MANAGING YOUR ADDISON’S DISEASE

What Is Addison’s Disease?

Addison’s disease, also known as adrenal insufficiency, is a condition in which the adrenal glands don’t work well. The two small adrenal glands sit atop the kidneys. They usually produce hormones called cortisol and aldosterone. Without these hormones, salt and water in the body is lost in urine, which makes blood pressure fall too low. Also, potassium builds up to a dangerous level. There is no effective way to prevent Addison’s disease.

What Causes Addison’s Disease?

Addison’s disease develops because the immune system (disease-fighting system) doesn’t work well. In an autoimmune disease, the body makes substances (antibodies) that damage adrenal glands. Other causes include infections (e.g., tuberculosis, AIDS), cancer, bleeding, and blocked blood vessels involving the adrenal glands. Adrenal glands may also develop poorly from birth. Surgery, medicines with harmful side effects, and x-ray treatments can also cause the disorder.

What Are the Symptoms of Addison’s Disease?

Some people may have no symptoms. Others may feel weak, tired, or sick to the stomach; there may also be weight loss, decreased appetite, low blood pressure, depression, or skin and hair changes. Darkening of the skin over knuckles, knees, elbows, toes, or lips, creases of palms, and mucous membranes may be present.

People with addisonian crisis have a more serious illness that is a medical emergency. The sudden crisis usually results from stress, such as during surgery, trauma, or illness. Symptoms may include severe nausea and vomiting, diarrhea, very low blood pressure, leg and stomach pain, and coma.

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How Is Addison’s Disease Diagnosed?

The health care provider will order blood and urine laboratory tests and measurements of adrenal hormones.

The health care provider may also want x-rays and CT (computed tomography) scans of the adrenal glands.

How Is Addison’s Disease Treated?

Medicine to replace adrenal hormones includes hydrocortisone, fludrocortisone, and prednisone. These medications work well for this lifelong illness.

DOs and DON’Ts in Managing Addison’s Disease:

DO see your health care provider regularly.
DO take medicine as recommended by your health care provider.
DO talk to your health care provider before you have surgery (to adjust your dose) and before using other prescription drugs.
DO wear a medical alert bracelet.
DO carry an emergency pack with medicine. Be sure that you and your family know how to give this medicine. Always be prepared for addisonian crisis.
DO avoid stress.
DO watch your lifestyle. Drink alcohol only in moderation. Eat a well-balanced diet with enough regular table salt.
DO exercise, but don’t overdo it.
DO call your health care provider when you feel poorly (nausea, vomiting, fever) or feel weak and tired and have weight loss.
DO slowly decrease your medicine if your health care provider recommends it. You’ll avoid complications, such as weight gain, diabetes, and high blood pressure, from too much medicine.

DON’T eat too much potassium (foods like bananas, oranges, and salt substitutes).
DON’T skip doses of medicine.

FOR MORE INFORMATION

Contact the following sources:

National Adrenal Disease Foundation
505 Northern Boulevard, Suite 200
Great Neck, NY 11021
Tel: (516) 487-4992
National Institute of Diabetes and Digestive and Kidney
Diseases
Website: http://www.niddk.nih.gov/index.htm
Medic Alert Foundation International
Tel: (209) 668-3333

Ferri’s Netter Patient Advisor