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Addison’s disease

Addison’s disease is a rare disorder of the adrenal glands. The glands produce two essential hormones. With Addison’s disease, not enough hormones are produced. It can affect people of any age, although it's most common between the ages of 30 and 50. It's also more common in women than men.

About Addison’s disease

The adrenal glands are two small glands that sit on top of the kidneys. They produce two essential hormones: cortisol and aldosterone.

In Addison's disease, the adrenal gland is damaged, and not enough cortisol and aldosterone are produced.

Symptoms of Addison’s disease

Addison’s disease can present in two ways depending on how low the hormone levels are.

Most patients present with vague symptoms similar to other more common health conditions, such as depression or flu. 

You may experience:

  • fatigue (lack of energy or motivation)
  • muscle weakness
  • low mood
  • loss of appetite and unintentional weight loss
  • increased thirst

Over time, these problems may become more severe.   

You may experience further symptoms, including :

  • dizziness
  •  fainting 
  • cramps 
  • exhaustion

You may also develop small areas of darkened skin, or darkened lips or gums.

Although these symptoms aren’t always caused by Addison’s disease, you should see your GP, so they can be investigated.

More than half of people with Addison's disease have symptoms and signs for more than one year before diagnosis.

If the hormone levels are very low a person with Addison's disease may have a sudden crisis (adrenal crisis) which may be triggered by an episode of infection or stress. This is a medical emergency.

Symptoms include:

  • dizziness
  • cold, clammy and pale skin
  • tummy pain
  • temperature
  • vomiting

Diagnosing Addison’s disease

To help diagnose Addison’s disease, your GP will first ask about your symptoms and review your medical history.

They're also likely to ask if anyone in your family has an autoimmune disorder (a condition caused by a problem with their immune system).

Your GP will examine your skin for any evidence of brownish discolouration (hyperpigmentation).

If Addison’s disease is suspected, blood tests will be carried out to measure the levels of sodium, potassium and cortisol in your body.

A low sodium, high potassium or low cortisol level may be an indication of Addison’s disease.

Causes of Addison’s disease

The condition is usually the result of a problem with the immune system.

It causes it to attack the outer layer of the adrenal gland (the adrenal cortex), disrupting the production of steroid hormones aldosterone and cortisol. It's not clear why this happens.

Other potential causes include conditions that can damage the adrenal glands, such as tuberculosis (TB), although this is uncommon in Northern Ireland.

Treating Addison's disease

Addison’s disease is treated with medication to replace the missing hormones. You'll need to take the medication for the rest of your life.

With treatment, symptoms of Addison's disease can largely be controlled.

Most people with the condition live a normal lifespan and are able to live an active life, with few limitations.

Many people with Addison's disease also find they must learn to manage bouts of fatigue and there may be associated health conditions, such as diabetes or an underactive thyroid.

People with Addison's disease must be constantly aware of the risk of a sudden worsening of symptoms, called an adrenal crisis. This can happen when the levels of cortisol in your body fall significantly.

An adrenal crisis is a medical emergency. If left untreated, it can be fatal. If you or someone you know has Addison’s disease and is experiencing severe symptoms, dial 999 for an ambulance.

More useful links

  • Addison's disease
  • How to use your health services

The information on this page has been adapted from original content from the NHS website.

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