Addison’s Disease
About one in 100,000 persons have Addison's disease, also known as primary or chronic adrenal insufficiency or hypocortisolism, which is a form of endocrine illness. Weight loss, exhaustion, muscle weakness, low blood pressure, and digestive problems are among the signs of Addison's disease that are typically noticeable.
According to popular belief, Addison's disease is typically autoimmune in nature and brought on by adrenal dysfunction, which lowers cortisol levels. It is estimated that autoimmune illnesses, in which the immune system produces significant amounts of antibodies to attack the adrenal glands, are to blame for about 70% of Addison's disease cases that have been recorded. Women are more likely than men to acquire Addison's disease, which most frequently affects persons between the ages of 30 and 50, however it can afflict anyone at any age. When the adrenal glands are injured and unable to produce adequate cortisol and, occasionally, aldosterone, Addison's disease develops.
Insufficient secondary adrenal glands
The pituitary, a pea-sized gland at the base of the brain, is where secondary adrenal insufficiency begins. Adrenocorticotropin (ACTH), a hormone produced by the pituitary, instructs the adrenal glands to produce cortisol. The adrenal glands can't produce enough cortisol if the pituitary doesn't produce enough ACTH. The adrenal glands may atrophy and eventually stop producing hormones.
Tertiary adrenal failure
The hypothalamus, a small region of the brain next to the pituitary, is where tertiary adrenal insufficiency begins. Corticotropin-releasing hormone (CRH), a hormone that instructs the pituitary to produce ACTH, is produced by the hypothalamus. The pituitary gland produces insufficient ACTH when the hypothalamus fails to produce enough CRH. The adrenal glands then fail to produce adequate cortisol.
Symptoms of Addison's Disease
The following list of signs and symptoms of Addison's disease:
Continual tiredness (lasting more than a couple of weeks)
Muscle tremor
Alterations in appetite (especially a loss of appetite)
Loss of weight
Intestinal problems (including abdominal pain, nausea, vomiting, diarrhea)
Reduced blood pressure
Fainting or vertigo
Depression, impatience, and mood swings
Headaches
The desire for salty foods
Hypoglycemia
Lack of sleep makes you feel fatigued all the time.
Sweating during the night
Missed or irregular menstruation in women
Poor libido
Aching joints
Hair fall
Symptoms of Acute Adrenal Failure
Adrenal crisis (or Addisonian/Addison disease crisis) is a rare and severe form of acute adrenal insufficiency that can occasionally occur.
This typically happens after a stressful event or physical injury, which increases stress on the adrenal glands and exacerbates symptoms. Low blood pressure, low blood sugar, and high blood potassium levels are the outcomes.
Low levels of cortisol, possibly as a result of delaying treatment for milder cases of adrenal insufficiency, are the cause of severe adrenal insufficiency. It's crucial to visit the emergency department as soon as symptoms appear because this ailment is life-threatening and needs to be treated straight away by professionals.
What results in adrenal insufficiency?
The reasons for various forms of adrenal insufficiency vary. The abrupt discontinuation of corticosteroids after a prolonged course of treatment is the most frequent cause of total adrenal insufficiency.
Addison's illness
In Addison's disease, the immune system's attack on the body's cells and organs are typical what damages the adrenal glands. 8 or 9 out of every 10 instances of Addison's disease in affluent nations are brought on by an autoimmune condition.
Addison's disease can also be brought on by specific illnesses. The most prevalent cause of Addison's disease in the past was tuberculosis (TB), which can harm the adrenal glands. TB became a considerably less common cause as medical care evolved through time. Those who have HIV/AIDS are additionally at risk since their compromised immune systems cannot defend against infections that could develop Addison's disease.
The following are less typical causes of Addison's disease:
The adrenal glands contain cancerous cells.
To treat other disorders, the adrenal glands may be surgically removed.
Adrenal gland bleeding
Medications, such as antifungal drugs or the general anesthetic etomidate, influence how the adrenal glands form or function as a result of genetic abnormalities.
How long will a person with Addison's illness live?
Patients with Addison's disease used to have a typical life expectancy. A 2009 research, however, found that "Addison's disease is still a potentially fatal condition, with higher mortality in acute adrenal failure, infection, and unexpected death in patients identified at a young age. For patients with Addison's disease, the prognosis is excellent.
Infection is the second-leading cause of death after acute adrenal failure. The mean ages at death in this study were, respectively, 3.2 and 11.2 years less for males (64.8 years) and females (75.7 years) than the predicted life expectancy for the general population.
Recommended Blood tests:
ACTH stimulation test
Insulin tolerance test
CRH stimulation test
Antibody blood tests
Computed tomography (CT) scan
Tests for TB
Magnetic resonance imaging (MRI)
RESOURCES:
https://www.nature.com/nrneurol/
2022. NP. Malika Katrouche. All Rights Reserved.
