Addison's disease: causes, symptoms, and management

When working with Addison's disease, a chronic disorder where the adrenal glands don’t make enough steroid hormones. Also called primary adrenal insufficiency, it often stems from autoimmune adrenalitis and causes a drop in cortisol and aldosterone production. This hormone shortfall throws off stress response, blood‑pressure control and electrolyte balance. In plain terms, your body loses the built‑in “emergency boost” it normally gets from the adrenal glands.

Key aspects to understand

First, Addison's disease encompasses adrenal insufficiency, meaning the glands can’t meet the body’s demand for glucocorticoids and mineralocorticoids. Second, the condition requires lifelong glucocorticoid replacement—typically hydrocortisone or prednisone—to mimic natural cortisol spikes. Third, autoimmune adrenalitis influences disease onset by attacking adrenal tissue, but infections, bleeding or certain medications can also trigger it. Finally, low cortisol leads to fatigue, muscle weakness and cravings for salty foods, while aldosterone loss pushes sodium out and potassium in, sparking low blood pressure and dehydration.

Symptoms often creep in slowly, so they’re easy to miss. People report persistent tiredness that doesn’t improve with rest, darkening of skin especially on scars or pressure points, and an unexplainable desire for salty snacks. You might also notice dizziness when you stand up, unexplained weight loss, or occasional nausea and abdominal pain. These clues point to the core problem: the body isn’t getting enough cortisol to regulate metabolism and the right amount of aldosterone to keep fluid balance.

Diagnosing Addison's disease starts with a simple blood test to check cortisol levels, often followed by an ACTH (adrenocorticotropic hormone) stimulation test. If cortisol stays low after ACTH is given, the adrenal glands are confirmed as the weak link. Doctors also measure electrolytes—low sodium and high potassium signal aldosterone deficiency. Imaging like CT scans can rule out tumors or bleeding that might damage the glands.

Once confirmed, treatment revolves around hormone replacement. Glucocorticoids (hydrocortisone, prednisone, or dexamethasone) are taken daily, usually in two doses to imitate the natural morning‑evening cortisol rhythm. Mineralocorticoids such as fludrocortisone replace aldosterone and help retain sodium. Dosages aren’t one‑size‑fits‑all; doctors adjust them based on symptoms, blood pressure, and lab results. Stress—like illness, surgery, or a fever—requires a temporary boost in steroid dose to avoid an adrenal crisis, a life‑threatening drop in blood pressure and glucose.

Living with Addison's disease means learning to read your body’s signals. Carry a medical alert bracelet, keep emergency injection kits (solved with injectable hydrocortisone) handy, and wear a small card that lists your medications. If you feel dizzy, nauseous, or unusually weak, treat it as a potential crisis: take a double dose of your glucocorticoid and seek medical help immediately. With proper management, most people lead normal, active lives.

Beyond the basics, many patients wonder how other health issues intersect with Addison's disease. For instance, autoimmune conditions like type 1 diabetes, thyroid disease, or vitiligo often appear together because the same immune system misfires. Understanding these connections helps you and your doctor monitor for new symptoms early. Nutrition also plays a role: a balanced diet rich in sodium (if your doctor allows) can ease aldosterone‑related cravings, while adequate protein supports overall hormone synthesis.

In the collection below you’ll find articles that dive deeper into related topics—whether you’re curious about hormone‑based drug comparisons, the impact of stress on hormone levels, or how other endocrine disorders intersect with adrenal health. These pieces offer practical tips, latest research findings, and clear guidance to empower you on your health journey. Explore the posts to expand your understanding and find actionable insights that complement your Addison's disease management plan.