Treatment of Adrenal Insufficiency (addisons Disease)

About the disease

Adrenal insufficiency, also known as Addison's disease, is an endocrine disorder that causes the adrenal glands to produce an insufficient amount of such hormones as cortisol and aldosterone. The adrenal glands are located just above the kidneys. Cortisol is a very important hormone and is responsible for such functions as helping the body to deal with stress, maintain normal blood pressure and balance normal metabolism. Aldosterone is responsible for regulating water and salt balance in the body. Normally, the amount of cortisol and aldosterone that is produced in the human body is regulated by the hypothalamus, which is part of the brain.

There are several reasons why the hypothalamus might start sending the wrong signals to the adrenal glands, causing a hormonal imbalance. According to the Pituitary Network Association, 70% of all adrenal insufficiency cases are caused by autoimmune diseases, whereby a person’s immune system starts to fight against itself. Another possible cause is disease of the adrenal gland itself. Adrenal insufficiency is considered to be a rare disease, with 1 out of 100,000 people being affected by it. 

Symptoms

• Fatigue
• Muscle weakness
• Nausea
• Diarrhea
• Weight loss
• Dizziness
• Darkened patches of skin
• Irritability
• Low blood sugar

Diagnosis

• Biochemical laboratory tests are primarily used to establish whether the patient has an insufficient amount of cortisol hormone in their bloodstream. After performing these tests, the doctors should have a better understanding of what might be causing the decrease of this hormone in the body.
• An insulin injection test is used to see how fast the body reacts to insulin that is administered into the blood. If there is no adrenal insufficiency, the cortisol level will start to rise 30 minutes after the injection. In people with adrenal insufficiency, the cortisol level will either not rise at all or it will rise very poorly. 

Treatment

• Most commonly, patients with adrenal insufficiency have to undergo conservative treatment. In order to substitute the hormones that are not produced properly by their adrenal glands, the patient will take hydrocortisone medication in order to get a sufficient amount of cortisone into their blood. The patient will also need to increase their salt, sugar and mineral levels with special injections.
• Saline treatment is needed if the amount of salt in the person's body becomes dangerously low. Intravenous saline injections help maintain salt balance in the body.

Authors: Dr. Vadim Zhiliuk, Dr. Sergey Pashchenko