Addison's disease 

Introduction 

Fatigue and low mood are common symptoms of Addison's disease 

The adrenal glands

The adrenal glands are two small, pyramid-shaped glands that sit on top of the kidneys. Each gland has inner and outer layers, which have separate functions:

  • the inner area (medulla) produces the hormone adrenaline
  • the outer layer (cortex) produces the hormones cortisol and aldosterone

In Addison's disease, the adrenal cortex is damaged and not enough cortisol and aldosterone are produced.

Addison’s disease (also known as primary adrenal insufficiency or hypoadrenalism) is a rare disorder of the adrenal glands. It affects the production of two essential hormones called cortisol and aldosterone.

The adrenal glands are two small glands that sit on top of the kidneys.

About 8,400 people in the UK have Addison's disease. It can affect people of any age, although it's most common between the ages of 30 and 50. It is also more common in women than men.

Early stages symptoms of Addison’s disease are similar to other more common health conditions such as depression or flu. You may experience:

  • fatigue (lack of energy or motivation)
  • muscle weakness
  • low mood
  • loss of appetite and unintentional weight loss
  • increased thirst

Over time, these problems may become more severe and you may experience further symptoms, such as dizziness, faintingcramps and exhaustion. You may also develop small areas of darkened skin.

Although these symptoms aren’t always caused by Addison’s disease, you should see your GP if you have them so they can be investigated.

Read more about the symptoms of Addison’s disease and diagnosing Addison’s disease.

Why it happens

The condition is usually the result of a problem with the immune system, which causes it to attack the outer later of the adrenal gland (the adrenal cortex), disrupting production of steroid hormones aldosterone and cortisol. It is not clear why this happens, but it is responsible for 70-90% of cases in the UK.

Other potential causes include conditions that can damage the adrenal glands, such as tuberculosis (TB), although this is uncommon in the UK.

Read more about the causes of Addison’s disease.

Treating Addison's disease

Addison’s disease is treated with medication to replace the missing hormones. You will need to take the medication for the rest of your life.

With treatment, symptoms of Addison's disease can largely be controlled and most people with the condition live a normal, healthy life.

However, there is a risk of a sudden worsening of symptoms called an adrenal crisis. This can happen when the levels of cortisol in your body fall significantly. 

An adrenal crisis is a medical emergency. If left untreated it can be fatal. If you or someone you know has Addison’s disease and is experiencing severe symptoms, dial 999 to request an ambulance.

Read more about treating Addison's disease.

Page last reviewed: 08/07/2013

Next review due: 08/07/2015

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Comments

The 11 comments posted are personal views. Any information they give has not been checked and may not be accurate.

Emmielou148 said on 17 August 2013

In regards to my last comment, my daughter is now 8 years old. Any advice gratefully received :)

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Emmielou148 said on 17 August 2013

Please can someone advise me. My daughter had meningococcal septicaemia when she was 11 months old. She has had development difficulties since but the biggest has been her waterworks. She is still in nappies of a night and us currently under a consultant due to persistent water infections. The first water infection started last summer when I also first noticed a discolouring of the skin on her forearm. Since them the doctors pumped her full if antibiotics but problem still ongoing. Last urine sample tested positive for white blood cells but no bacteria present. She is on medication for 6 months for irritable bladder. However, this summer the discolouration on her forearm has become darker and has spread up her arm and has a bit on her neck. Does this sound like it could be related to Addisons?

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My Input said on 10 June 2013

I was diagnosed with Addison's disease 32 years ago when I was 26. My dentist noticed the darkening of my gums and at my knuckles and elbows. I consider myself in good health with assistance. I spread my corticosteroids over the day - at breakfast, at lunch, in the afternoon with a snack (apple, cottage cheese, etc.) and at dinner. This best mimics nature. I also take florinef / fludrocortisone. I also take DHEA every day. An injectable is an absolute must for emergencies. My insurance doesn't cover, but it's $5 US at Wal-Mart. I'd have been to the emergency room 5 or 6 times in last 20 years without. I've also been able to head off some crises before they were full-blown. My advice is to not hang back, live your life. You can have a family (I started late and have one son). Except for a propensity to put on weight and a long labor, I had a very uneventful pregnancy and my son is fine. I work full time and do trail walking and swimming for recreation. Eat well, get enough rest, and drink alcohol moderately. You can have a great life. Over time, lots of people develop health problems. By the time you're my age, you won't feel so out of place. You are not damaged goods, you just have something to deal with. I have never developed any other endocrine disorders, but I do take medication for thinning bones. Be sure to start taking vitamin D no later than your mid 40s (my levels were way too low at that age). I hope I make 85 (my mother is still living at 93 and her brother is 96). I know I will not be able to live alone in old age because of the fear of having an Addisonian crisis without help, but I can deal with that.

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snekcid said on 09 March 2013

@ addisonsfighter

Generally speaking, coping with Addison's is not easy. The doctors valiantly try to present an optimistic picture but as I have said elsewhere, they may know all about the ship but they don't have to put to sea with it. The real truth is, that it has it's up's and downs and I think it is generally true to say that things compound with age, but that should not worry you for a while yet. You must give yourself plenty of time to rest and you should not hesitate to let the Doctor know when you feel unwell. Any infection has a fine old time with your immunity down and that's why you need the rest. I am a lot older than you, I am 66 and I have lived with this thing since I was fifteen. In fact I nearly died with it, but I've had a good life, even though there have been difficult times. Now, as I get older I really am finding things a pain. I think that's because your body gets tired of firing on three cylinders. I have the thyroid problems and diabetes that go with this thing plus ulcerative colitis ( slightly ). Some people fair better than others and you are just settling down to coping with it really. Things will improve and you will have a good happy life I'm sure, but always remember, you are running with a problem, you must remember that and not push things too far. You cannot expect to burn the candle at both ends like your companions may do. Also, you must be brave when things go wrong and although it seems hard for me to say this, you must soldier on. You have a young son dependant on you.Brace up as they say and pick up your burden, wait until you are sixty six ( I shall be gone by then no doubt) you'll find you get through and with plenty of worthwhile times to remember.

Barry Waterfield

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addisonsfighter said on 23 October 2012

I would like some advice please after being diagnosed with Addisons 2 yrs ago i have gone through hell with it. I've been in and out of hospital with various illnesses and bugs I have developed tiezes syndrome inflammation of the chest wall and i constantly feel and look ill. I have so many meds to try and boost my immune system and feel I'm not getting anywhere. I've had a chest infection for the past mnth which has exhausted me I also contracted pneumonia and now I'm in agony with pleurisy. I have had 2 courses of anti biotics but it doesn't seem to do anything. I double up on my hydrocortisone steroids when I'm ill but even that leads to a crises. Am I right in saying my condition will get worse and il develop more problems and health issues as I get older. I'm now 27 have a 9 yr old and I'm worried things Arnt going to improve I live with my parents cos wen I'm ill I just can't do anything I get extremely ill feel sick bad headaches and have extreme fatigue. Will it get any better. Because I feel that the steroids are just making my immune system weaker and I'm prone to getting anything now.

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snekcid said on 30 April 2012

This website states that people with Addisons disease have a higher than average risk of developing Heart Disease and Cancer in later life. Can anyone tell me why this is ?

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annelben said on 02 August 2011

I'm in the Addisons disease self help group and the advice from other members with Addisons is a great help.

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snekcid said on 25 July 2011

I have lived with Addison's disease since I was app 16yrs old and I am now 64. Whilst I am obviously grateful to medical science and whilst I can understand any parent wanting their child to live, as mine did all those years ago, I can say that there are many days when I wish to god they had never found a 'cure', because I would be history by now and at least the struggle with this wretched thing would be finished. I have to re-enter hospital if ever I pick up a simple sickness bug and I've lost count as to how many times that has happened.and I have now got at least two of the 'extras' that go with this disease, arthritis and thyroid disease. Even with replacement therapy there are frequent periods when I feel very unwell and crushingly tired. I would imagine that it would be the same for people with adrenal fatigue. I always try to keep a happy face for the doctor at the hospital but I am tired at heart and it gets worse, or so it seems, the older I get.The problem is I don't see how replacement therapy can ever match the output of a health body. Doctors are very helpful and know all about the running of the ship but they have never had to put to sea with it and that's the difference. I do feel for those people with adrenal fatigue but all I'm saying is, don't think it all gets magically better with medication because it does not, not in my case and many others from what I'.ve been told.

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shipshape said on 05 April 2011

i take licorace drops for my adrenal support but the reason i put in brackets ( not if you have high blood pressure ) is because licorace can raise blood pressure and if you already have high pressure it could raise it even more...., it would be best to get this monitored by your doctor. its ok for me becos i do not have high blood pressure, so look up an ddo your own research as i had to do. i am stilll suffering with night time wakefulness which is another adrenal problem ( circadian rythmn all wrong but no-one wants to help) sleepness ness in it self is detrimental to health but again no doc wants to investigate why a patient keeps waking up... check out low cortisol and sleepnessness.. info is out there why dont doctors know it.

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shipshape said on 03 April 2011

i do not understand why nhs do not accept or treat adrenal fatique.. as far as nhs is concerned there are only 2 functions, either fully functioning adrenal glands or addisons... what about the bit in the middle when you are getting worn down..it makes sense to trreat this before addisons sets in..it is not rare in this day and age. its disgusting that it is ignored, the symptoms are so awful . if you do not fit in the text book of endo's basic knowlegde then you get told you are a hypocondriac or sent off to a psychiatrist. all i can say is this. fully functioning doctors etc do not have a clue,what its like to have an adrenal crash it is torture and it would be best if nhs furthered their knowledge, if they dont know then look up Dr Lam or Dr James Wilson, the info is out there..with all the symptoms and every single body function that it affects and trust me it is not pleasant. i would also like to offer myself as a case study like the lady above me as i have all my notes.i am also writing to the society of endocrinology as its a national disgrace to leave us to fend for ourself. i now take b3 and b5 , a whole b complex, and licorace drops. i wish all you suffers well and email me back but be careful not to mention names.

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stardust71 said on 03 May 2010

i had seen in statistical info from nhs/governmnt mortality figures that there seemed tp be more women/females than men diagnosed with this condition. j have also noticed since diagnosis that there seems to be an inconsistent basic knowledge of the disease and treatment itself, either day to day or when in crisis. it could be seen as misleadinbasis.g having looked as best i can at your material that this disease does not affect peoples lives on a day to day basis - it can abd it does. having been given the labelof addissons health care providers then tend to attribute everything to the disease. i look back now almost 40 now, and, can see how this disease can me missed easily as rare but also because it can take years before you reach almost death before someone pieces together a history that = addisons. i genuinuly believed i would become well and bounce back, but have had many crisis's and am now disabled and unable to work. i would make an interesting case study for a young dr starting out as have all my notes - plse feel free to contact me. there would be no charge from myself or family, and it may improve ones knowledge base. i would only ask that i remained anonymous in any writings. family history of autoimmune ad endocrine disorders is very strong on my maternal side.

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