glands to produce it, Addisonian crisis may occur. Symptoms of this include dehydration, confusion, weakness, vomiting and severe abdominal pain resulting from excessive loss of salt and water. It can lead to coma and even death unless treated quickly.

When possible, the underlying cause of the Addison's disease is treated.

Oral corticosteroid drugs are taken to replace those hormones not being produced in sufficient quantities by the adrenal glands.

Occasionally, the dose of treatment may need to be increased, such as during times of infection. Patients with Addison's are always given clear advice about these issues, about the importance of always letting a doctor or dentist know they're taking steroid medication, and not to stop treatment suddenly.

People with Addison's disease are encouraged to carry a steroid card or wear an identification bracelet so people know they're taking steroid therapy if problems arise.

With treatment and regular specialist monitoring, people with Addison's disease can expect to live long and active lives.

This article was last medically reviewed by Dr Rob Hicks in October 2007