Underactive Adrenal Glands / Addison's Disease
Lack of corticosteroids in the blood may cause the pituitary gland to produce more corticotropin hormones to stimulate the adrenal glands. Since corticotrophin affects melanin production, excess levels of corticotropins may cause dark pigmentation of the skin and lining of the mouth.
Addison's disease is the result of an underactive adrenal gland. An underactive adrenal gland produces insufficient amounts of cortisol (a steroid hormone that helps to control the body's use of fats, proteins, and carbohydrates, suppresses inflammatory reactions in the body, and affects immune system functions) and aldosterone (a steroid hormone that controls sodium and potassium in the blood). Addison's disease is considered rare. Onset of this disease may occur at any age.
Destruction of the adrenal gland due to an auto-immune response is the most common cause of the disease. Some Addison's disease cases are caused by the actual destruction of the adrenal glands through cancer, infection, or other diseases. Other causes may include:
- Use of corticosteroids as a treatment (such as prednisone) causes a slow down in production of natural corticosteroids by the adrenal glands.
- Certain drugs used to treat fungal infections may block production of corticosteroids in the adrenal glands.
Lack of adrenal hormones may cause:
- elevated levels of potassium.
- extreme sensitivity to the hormone insulin, which normally is present in the bloodstream. This sensitivity may lead to low blood sugar levels.
- increased risk during stressful periods, such as surgery, infection, or injury. Corticosteroids play an important role in helping the body fight infection and promote health during physical stress.
Mild Addison's disease symptoms may only be apparent when the patient is under physical stress. The following are the most common symptoms of Addison's disease. However, each individual may experience symptoms differently. Symptoms may include:
- dark skin
- black freckles
- bluish-black discoloration around the nipples, mouth, rectum, scrotum, or vagina
- weight loss
- lack of appetite
- muscle aches
- intolerance to cold
If not treated, Addison's disease may lead to severe abdominal pain, extreme weakness, low blood pressure, kidney failure, and shock - especially when the patient is experiencing physical stress.
The symptoms of Addison's disease may resemble other conditions or medical problems. Always consult your physician for a diagnosis.
In addition to a complete medical history and medical examination, diagnostic procedures for Addison's disease may include:
- blood tests to measure corticosteroid hormone levels
- kidney function tests to determine if urine is concentrated
The goal of treatment is to restore the adrenal glands to normal function, producing normal levels of corticosteroid hormones. Specific treatment for Addison's disease will be determined by your physician based on:
- your age, overall health, and medical history
- extent of the disease
- your tolerance for specific medications, procedures, or therapies
- expectations for the course of the disease
- your opinion or preference
Since Addison's disease can be life threatening, treatment often begins with administration of corticosteroids. Corticosteroids, such as prednisone, may be taken orally or intravenously, depending on the patient's condition. Usually the patient has to continue taking the corticosteroid the rest of his/her life. Treatment may also include taking fludrocortisone, a drug that helps restore the body's level of sodium and potassium.
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