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Understanding Addison’s Disease

Understanding Addison’s Disease



Addison’s disease is a rare disorder, affecting just 1 in 10,000 people. As there is no known cure for it, patients have to settle for steroid replacement therapy in order to give them the best possible chances of resuming a life that’s close to normal. Symptoms can be vast and overwhelming, though research shows they do respond well to treatment. Each sufferer experiences Addison’s disease in their own unique way, so emphasis on managing the disease is always at the heart of any treatment plan.


Sufferers of Addison’s show higher than average rates of mental health disorders, with psychotherapy being offered by practitioners in 1 in 12 cases. Adrenal failure brings with it it’s own complications, so successful management of the illness is high on any doctor’s list of priorities when treating their patient.


To understand Addison’s disease better, we’ll take a look at some of the most commonly questions asked by those with an interest in adrenal health.


What is Addison’s Disease?


Internal structure of kidneys with adrenal glandIn a healthy human being, the adrenal glands secrete the hormones cortisol and aldosterone in healthy amounts. There’s never any reason to suspect an imbalance in either, and no symptoms exist to cause any suspicion that the adrenal gland is underperforming.


In the Addison’s patient, the above hormones aren’t produced at the correct levels, causing physical symptoms to manifest, usually leading to the diagnosis of an adrenal disorder.


The disorder was named after Thomas Addison, a British Physician specializing in endocrinology. One of the most famous sufferers of Addison’s was ex-president John F. Kennedy, who was among of the first people with the condition to survive having a major surgical operation.


What are the symptoms of Addison’s disease?


Addison’s disease usually has two types of symptoms: physical manifestations of the illness, and regular, everyday symptoms sufferers report to experiencing. When experiencing the early stages of Addison’s disease, extreme fatigue, low mood, weakness and flu-like symptoms are usually present.


Symptoms are known to progress as time passes, often becoming more severe and more life-altering. Sickness, low blood-pressure, fainting, cramping and joint pain are just some of the discomforts Addison’s sufferers face.


Occasionally, more severe symptoms can develop, such as psychosis, or delayed periods in women. Children with the condition may experience the onset of puberty much later than normal, and are prone to anxiety and depression as they age.


What causes Addison’s Disease?


Addison’s disease develops when the outer layer of the adrenal gland becomes damaged. This alters the way in which it produces hormones, resulting in an eventual diagnosis. Some reasons for the damaging of the adrenal gland include auto-immune disorders and genetics.


Other reasons for Addison’s disease include tuberculosis, cancer, hemorrhaging and surgical removal of the adrenal glands. As each of these are extremely rare, the likelihood of any individual developing Addison’s disease is low, however in certain countries, where sanitation is less developed, rates of the disease are much higher than in the Western world.


Getting a Diagnosis


As Addison’s is such a consequential complaint, doctor’s will take any indications that it may be a problem extremely seriously. At first, a doctor will usually ask about a patient’s symptoms, then their family history. If there are any indications that Addison’s disease or auto-immune disorders are genetic, further testing will be sure to take place.


Doctor’s will also check a patient for any hyperpigmentation on their skin, an often tell-tale sign the disorder is present. This can be found around the elbows, and on any recent scarring that the patient may have.


Further Testing to Establish a Diagnosis


Blood testing will be carried out if a doctor suspects Addison’s may be a realistic possibility. Sodium, potassium and cortisol levels will usually indicate the state of a person’s adrenal health. Depending on the health care plan, blood work may also check aldosterone levels, adrenocorticotrophic levels and blood glucose, all of which can provide deeper insight into the state of the adrenals.


The synacthen stimulation test will be the final test before getting a diagnosis. A synthetic copy of the adrenocorticotrophic hormone will be administered, before testing the levels of cortisol in the blood. If levels are high when tested, it’s usually enough to confirm an Addison’s diagnosis.


Other Tests


To make sure the problems are only confined to one area, doctor’s will often recommend other tests along with Addison’s testing. One of the tests recommended is for the thyroid. As the thyroid gland is sensitive to its surroundings, checking it for normal function is recommended.


Studies show Addison’s sufferers often suffer from an underactive thyroid along with their condition, usually something that needs medicating.




Treatment for Addison’s disease involves taking a daily dose of replacement hormones. On average, treatment is successful, and allows the diagnosed to lead a normal life. Hydrocortisone is the most common form of medication prescribed, replacing the cortisol that’s naturally missing from a person’s endocrinological system.


In some cases, the reason for the Addisons disease can be treated, causing a reversal in symptoms, but this is extremely rare. Tuberculosis can be treated with a six-eight month course of antibiotics, but damage to the immune system caused by an auto-immune disease cannot be undone.


Living With Addison’s


Once the disease is fully under control and a prescription of medication administered, the quality of life for an Addison’s suffer should increase dramatically. Managed Addison’s disease doesn’t affect life quality or life expectancy by any great amount.


Appointments with an endocrinologist should usually be scheduled every 6 to 12 months, just to ensure hormonal levels and general health levels remain optimal.


Extra care must also be taken to ensure a healthy routine remains in place. A large part of this routine is the medicinal side of things, which is why it’s recommended Addison’s sufferers always request repeat prescriptions, and keep hold of extra doses of medication in their wallets and in cars incase of an unexpected situation.


Some choose to wear medical alert bracelets, detailing their condition. Others choose to notify family, friends and work colleagues. The choice, is of course up to the patient, with some choosing to keep their illness personal.





Anna C. RN-BC, BSN, PHN, CMSRN Anna began writing extra materials to help her BSN and LVN students with their studies. She takes the topics that the students are learning and expands on them to try to help with their understanding of the nursing process. She is a clinical instructor for LVN and BSN students along with a critical care transport nurse.

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