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Addison Disease

WHAT YOU NEED TO KNOW:

What is Addison disease?

Addison disease is a condition that causes low levels of aldosterone and cortisol. These hormones are made by your adrenal glands. Cortisol helps your body handle stress. Aldosterone helps your body balance salt, potassium, and fluid.

What causes Addison disease?

A family member with Addison disease may increase your risk for this condition. Addison disease is often caused by damage to your adrenal glands. It may also be caused by a problem in your pituitary gland. The pituitary gland makes hormones that control how the adrenal glands work. The following can increase your risk for Addison disease:

  • A disease that attacks your immune system
  • Infections such as tuberculosis, meningococcus, a fungal infection, or HIV
  • A genetic disorder that causes problems with your adrenal gland or pituitary gland
  • Surgery to remove both of your adrenal glands
  • Bleeding in your adrenal gland caused by blood thinner medicine or trauma
  • Certain medicines, such as antifungals
  • Suddenly stopping certain medicines, such as steroids
  • Certain types of cancer, or radiation to your adrenal gland

What are the signs and symptoms of Addison disease?

Signs and symptoms may show up slowly over months or years. You may have any of the following:

  • Dizziness, weakness, and tiredness
  • Decreased appetite or weight loss
  • Nausea, vomiting, or diarrhea
  • Muscle, joint, stomach, or back pain
  • A craving for salty foods
  • An increased sensitivity to cold temperatures or sweating more than usual
  • Darkening of the skin on your lips, palms, nipples, genital area, and inside your mouth
  • Depression or trouble thinking clearly
  • Females may lose body hair, stop having a monthly period, or lose interest in sex

How is Addison disease diagnosed?

Your healthcare provider will examine you and ask about your signs and symptoms. Tell the provider about other health conditions and if a family member has Addison disease. You may need any of the following:

  • Blood and urine tests may be collected to measure your hormone levels. Your blood may be collected after you are injected with a hormone. The hormone causes the adrenal glands to make its hormones. Blood tests also check your blood sugar levels, electrolyte levels, blood cell levels, and kidney function. Your pituitary and thyroid gland hormone levels may also be measured.
  • An x-ray, CT, or MRI are done to check the size of your adrenal gland. These tests also check for problems that may cause Addison disease. You may be given contrast liquid to help the pictures show up better. Tell a healthcare provider if you have ever had an allergic reaction to contrast liquid. Do not enter the MRI room with anything metal. Metal can cause serious injury. Tell a healthcare provider if you have any metal in or on your body.
  • A biopsy takes a sample of your adrenal gland. The sample can be checked for signs of Addison disease.

How is Addison disease treated?

Causes of Addison disease will be treated. You may need any of the following:

  • Steroid medicine is given to increase your cortisol level. Take this medicine as directed. Steroid medicine helps your body handle stress and prevent an adrenal crisis. Steroid medicine will also help decrease your symptoms such as weakness and fatigue. Always carry extra steroid medicine with you. You may need to take steroid medicine several many times a day. Do not skip a dose of your medicine. Do not stop taking this medicine without talking to your healthcare provider. You may have an adrenal crisis if you skip a dose or stop taking your medicine.
  • Aldosterone supplements may be given to help your body balance salt and fluid. This can help prevent dehydration and low sodium (salt) levels.
  • Sodium supplements help increase the amount of salt in your blood. You may need to take salt supplements every day. Instead you may need to take salt supplements before exercise, in hot weather, or when you have diarrhea or are vomiting.

What can I do to care for myself?

  • Manage your condition during sick days. Sick days may include days you have a cold, diarrhea, or are vomiting. Your body will need more steroid medicine when you are sick to prevent an adrenal crisis. Increase your steroid dose as directed when you are sick. You may need to inject your steroid medicine if you are vomiting and cannot swallow your medicine. Your healthcare provider will show you how to inject your medicine. Ask if you need to drink an oral rehydration solution (ORS) when you are sick. An ORS has the right amounts of water, salts, and sugar that you need to replace lost body fluids.
  • Check your blood pressure and blood sugar as directed. Write down your blood pressure readings and blood sugar levels. Bring these numbers with you to your follow-up appointments. Ask your healthcare provider for more information on how to check your blood pressure and blood sugar level.
  • Wear medical alert jewelry or carry a card that says you have Addison disease. Ask your healthcare provider where to get these items.
    Medical alert ID bracelet
  • Ask about vaccines. Vaccines can help prevent illnesses that may cause an adrenal crisis. Ask your healthcare provider if you should get a flu or pneumonia vaccine, and when to get the vaccine.

What is an adrenal crisis?

An adrenal crisis happens when your cortisol and aldosterone levels suddenly drop. This may lead to low blood pressure, dehydration, and low blood sugar. An adrenal crisis is life-threatening and needs immediate treatment. An adrenal crisis can happen if you suddenly stop taking your medicine. It can also happen when your body is under more stress than usual. This may happen during surgery, an illness, or trauma.

How is an adrenal crisis treated?

You will need treatment and monitoring in the hospital. You will be given steroids and glucose (sugar). You may be given sodium (salt) and medicine to increase your blood pressure. You may also need IV fluids to treat dehydration.

Call 911 or have someone else call for the following:

  • You have a seizure.
  • You lose consciousness or cannot be woken.
  • You have shortness of breath or trouble breathing.

When should I seek immediate care?

The following are early signs and symptoms of an adrenal crisis:

  • Your heart is beating faster than usual.
  • You have a headache, hallucinations, or feel confused.
  • You have muscle weakness or muscle cramps.
  • You have severe pain in your stomach, back, or legs.
  • You have numbness and tingling in your fingers or around your mouth.
  • You have trouble staying awake.
  • You urinate less than usual or stop urinating.

When should I contact my healthcare provider?

  • You have a fever.
  • You have symptoms of a cold or the flu such as a cough or congestion.
  • You have 2 or more episodes of diarrhea.
  • You have nausea or stomach pain, or are vomiting.
  • You are vomiting so much that you cannot drink any liquids.
  • You sweat more than usual.
  • You have questions or concerns about your condition or care.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2017 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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