Addison’s Disease Patient Information Sheet

What is Addison’s Disease?
Addison’s disease, also known as primary or chronic adrenal insufficiency, is a relatively rare disorder in which the adrenal glands (located just above the kidneys) are unable to produce sufficient hormones. Cortisol is the hormone that is usually lacking, but sometimes another hormone called aldosterone is also affected.

Cortisol plays a vital role in many bodily functions, the most important being that of helping the body to respond to stress. It also aids in other processes, including maintaining blood pressure, slowing the immune system’s inflammatory response, balancing the effect of insulin breaking down sugar, and regulating the metabolism of proteins, carbohydrates, and fats. The amount of cortisol produced by the adrenal glands is usually in fine balance, but in Addison’s disease this process is disrupted and lower levels are produced. Cortisol production is controlled by two glands: the adrenal gland and the pituitary gland. Aldosterone acts on the kidney and regulates the excretion of sodium and potassium in the urine. Addison’s disease is thought to affect 1 to 4 people per 100,000. 

What are the symptoms of Addison’s disease?
The symptoms of Addison’s disease usually appear gradually. Chronic fatigue and muscle weakness, loss of appetite, and weight loss are all symptoms of the disease. In around half of people, nausea, diarrhea and vomiting occur. If aldosterone levels are low, blood pressure will drop and may cause dizziness or fainting. In addition, the skin may become pigmented (darkened) in skin folds, elbows, knees, knuckles, and joints. The pigmentation may be more noticeable on areas of scarring or on the lips. A craving for salty foods may occur as a result of salt loss, and irritability and depression may also be present. In women, menstrual periods may become irregular or stop altogether. Hypoglycemia (low blood sugar) may also occur. This may be more severe in children than in adults.

An Addisonian crisis may be triggered by a stressful event such as an illness or an accident. In about 25% of people with Addison’s disease, a crisis is the first appearance of symptoms; however, in the remainder of people, the symptoms are usually severe enough to cause them to seek medical advice before a crisis occurs. The symptoms of an Addisonian crisis are exaggerated symptoms of Addison’s disease and include pain in the lower back, abdomen or legs, and severe vomiting and diarrhea. This is followed by dehydration, low blood pressure, and loss of consciousness, all of which may occur suddenly. If left untreated, an Addisonian crisis can be fatal.