Addison's disease

Addison's disease (also known as chronic adrenal insufficiency, or hypocortisolism) is a rare endocrine disorder. It occurs when the adrenal glands, seated above the kidneys, fail to produce enough of the hormone cortisol and, sometimes, the hormone aldosterone.

There are two forms of Addison's disease, based on the reason for the disorder. Primary adrenal insufficiency occurs when the adrenal glands themselves are not working properly; secondary adrenal insufficiency occurs when the pituitary gland does not produce enough adrenocorticotropin (ACTH) to adequately stimulate the adrenal glands.

Addison's disease progresses slowly, and symptoms may not present or be noticed until some stressful illness or situation occurs. Common symptoms are:

• chronic fatigue that gradually worsens
• muscle weakness
• loss of appetite
• weight loss
• nausea/vomiting
• diarrhea
• low blood pressure that falls further when standing (orthostatic hypotension)
• areas of hyperpigmentation (darkened skin)
• irritability
• depression
• craving for salt and salty foods
• hypoglycaemia (worse in children)

- for women, menstrual periods that become irregular or that stop

An illness or accident can aggravate the adrenal problems and cause an Addisonian crisis in which the symptoms include:

• sudden penetrating pain in the legs, lower back or abdomen
• severe vomiting and diarrhea, resulting in dehydration
• low blood pressure
• loss of consciousness

Untreated, an Addisonian crisis can be fatal.

Treatment for Addison's disease basically involves replacing the missing cortisol and, if necessary, providing replacement therapy for the missing aldosterone. Caution must be exercised when the person with Addison's disease has surgery or becomes pregnant.

adapted from public-domain resource at " class="external">http://www.niddk.nih.gov/health/endo/pubs/addison/addison.htm