What is Addison Disease? Many sufferers do not notice their adrenal cortical disease until it is too late: Addison’s disease is a rare but very dangerous disease that leads to a disruption of the hormone and electrolyte balance. However, if recognized in time, there is the possibility of therapy.
What is Addison Disease?
There are many other names for Addison’s disease: Addison’s disease, adrenal insufficiency, bronchial skin disease. The adrenal cortex cannot produce any endogenous hormones that are important for the metabolism, such as cortisol, aldosterone and sex hormones. Among other things, this leads to a disruption of the electrolyte balance , which has serious health consequences and can even be fatal.
Because one of the first signs is a brownish discoloration of the skin, Addison’s disease is also called bronze skin disease. However, this skin change is responsible for the fact that the disease is often recognized late. Because those affected make a healthy and relaxed impression, even though the organ is already damaged. Therefore, the course is usually difficult, but Addison’s disease is quite rare overall.
What is the Adrenal Cortex?
The adrenal glands are part of the kidneys and are made up of the adrenal cortex and the adrenal medulla. Various messenger substances are produced in the adrenal cortex:
- Glucocorticoids: The hormones in this group are needed for energy production and ensure that we can cope better with stress.
- Mineral corticoids: They ensure that there is enough electrolytes in the blood and that the sodium and potassium levels are balanced. They also balance the blood pressure.
- Androgens: These male sex hormones are important for building muscles and bones, among other things.
Adrenal insufficiency can take several forms:
- Primary adrenal Insufficiency: Here the adrenal gland itself is damaged and causes the hormone deficiency.
- Secondary adrenal Insufficiency: Here the disorder is in the part of the brain that is responsible for the production of messenger substances. This is usually in the pituitary gland or in the hypothalamus. This form occurs very rarely and is triggered by
- A stroke
- A tumor
- An injury
- Brain surgery
- Tertiary adrenal insufficiency: This third form usually occurs as a result of cortisone therapy. If the medication is gradually withdrawn, the adrenal cortex slowly starts producing the messenger substances again. So that the change can take place gradually, cortisone preparations should never be discontinued overnight, but always gradually. Since this form of adrenal insufficiency is not pathological, but can be reversed, it is only a temporary dysfunction.
Strictly speaking, only the primary form is Addison’s disease . However, because the symptoms are similar, the other two forms are also associated with it.
What is an Addison Crisis?
A particularly severe form of Addison’s disease is the Addison’s crisis. Psychological stress, an infection, the loss of electrolytes in diarrhea or an accident can aggravate an existing adrenal insufficiency to such an extent that it comes to a complete stop of hormone production and thus also to the breakdown of some body functions. An Addison’s crisis is life -threatening if the emergency doctor does not start treatment as soon as possible.
What are the Causes of Addison’s Disease?
The cause of Addison’s disease is a massive hormone deficiency triggered by damage to the adrenal cortex. Responsible for this can be:
- Autoimmune diseases, when the immune system turns against and destroys the body’s own adrenal tissue. About 70 to 90 percent of cases occur as a result of such a defensive disorder, especially in patients with Hashimoto’s thyroiditis (a disease of the thyroid gland) and type 1 diabetes mellitus (diabetes).
- a blood poisoning by meningococcal
- an infection with pathogens
- Tumors that affect the function of the adrenal cortex
What are the Symptoms of Addison’s Disease?
Typical signs of Addison’s disease and serious alarm signals are
- Brown discoloration of the skin, including the palms of the hands, soles of the feet and mucous membranes At the same time, in some cases there is a pigment disorder vitiligo , the white spot disease in which the skin turns lighter in color.
- Hungry for salty food
- Low blood pressure
However, since the disease is heralded by very atypical symptoms in the early stages, Addison’s disease is often not recognized immediately. Most of the time it comes to
- Stomach pain
- Weight loss
- Erectile dysfunction in men
- Menstrual cycle disorder and pubic hair loss in women
- Stops growth in infants
An Addison’s crisis leads to life-threatening symptoms that must be treated immediately by the emergency doctor , such as
- Sudden drop in blood pressure
- Severe fluid loss
- Circulatory failure
- Severe abdominal pain
How Does the Doctor Recognize Addison’s Disease?
The diagnosis of Addison’s disease is not easy for the doctor to make . Because the diverse symptoms can indicate many different diseases. In addition, the pigmentation of the skin does not make the patients look seriously ill at first glance – but they already are. Therapy should therefore be started as soon as possible in order to combat Addison’s disease in good time .
The specialist in charge is an endocrinologist . In a detailed conversation he will ask about the symptoms and their duration, as well as the medical history. Various laboratory tests can use a blood test to show whether the problem is actually adrenal insufficiency. The cortisol level and the ACTH value are important here . ACTH (adrenocorticotropic hormone) is produced in the pituitary gland and promotes the formation of cortisol. Since the blood values can be normal in the morning with a chronic course of Addison’s disease, a 24-hour test of the urine is also carried out.
The blood will also be tested for antibodies to determine if there is an autoimmune disease. Tumors and changes in the tissue can be made visible by a CT (computed tomography), MRI (magnetic resonance tomography) or ultrasound.
How is Addison’s Disease Treated?
When Addison’s disease occurs, the adrenal cortex has usually lost more than 90 percent of its function. This damage cannot be reversed. The only therapy is therefore the lifelong intake of the vital hormones hydrocortisol and fludrocortisol, which the organ can no longer produce.
In addition, the will hormone levels by a doctor regularly checked to prevent a deficiency. The need for hormones can increase, especially during stress. A hormone deficiency makes itself felt
- Cardiac arrhythmias
- low blood pressure
Overdosing should also be avoided, as this can lead to the following symptoms:
- High blood pressure
- Weight gain
- Water retention in the tissue
How can I Prevent it?
Since one of the main causes of Addison’s disease is an autoimmune disease, sufferers should adjust their lifestyle . The immune system can be supported by a healthy diet, exercise, fresh air, an adequate intake of at least two liters of water per day and avoiding alcohol and nicotine.
Also, excessive stress, which could lead to Addison’s crisis should be avoided. Special relaxation methods such as yoga or meditation help here.
What are the Chances of Recovery from Addison’s Disease?
Addison’s disease is considered incurable . If the function of the adrenal cortex is already damaged, this damage cannot be reversed. However, if the disease is detected in time, the hormones can be replaced. As a result, the life expectancy of those affected can be increased considerably and they can lead an almost normal life. Even pregnancy is possible with Addison’s disease if the hormone levels are monitored and adjusted.
However, if the disease is not recognized for a long time and the Addison’s crisis occurs, the disease is often fatal. Acting in good time therefore increases the prognosis for an almost symptom-free life. The first alarm signals should therefore be taken seriously.