Addison’s Disease

Overview

Addison’s disease is a rare endocrine condition in which the adrenal glands do not produce enough essential hormones. The adrenal glands are small glands located on top of the kidneys. They help regulate many important body functions, including blood pressure, salt and water balance, energy use, and the body’s response to stress.

The condition is also called primary adrenal insufficiency. It develops gradually in many people, and early symptoms can be vague or similar to other health problems. With timely diagnosis and appropriate medical care, many people with Addison’s disease can manage the condition and continue daily activities.

Symptoms

Symptoms of Addison’s disease often appear slowly over weeks or months. They may become more noticeable during physical stress, such as an illness, injury, or surgery. Common symptoms can include:

• Ongoing tiredness or weakness
• Loss of appetite and unintentional weight loss
• Dizziness or lightheadedness, especially when standing
• Low blood pressure
• Nausea, vomiting, or abdominal discomfort
• Muscle or joint pain
• Craving for salty foods
• Darkening of the skin, especially in skin folds, scars, gums, or areas exposed to friction
• Low mood, irritability, or difficulty concentrating
• Low blood sugar, which may cause shakiness, sweating, or confusion

In some cases, symptoms can suddenly become severe. This is known as an adrenal crisis and is a medical emergency. It may involve severe weakness, dehydration, confusion, very low blood pressure, severe abdominal pain, vomiting, or fainting.

Causes and Risk Factors

Addison’s disease occurs when the adrenal glands are damaged and cannot make enough hormones. In many cases, this damage is caused by an autoimmune process, where the immune system mistakenly attacks the adrenal glands.

Other possible causes include certain infections, bleeding into the adrenal glands, inherited conditions, or diseases that affect the adrenal tissue. Less commonly, adrenal function may be affected by cancer involving the adrenal glands or by some medical treatments.

Risk factors may include having other autoimmune conditions, such as thyroid disease or type 1 diabetes, or a family history of autoimmune disorders. However, Addison’s disease can also occur in people without known risk factors.

Diagnosis

Diagnosing Addison’s disease usually involves a careful review of symptoms, medical history, physical examination, and laboratory tests. Because symptoms can be nonspecific, blood tests are important to evaluate hormone levels and the body’s salt and mineral balance.

Tests may assess adrenal hormone production and the signals sent from the brain to the adrenal glands. Blood sodium, potassium, and blood sugar levels may also be checked. In some cases, imaging tests may be used to look at the adrenal glands, especially if a cause other than autoimmune disease is suspected.

An endocrinologist, a doctor specializing in hormone-related conditions, may be involved in confirming the diagnosis and planning long-term care.

Treatment Options

Treatment for Addison’s disease focuses on replacing the hormones that the adrenal glands are not producing adequately. This usually involves long-term hormone replacement therapy prescribed and monitored by a doctor. The exact treatment plan depends on the individual’s hormone levels, symptoms, overall health, and response to treatment.

People with Addison’s disease need regular follow-up to ensure hormone replacement is appropriate. Monitoring may include assessment of symptoms, blood pressure, weight, and laboratory results. Treatment needs may change during times of illness, surgery, injury, or significant physical stress, so patients are usually given personalized medical guidance for these situations.

Education is an important part of care. Patients may be advised to carry medical identification indicating that they have adrenal insufficiency. They may also be given instructions by their healthcare team about how to respond if they become seriously ill or cannot take their usual medication. These plans should always be individualized by a medical professional.

Diet and lifestyle measures may also support general health, but they do not replace medical treatment. Maintaining regular follow-up and discussing new symptoms promptly with a healthcare provider are important parts of long-term management.

When to See a Doctor

Medical evaluation is recommended if a person has persistent unexplained fatigue, weight loss, dizziness, low blood pressure, darkening of the skin, frequent nausea, or salt cravings. These symptoms do not always mean Addison’s disease, but they should be assessed, especially if they are ongoing or worsening.

Urgent medical care is needed if symptoms suggest an adrenal crisis, such as severe weakness, fainting, confusion, severe vomiting, dehydration, or very low blood pressure. This situation can be serious and requires immediate professional treatment.

People already diagnosed with Addison’s disease should seek medical advice if they develop a significant illness, have repeated vomiting or diarrhea, experience worsening symptoms, or are planning surgery or major medical procedures. Regular communication with an endocrinology team helps support safe and effective ongoing care.

Frequently Asked Questions

What is Addison's disease?

Addison's disease, also called primary adrenal insufficiency, is a rare long-term condition in which the adrenal glands do not produce enough cortisol and, in many people, aldosterone. These hormones help regulate blood pressure, salt and water balance, energy use and the body's response to stress. The condition usually develops gradually, and early symptoms can be vague or resemble other health problems, which is why diagnosis is sometimes delayed.

What are the early symptoms of Addison's disease?

Early symptoms often appear slowly over weeks or months and may include ongoing tiredness, weakness, loss of appetite, unintentional weight loss, dizziness when standing, nausea or abdominal discomfort, muscle or joint pain and a craving for salty foods. Darkening of the skin in folds, scars or gums is a characteristic sign. Low mood, irritability and episodes of low blood sugar can also occur, and symptoms may worsen during illness or injury.

What causes Addison's disease?

Addison's disease develops when the adrenal glands are damaged and can no longer make enough hormones. In many people the damage is autoimmune, meaning the immune system mistakenly attacks adrenal tissue. Other causes include certain infections, bleeding into the glands, inherited conditions, cancer involving the adrenal glands or some medical treatments. Having another autoimmune condition, such as thyroid disease or type 1 diabetes, may increase the risk.

How is Addison's disease diagnosed?

Diagnosis combines a review of symptoms and medical history, a physical examination and laboratory tests. Blood tests assess adrenal hormone levels, the signals sent from the brain to the adrenal glands, and sodium, potassium and blood sugar levels. A stimulation test may be used to confirm how the glands respond. Imaging is sometimes added when a cause other than autoimmune damage is suspected. An endocrinologist usually confirms the diagnosis.

Is an adrenal crisis an emergency?

Yes. An adrenal crisis is a sudden, severe worsening of Addison's disease that requires emergency medical care. Warning signs include severe weakness, confusion, dehydration, very low blood pressure, severe abdominal pain, persistent vomiting or fainting. It can be triggered by infection, injury, surgery or missed medication. People with a confirmed diagnosis are usually taught sick-day rules and given an emergency plan by their treating team.

How is Addison's disease treated long term?

Treatment replaces the hormones the adrenal glands no longer produce, usually with daily tablets taken for life and adjusted by a doctor according to hormone levels, symptoms and overall health. Regular follow-up helps fine-tune doses and check for related conditions. Replacement medication should never be stopped suddenly, and any change in dose belongs with the treating endocrinologist. With consistent treatment many people continue normal daily activities.