Addison’s disease rarely affects people. When the adrenal glands cannot produce steriod hormones that are essential for the normal functioning of a human body, then the condition is called as Addison’s disease. The adrenal gland in our body is responsible for secreting two major types of hormones known as cortisol and aldosterone. The cortisol hormones helps to regulate the metabolism of blood glucose, and the aldosterone hormones helps to maintain proper water-salt balance in our body. Both these hormones play a very important role in the overall well being of a person.
Low production of cortisol hormones can affect blood pressure, metabolism of protein and fats, ability to respond to stress, ability to stay mentally alert, and insulin break down. Similarly, low level of aldosterone hormones can affect water-salt proportion and proper functioning of kidneys. Whenever there is a damage in the adrenal gland or in the pituitary gland, the production of these hormones are affected. Moreover, this disease can affect people of all ages.
Causes
The two major causes for the lack of production of hormones by adrenal glands are: damage to the adrenal gland itself and damage to the pituitary gland.
An adrenal gland can be damaged in many numbers of ways. One of the common attacks is by a process called as autoimmune disorder. In the case of autoimmune disorder, the body’s immune system produces antibodies that can attack a body’s own organs and destroy them gradually. So when antibodies attack adrenal glands, the adrenal cortex, the outer covering of adrenal glands, is damaged. When adrenal cortex is destroyed, the adrenal glands loses the capability to produce enough amount of cortisols or aldosterones hormones. An adrenal gland can also be damaged due to tuberculosis infection, fungal infection, cancer cells, or abnormal deposits of protein on the glands.
Another cause of Addison’s disease is due to damage to the pituitary gland or when the pituitary gland do not get enough stimulant to produce a hormone called as adrenocorticotropin (ACTH). A pituitary gland can be affected in many ways including infection over the glands, low blood flow, or treatment for pituitary tumors. In all these cases, the pituitary gland can decrease in size and may not produce enough hormones to stimulate adrenal glands.
Symptoms
When adrenal glands begin to malfunction, the symptoms are not immediately obvious. The following symptoms can be noticed over a period of time.
1. Low blood pressure
As the aldosterones hormones are needed to maintain proper water-salt balance, a person affected with Addison’s disease would notice a sudden decrease in blood pressure. This symptom is usually accompanied by dizziness and fainting. At this stage, it is better to take a blood test to know whether a person has Addison’s disease.
2. Nausea, Vomiting and Diarrhea
These symptoms gradually show up in the initial stage of Addison’s disease. When these symptoms are coupled with weight loss, loss of appetite, or muscle weakness, then it is essential to consult a qualified physician.
3. Skin color change
A person affected with Addison’s disease can notice gradual tanning in both exposed and non-exposed parts of body. The skin darkening is more visible in the area of skin folds, knees, toes, and lips.
4. Irritation and depression
As the hormones that are responsible for maintaining salt-water balance and blood glucose level are not produced by the adrenal glands, it can lead to irritation, sudden mood swing, and craving for salty foods.
5. Addisonian crisis
If a person ignores the early symptoms, then it can lead to Addisonian crisis, which can make the condition even more worse. The symptoms of Addisonian crisis are dehydration, loss of consciousness, very low blood pressure, penetrating back pain, and severe diarrhea. As these symptoms are severe, it is necessary to consult a doctor at this stage.
Diagnosis
As the symptoms of adrenal malfunction develop slowly, it is difficult to diagnose the disease at its initial stage. A normal blood test can be used to find the level of cortisol and aldosterone hormones. Once the amount of cortisol has been found to be insufficient, further diagnosis would involve a series of simulation test including taking x-rays of adrenal gland and pituitary glands.
1. ACTH simulation test
When the adrenal glands function normally, they react to ACTH hormones released by pituitary gland. In this test, an artificial form of ACTH hormone is injected into the blood stream and the presence of cortisol hormone in the blood is measured after an hour. If the blood has low level of cortisol, then it indicates adrenal gland damage.
2. Test to determine calcium deposits
X-raying the adrenal glands can reveal the presence of calcium deposits on adrenal glands.
3. CT scan
By scanning the pituitary glands, doctors can determine whether there is a reduction in the size of the pituitary glands. Moreover, the ability of the pituitary glands to produce hormones is also tested.
4. CRH simulation test
This test is similar to ACTH simulation test. This test is conducted when the results of ACTH test are not satisfactory. In this test, an artificial form of CRH hormone is injected and the level of ACTH and blood cortisol hormone are inspected at various intervals.
Treatment
When adrenal glands cannot produce hormones, the needs are met by giving oral medications that function similar to the hormones produced by adrenal glands. The oral medications are a form of synthetic hormones that help to maintain proper blood sugar and water-salt balance. In the case of aldosterone deficiency, a person is advised to take more salt.
In the case of Addisonian crisis, a patient is given intravenous injection of salt, sugar and other essential fluids. After a patient has been injected, the level of cortisol and ACTH are monitored to determine further medications.
Prevention
Addison’s disease can be prevented by regularly cleansing the body to remove toxins and other antibodies, which can damage the adrenal glands. The cleansing should focus on bowel and liver. It is also essential to do a regular dental cleanup. Apart from regularly cleansing the body, a person having Addison’s disease must always carry the medications with them to prevent relapse of the disease.
