ADDISON'S DISEASE

General Information

DEFINITION--Underactive adrenal glands. The adrenal glands secrete several hormones that are essential to a number of body functions. These hormones help to maintain body fluid balance and are involved in sugar and protein metabolism, maintenance of blood pressure and response to physical stress.

BODY PARTS INVOLVED--Adrenal glands (located over the kidneys).

SEX OR AGE MOST AFFECTED--Both sexes; all ages.

SIGNS & SYMPTOMS

Symptoms may develop slowly, including:

• Weakness and fatigue.
• Gastrointestinal disturbances (nausea, vomiting, abdominal pain, diarrhea, and appetite and weight loss).
• Low blood pressure causing faintness and dizziness.
• Brownish skin (looks suntanned) with white patches.
• Darkening of freckles, scars and breast nipples.
• Hair loss.
• Feeling cold all the time.
• Dramatic behavior or mood changes, including aggression or depression.

CAUSES

• Symptoms and signs are caused by low levels of cortisone-like hormones produced by the adrenal glands. The cause of adrenal insufficiency is usually unknown, but is sometimes a complication of tuberculosis, cancer, pituitary disease or AIDS.
• Use of cortisone drugs for other conditions. When cortisone is withdrawn, normal adrenal function sometimes does not return.

RISK INCREASES WITH

Stress; diabetes mellitus; injury to the abdomen; anticoagulant therapy.

HOW TO PREVENT--Don't discontinue use of cortisone drugs or change the dosage without consulting your doctor.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms. "Before and after" pictures may emphasize the gradual skin change.
• Medical history and physical by a doctor.
• Laboratory blood counts, blood and urine measurement of adrenal hormones and a test of adrenal-gland function.

APPROPRIATE HEALTH CARE

• Doctor's treatment.
• Hospitalization for an adrenal crisis (see Possible Complications).

POSSIBLE COMPLICATIONS

• Adrenal crisis (pains, weakness, low blood pressure, high or low temperature, fainting) caused by any injury or illness.
• Increased susceptibility to infections.
• Misdiagnosis as a mental condition.

PROBABLE OUTCOME--When diagnosed in its early stages, symptoms can be controlled with hormone replacement. In advanced stages, it can be fatal without treatment.

How To Treat

GENERAL MEASURES--

• This is a lifelong condition. Learn how to care for yourself. Strict attention to medication schedules is vital.
• Learn about adrenal crisis and its relationship to body stress (infection, surgery or injury).
• Advise any doctor or dentist who treats you that you have Addison's disease.
• Wear a Medic-Alert bracelet or pendant (See Glossary).
• Stay current on immunizations, including those for influenza and pneumonia.
• If you live or travel where medical care may not be readily available, get instructions on giving yourself cortisone injections in case of emergency.

MEDICATION--Your doctor may prescribe one of several types of cortisone drugs. Follow medication schedule exactly. Never change or omit medication without your doctor's advice.

ACTIVITY--No restrictions.

DIET--Consult your doctor about diet. A diet to maintain sodium and potassium or to increase protein or carbohydrates may be required.

Call Your Doctor If

• You have symptoms of Addison's disease--especially an adrenal crisis. Call immediately. Adrenal crisis is an emergency!
• The following occurs after diagnosis: Any signs of infection, such as fever, chills, muscle aches, headache and dizziness. Serious injury, such as bone fracture, dislocation or internal injuries.
• You are scheduled for elective surgery or require anesthesia for any reason.
• New, unexplained symptoms develop. Drugs used in treatment may produce side effects, such as: protruding abdomen, thin extremities, puffy face and eyes, acne, growth of facial hair.