Addison’s Disease – Diagnosis and Treatment
Addison disease affects the adrenal glands, which sit above the kidneys. These glands do not make enough of certain hormones, causing health problems.
People with Addison disease may feel tired, have muscle weakness, lose weight, or notice their skin getting darker.
Doctors identify Addison disease by performing medical evaluations, physical exams, and hormone tests. Early diagnosis and treatment are necessary because the condition can become life-threatening if not managed.
Diagnosis
Doctors look for symptoms like tiredness, skin darkening, weight loss, and low blood pressure to diagnose Addison’s disease. They use a full medical history to guide which tests to order.
Doctors usually start with blood tests. These tests measure cortisol, aldosterone, sodium, potassium, and adrenocorticotropic hormone (ACTH) levels. Low cortisol and high ACTH suggest primary adrenal insufficiency.
Some blood tests also check for antibodies to see if autoimmune problems affect the adrenal glands.
Doctors use the ACTH stimulation test to check how well the adrenal cortex makes cortisol. They give a shot of lab-made ACTH and then measure cortisol levels. If cortisol stays low, the adrenal glands are not working well.
Doctors may use the insulin-induced hypoglycemia test to check the pituitary gland. After giving insulin, they measure blood sugar and cortisol. A poor response may show secondary adrenal insufficiency.
Imaging tests like CT scans can show changes in the adrenal glands. MRI scans look at the pituitary gland for damage.
| Test | What it Checks |
|---|---|
| Blood tests | Hormone, sodium, potassium, antibodies |
| ACTH stimulation | Cortisol response to ACTH |
| Insulin test | Cortisol response after low blood sugar |
| CT/MRI scans | Size/damage in adrenal or pituitary glands |
Treatment
Doctors treat Addison’s disease by replacing the hormones the adrenal glands do not make. Most people take a steroid medicine every day.
These medicines include glucocorticoids to replace cortisol. Doctors often prescribe a mineralocorticoid to replace aldosterone. People take these medicines on a set schedule to match the body’s normal hormone changes.
People with Addison’s disease need to watch their sodium intake. Exercise, hot weather, or diarrhea can cause the body to lose extra salt and water, which increases the risk of dehydration and low blood pressure.
Eating more salt can help control dizziness, weakness, and muscle cramps.
Doctors may change the medicine dose during stress, surgery, infection, or illness. If someone cannot keep down pills because of vomiting or diarrhea, doctors give a corticosteroid injection to prevent an adrenal crisis.
An Addisonian crisis can cause low blood pressure, shock, and even death if not treated quickly. Doctors give IV steroids, saline, and glucose right away in an emergency.
Common Signs of Adrenal Insufficiency
| Symptom | Possible Cause |
|---|---|
| Fatigue | Low cortisol |
| Weight loss | Not enough steroid hormone |
| Nausea, vomiting | Hormone imbalance |
| Dizziness | Low blood pressure |
| Salt craving | Lack of aldosterone |
| Muscle weakness | Dehydration, low sodium |
| Hypoglycemia | Cortisol deficiency |
| Darkened skin | Hormonal changes |
People should wear a medical alert bracelet and carry an emergency steroid card. They need to keep extra medicine at work or when traveling. A corticosteroid injection kit should be ready for emergencies.
Regular checkups with a healthcare professional are important. These visits may include screening for other autoimmune diseases and checking blood levels like potassium and sodium.
The healthcare team helps adjust medicine doses and manage side effects like low blood sugar and muscle weakness.
Some people ask about taking over-the-counter supplements like dehydroepiandrosterone (DHEA) or prescription hormone therapy for certain symptoms, but they should always talk to their doctor first.
Getting Ready for Your Visit
Steps You Can Take Before Seeing Your Doctor
Preparing for a medical visit helps make the most of the time with your healthcare provider. Bringing a family member or friend can help recall important details.
Key steps to get ready:
- Write down your symptoms, when they started, and any changes.
- List all medicines and supplements, including prescription drugs, over-the-counter pills, vitamins, and herbal products. Note the amount taken each day.
- Make a note of recent stress, illness, or life changes that may affect your health.
- Prepare questions to ask your doctor.
Sample questions to consider:
| Question | Purpose |
|---|---|
| What might be causing these symptoms? | Help understand possible conditions |
| Which tests are necessary? | Plan next steps with the healthcare provider |
| Is this condition long-term or temporary? | Set expectations for future care |
| What is the recommended treatment? | Get clarity on the treatment plan |
| How should other health conditions be managed together? | Ensure overall health management |
| Are there any activity restrictions? | Avoid complications with daily activities |
Tips:
- Bring a notepad or smartphone to take notes.
- Carry an emergency ID if you have Addison’s or another hormone condition.
- Tell your provider if you need extra support from social work.
What the Healthcare Provider May Ask
Doctors often ask if symptoms are always present or come and go. They want to know how severe the symptoms are.
Doctors may ask what makes symptoms better or worse and if anything has changed. They may talk about your medicines, stress, or other health concerns.
Doctors may check if you need emergency plans, special identification, or referrals to support services. Expect regular follow-up visits to track your progress and adjust treatment.
Helpful hint: Organizing your medical information helps you have better conversations with your doctor.
