- Posted on: Apr 15 2017
At Park Avenue Endocrinology & Nutrition, we have extensive experience treating various adrenal gland issues, including Addison’s Disease, also known as adrenal insufficiency.
Addison’s disease is a rare hormonal disorder that affects 1 in 100,000 people, affecting all age groups and both sexes equally. The disease is characterized by weight loss, muscle weakness, fatigue, low blood pressure, and darkening of the skin.
What causes Addison’s disease?
Cortisol is one of the hormones classified as glucocorticoids, and cortisol’s effects are felt across just about every part of the body. Cortisol is normally produced by the adrenal glands, which are located just above the kidneys. It is thought that cortisol has hundreds of impacts on the body, the most important job being to help the body respond to stress. Cortisol also helps:
- Maintain blood pressure and cardiovascular function
- Slow the immune system’s inflammatory response
- Balance the effects of insulin in breaking down sugar for energy
- Regulate the metabolism of proteins, carbohydrates, and fat
Addison’s disease occurs when the adrenal glands do not produce enough cortisol. The problem is usually due to either a disorder of the adrenal glands (primary adrenal insufficiency) or to inadequate secretion of a hormone from the pituitary gland that triggers cortisol production in the adrenal gland (secondary adrenal insufficiency).
Symptoms of adrenal insufficiency build gradually. Chronic, worsening fatigue and muscle weakness, loss of appetite, and weight loss are standard symptoms. Nausea, vomiting, and diarrhea occur in about half of the cases. Blood pressure is low and falls further when a patient is standing. This leads to dizziness and fainting. Skin color changes are common with hyperpigmentation occurring. This darkened skin is most visible on scars; skin folds; pressure points such as the elbows, knees, knuckles, and toes; lips; and mucous membranes.
How we diagnose Addison’s
We diagnose Addison’s disease through biochemical lab tests combined with a review of the patient’s medical history. The most specific test for Addison’s is the ACTH stimulation test. In this test, blood and urine cortisol levels are measured before and after a synthetic form of ACTH (adrenocorticotropin) is given by injection.
Treatment of Addison’s involves replacing, or substituting, the hormones that the adrenal glands are not producing. We can replace cortisol with hydrocortisone tablets. We also sometimes need to replace aldosterone with fludrocortisone acetate. Throughout, we provide monitoring and other treatment to help Addison’s patients lead normal lives.
Posted in: Pituitary Gland