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 hormones – cortisol and aldosterone – which help to regulate blood pressure.
The adrenal glands are two small, pyramid-shaped glands that sit on top of the kidneys.
Each gland has inner and outer layers, each of which has a separate function:
- the inner area (the medulla) produces the hormone adrenaline
- the outer layer (the cortex) produces steroid hormones
In Addison’s disease, usually the cortex of the both adrenal glands has been destroyed. This disrupts the production of two steroid hormones, called cortisol and aldosterone.
Cortisol is released in stressful situations and helps to maintain your energy levels, your blood sugar levels and carbohydrate metabolism. Aldosterone maintains the balance of salt and water in your body, which helps to control blood pressure.
When the adrenal glands don't produce enough cortisol and aldosterone, symptoms of Addison's disease can appear.
Addison’s disease is usually caused by an autoimmune condition, where the immune system produces antibodies that attack the body. This can damage the adrenal glands and disrupt the production of cortisol and aldosterone.
There is also research to show that people with certain genes may be more likely to develop Addison’s disease, especially those who already have another autoimmune condition, such as diabetes. Other potential causes include conditions that might damage the adrenal glands, such as tuberculosis (TB).
Addison's disease is rare. It is estimated that it affects around 14 people in every 100,000 in the UK. It can affect anyone of any age and both men and women equally.
Read more about the causes of Addison’s disease.
What are the symptoms of Addison’s disease?
At first, the symptoms of Addison’s disease are similar to other more common health conditions such as depression or flu. Dehydration can also be an early sign due to the lack of aldosterone in the body.
Over time, these symptoms may become more frequent, or get worse and you may also experience further symptoms, such as dizziness, fainting, cramps, exhaustion and increasing skin pigmentation.
It is thought that stress such as an illness or accident can also trigger these symptoms, or cause them to get worse.
Read more about the symptoms of Addison’s disease.
Although these aren’t always caused by Addison’s disease, if you have them, see your GP. They may want to confirm or rule out a diagnosis 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 medication for the rest of your life.
The medication is reasonably effective at controlling the symptoms, although there may be times, particularly when you are feeling stressed or under pressure, where you experience tiredness, lethargy (a lack of energy), depression and, in women, a reduced libido (sex drive).
Due to advancements in treatment, the average life expectancy for people with Addison’s disease has improved significantly over the last 50 years and is now similar to the population at large. However, people with Addison’s disease do have a higher than average risk of developing serious conditions in later life, such as heart disease and cancer.
Read more information about living with Addison's disease and how Addison's disease is treated.
If Addison’s disease if left untreated and your levels of cortisol reach dangerously low levels, it can lead to complications such as hypoglycaemia or a situation known as an adrenal crisis.
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 the complications of Addison’s disease.
