Addison Disease

Addison disease is a rare condition in which damaged or poorly functioning adrenal glands do not make enough cortisol and often do not make enough aldosterone. Cortisol helps the body respond to stress and maintain blood pressure and blood sugar, while aldosterone helps control salt, potassium, fluid balance, and blood pressure. Also called primary adrenal insufficiency, Addison disease can affect children and adults of any age.

Addison disease symptoms often develop gradually and may be mistaken for other health problems. They can be persistent or nonspecific, then become more noticeable during an infection, injury, surgery, or another physical stress. In children and adolescents, adrenal hormone deficiency may also affect growth, puberty, or school performance.

Addison disease develops when injury or dysfunction of the adrenal cortex reduces production of cortisol and often aldosterone. Without enough of these hormones, the body may struggle to respond to stress, maintain blood pressure, and keep sodium, potassium, and fluid levels balanced. Autoimmune damage is the most common cause in many settings, but infections, bleeding, cancer, inherited disorders, and treatments can also damage the adrenal glands.

Genetic traits and an autoimmune tendency are generally nonmodifiable, while infection prevention, medication review, and careful medical follow-up may help manage some contributors. Many cases of addisons cannot be prevented because the underlying cause is not controllable. Having a risk factor does not mean that someone has Addison disease; persistent symptoms require medical evaluation and appropriate testing.

Infection, injury, surgery, severe stress, vomiting, or missed medicine can increase the risk of complications. An individualized sick-day plan explains when to adjust steroid doses, seek advice, or use emergency medicine. People with Addison disease should review this plan regularly with their clinician and share it with trusted caregivers.

Clinicians review symptoms, medicines, medical history, family history, and autoimmune conditions before examining blood pressure, skin changes, and signs of dehydration. Because symptoms may overlap with other illnesses, the evaluation usually combines a physical examination with hormone and electrolyte testing. The results help determine whether adrenal insufficiency is present and whether it is likely primary Addison disease or another form of adrenal insufficiency.

Hormone tests and imaging should be interpreted by a qualified clinician because results can be affected by medicines, illness, and timing. If an adrenal crisis is suspected, urgent treatment may begin before every result is available.

Addison disease treatment usually replaces missing cortisol with hydrocortisone or another glucocorticoid. Fludrocortisone may replace aldosterone when mineralocorticoid support is needed. An endocrinology team individualizes the dose and may adjust it during illness, injury, surgery, or other physical stress.

Addison disease is usually chronic rather than curable, so most people need lifelong hormone replacement. With accurate treatment, monitoring, and a plan for illness, replacement therapy can control symptoms and support work, school, exercise, and everyday activities. Ongoing education is important because hormone needs can change during physical stress.

Schedule a medical evaluation for ongoing fatigue, unexplained weight loss, darker skin, salt craving, dizziness, low blood pressure, recurrent gastrointestinal symptoms, or symptoms that worsen during illness. These signs can have many causes, but timely assessment can identify adrenal hormone deficiency and other treatable conditions. People already taking replacement medicine should contact their care team when illness affects their ability to follow the treatment plan.