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What is Addison's Disease? |
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Symptoms
Addison’s disease is an adrenal insufficiency disorder of either the endocrine or hormonal system, and it affects persons of all ages and genders equally. The symptoms of the condition develop gradually, and are initially associated with weight loss, fatigue and muscle debilitation, or a reduced blood pressure. In about half of all cases, queasiness and vomiting follows, as well as bouts of diarrhea. Some patients also experience regional changes in skin tone – hyperpigmentation or skin darkening is observed on both bare and unexposed parts of the body, and is more prominent on scars, folds, lips, and the jointed parts like the elbows, knees, and knuckles.
Causes
Addison’s disease is the result of an underproduction of cortisol or aldosterone, hormones which are secreted by the adrenal glands; the former is a natural steroid which promotes the body’s normal functioning, and the latter controls blood pressure by maintaining the normal salt levels in the bloodstream. Addison’s disease may be an auto-immune condition, meaning that the body itself produces the antibodies which pair with the cells (those responsible for secreting the hormones) within the adrenal glands and break down; it may also be caused by prior conditions, such as tuberculosis or any other type of infections, or a tumor or cancer which spreads to and afflicts both of the adrenal glands. Underproduction of the ACTH hormone by the pituitary can also reduce the production of cortisol, and may be considered as a secondary cause of Addison’s disease.
Diagnosis
Addison’s disease is hard to diagnose in the early phases, and the doctor usually relies on the patient’s history of physical symptoms when confirming a suspicion. Lab tests follow the consultation in order to detect cortisol insufficiency and to ascertain the reason behind it. An ACTH stimulation test is by far the most efficient means of diagnosis; the patient’s levels of cortisol in the urine or blood are measured prior to and after an intravenous shot of synthesized ACTH. There should be an increase cortisol levels in a normal reaction; a patient with an adrenal insufficiency either responds inadequately or does not react at all. The measurement is usually repeated at least a half-hour after the injection, and if the results are abnormal, a CRH stimulation test is performed to determine the cause, wherein the patient’s blood cortisol levels are measured in half-hour increments following a synthesized CRH injection.
Treatment Info
The condition may be reversed or treated by making up for the insufficiency, primarily through replacement therapy. The patient takes oral hydrocortisone tablets as a substitute for the cortisol deficiency; this is a synthesized glucocorticoid, and is taken up to two times a day. If the patient also suffers a deficiency in aldosterone, daily oral intakes of single doses of fludrocortisone acetate is advised, supplemented by an increased salt content in the diet. Since the condition also involves health-threatening, low levels of blood pressure and glucose, as well as an increase in potassium levels, the patient may also undergo intravenous therapies of synthesized hydrocortisone, saline solution, and dextrose. The applicable doses depend on the severity of the condition and the needs of the patient.
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