Symptoms of Addison's Disease

How to Tell if Someone Has this Illness

May 2, 2009 Naheed Ali

The most noticeable signs and symptoms of Addison's Disease are weakness, fatigue, and unplanned weight loss.

In Addison’s Disease, a patient’s dermatological surface (skin) color may turn darker, an illness termed hyperpigmentation. Other possible signs and symptoms are lightheadedness, loss of appetite, vomiting, nausea, and diarrhea, as well as an uncontrollable desire for salt. In patients with diabetes mellitus, symptoms of low blood sugar (hypoglycemia) often turn frequent and are much more serious.

Signs and symptoms generally occur slowly and often are not noticeable until a severe adrenal problem (Addisonian crisis) happens because of a stressful incident, like a severe infection, traumatic event, surgery, or dehydration. The human body is not necessarily able to make enough cortisol to deal with extreme stress. If not addressed properly, an adrenal problem may be fatal as a result of shock from a rapid drop in blood pressure.

When Addison’s Disease Strikes

In some cases, Addison’s Disease appears rapidly. These patients may already be in an adrenal crisis when they visit a physician.

Signs and symptoms of a severe adrenal problem can include: nausea and vomiting, fatigue and lightheadedness, restlessness, confusion, feeling fearful, difficulty remaining awake, and a severe fever.

Diagnosis of Addison’s Disease

Addison’s Disease is diagnosed by evaluating your clinical history, a comprehensive physical examination, and laboratory procedures. During the physical history-taking, your physician will ask about your problems and issues. He will ask if you have a family history of the disease, and whether you have fallen victim to cancer, HIV, or tuberculosis infection. At the medical examination, your physician will look for hyperpigmentation, low blood pressure, and dehydration.

Laboratory procedures can expose high potassium and low sodium amounts in your bloodstream—symptoms of possible Addison's disease. When your physician believes you have Addison’s Disease, he or she is likely to inquire about your bloodstream cortisol and ACTH (adreno-corticotropic hormone) amounts. If your ACTH level is extremely high, and your cortisol level is low, your doctor may have enough information to diagnose you with Addison's.

In the event the medical diagnosis is still unclear, an ACTH stimulation test may be done. You’ll be provided with a synthetic (man-made) version of ACTH to evaluate whether your system produces cortisol.

A low level of this chemical after an injection of ACTH indicates severe adrenal insufficiency. Further procedures will determine if you have primary adrenocortical insufficiency (Addison’s Disease) or a related illness termed secondary adrenocortical insufficiency. Your physician could recommend imaging procedures of the adrenal organs, the pituitary gland, or the hypothalamus, once the crisis area is located.

Your healthcare professional may begin treatment after the testing when he or she thinks adrenocortical insufficiency is eminent. If therapy is deemed unnecessary, treatment could be stopped once all the required medical testing is done.

How is Addison’s Disease Treated?

If someone has Addison's disease (or adrenal failure from another source), he has to take drugs for the rest of his life to replace the ACTH and aldosterone his system no longer creates. He might be provided with hydrocortisone, since it could act like both of these chemicals. If one receives a different steroid in place of cortisol, one can also take a drug (generally fludrocortisone) instead of aldosterone.

The dose of drug may have to be increased in times of mental and physical stress or disease. Furthermore, one might need to use extra salt in food during warm and humid weather in order to replace salt lost through sweating.

Any individual with Addison’s Disease should always wear clinical identification (such as a medical alert wristband or necklace). If you are constantly injured or severely ill and can't tell clinical personnel that you are an Addison's disease patient, the low amounts of cortisol can lead to death. You can have a very long, healthy life by following therapy and preventing a severe adrenal problem.