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Addison's disease

Addison's disease is a rare chronic disease that affects the two small glands on top of the kidneys. It results in insufficient production of important hormones especially cortisol and aldosterone.

The main causes of Addison's disease

  • Autoimmune destruction: The most common cause is when the body's own immune system attacks and destroys the adrenal cortex. This is called autoimmune adrenalitis.

  • Infections: Certain infectious diseases such as tuberculosis can damage the adrenal cortex and lead to Addison's disease.

  • Tumours: Tumors in the adrenal glands or pituitary gland can affect the production of cortisol and aldosterone which can cause the disease.

  • Long-term use of steroid drugs: If a person takes steroid drugs for a long time and then suddenly stops, it can inhibit the adrenal glands and lead to Addison's disease.

  • Genetic causes: In rare cases, genetic mutations affecting the function of the adrenal cortex may be responsible for the disease.

Symptoms of Addison's disease

The symptoms of Addison's disease (adrenocortical insufficiency) may vary from person to person and may be gradual. The most common symptoms include:

  • Fatigue and weakness: This is one of the most prominent and distinctive symptoms. People with Addison's disease often feel extremely tired and have low energy levels.

  • Low blood pressure: Addison's disease can lead to low blood pressure which can cause dizziness, fainting and a general feeling of weakness.

  • Weight loss: People with the disease may experience unexplained weight loss due to loss of appetite and muscle weakness.

  • Darker skin tone: Some people with Addison's disease may develop an uneven darker skin tone especially in areas exposed to the sun, scars, lips and cheeks.

  • Nausea and vomiting: Stomach problems including nausea and vomiting are common symptoms.

  • Muscle and joint pain: Pain and weakness in muscles and joints may occur.

  • Loss of appetite and weight loss: Many people with Addison's disease may lose appetite and lose weight in weight.

  • Salt and craving for salty foods: Because the disease also affects the production of aldosterone, people with Addison's disease may develop a strong craving for salt which can be dangerous because it affects the body's electrolyte balance.

  • Low blood sugar (hypoglycemia): Some people with Addison's disease may experience low blood sugar, which can lead to fainting, confusion and weakness.

  • Mental fatigue and depression: The disease can affect mental health, which can lead to fatigue, depression and anxiety.

The symptoms of Addison's disease can be subtle at first and be confused with other conditions.

Treatment of Addison's disease

Treatment aims to control the symptoms and maintain the normal functioning of the body. Here is an overview of the treatment measures:

  • Cortisol replacement: The most important part of the treatment is to replace the lack of cortisol. This is done by taking cortisol-like medicines daily often in the form of tablets taken in the morning and in some cases also in the evening.

  • Aldosterone replacement: If it if there is a lack of aldosterone, it can also be replaced with drugs containing mineralocorticoids such as fludrocortisone. This medication helps to regulate the salt and fluid balance in the body.

  • Daily medication: As the treatment involves taking medication daily, it is important to follow a careful dosing plan prescribed by a doctor.

  • Emergencies: People with Addison's disease need to be aware of emergencies that may require extra doses of cortisol for example in case of severe stress, injuries or infections. This is called an "emergency measure" and involves a higher dose of cortisol than the usual daily dose.

  • Continuous medical monitoring: Regular visits to a specialist doctor are important to monitor the disease and adjust the medication dose if necessary.

  • Information and education: It is crucial that both the person with Addison's disease and their caregiver have a good understanding of the disease and its management especially in emergency situations.

It is important to follow the doctor's advice carefully and be aware of symptoms of lack of cortisol or changes in the state of health.

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