Addison's disease
Addison's disease is a rare condition that's estimated to affect about one in 40,000 people.
The adrenal glands are very important manufacturers of different hormones. They help to control blood pressure, salt and water balance, and help our immune system to fight off infection and deal with stress and illness.
There are two adrenal glands. Each one sits like a cap on top of the kidney. The inner part of the gland secretes adrenalin and noradrenaline. The outer part of the adrenal gland is made up of three zones that secrete a group of hormones collectively called corticosteroids or the adrenal hormones. These are:
- Aldosterone. This regulates salt and water loss through the kidneys and so helps control blood pressure.
- Cortisol (or hydrocortisone) and corticosterone. These are involved in the metabolism of fats, carbohydrates and proteins; the control of inflammation; and they help the body to recover from stress.
- Male and female sex hormones. Testosterone and oestrogen are produced in small amounts by the adrenal glands.
Insufficient hormones
Addison's disease is caused when something upsets the production of the corticosteroid hormones. Consequently, insufficient amounts of these hormones are available, which results in disturbances in body chemistry.
People with Addison's disease feel weak, lethargic, lose their appetite and weight, and may suffer recurrent abdominal pain and vomiting. Other symptoms include, falling blood pressure, rising blood potassium levels and falling sodium levels in the blood.
These problems develop over time, usually weeks or months, and often it takes a while before the diagnosis is made. A characteristic feature of Addison's disease is the change in pigmentation that often occurs on certain parts of the body. The skin creases of the palms become hyperpigmented, looking similar to that of a suntan. This colour change may also occur on the knuckles, elbows and knees. The inside of the mouth may also darken in colour.
Getting the balance back
Where possible the underlying cause of the Addison's disease is treated. Oral corticosteroid drugs are taken to replace those hormones not being produced in sufficient quantities by the adrenal glands.
There are times when the dose of treatment needs to be increased, such as during times of infection. Patients with Addison's are always given clear advice about these issues, about the importance of always letting a doctor or dentist giving them treatment know that they're taking steroid medication, and not to stop treatment suddenly.
It's a good idea to carry a steroid card or wear an identification bracelet, so that if problems arise other people know you're taking steroid therapy.
With treatment and regular specialist monitoring, people with Addison's disease can expect to live active and long lives.
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