Addison’s disease

What is Addison’s disease?

The condition is generally caused by an autoimmune disease in which the tissue of the adrenal gland is attacked and subsequently destroyed by the body itself. As the adrenal cortex is responsible for the production of hormones such as cortisol and aldosterone, Addison's disease leads to a hormone deficiency in the body. This is why the treatment for Addison's disease consists primarily of replacing the hormones that the body is lacking.

How does Addison’s disease manifest itself?

The symptoms of Addison's disease are rather unspecific in the beginning. Affected individuals describe feeling tired, fatigued, losing weight or an increased thirst. As the disease progresses, low blood pressure and salt cravings often become noticeable. The reason for this is aldosterone deficiency, as aldosterone plays an important role in the body's own blood pressure control by regulating the salt balance in the body. Salt attracts water, so increased salt consumption also increases the volume of fluid in the blood vessels long-term.

One of the most noticeable symptoms of the disease is the bronze-colored skin and mucous membranes of those affected, which can be seen regardless of sun exposure. The dark pigmentation of the skin is caused by a specific type of cell, melanocytes, which normally produce the pigment melanin as a reaction to increased UV radiation in the skin. When there is a cortisol deficiency (as occurs in Addison's disease), an increased amount of other hormones are secreted by the brain to stimulate cortisol production in the kidneys. One of these cortisol-stimulating hormones is also converted into a hormone responsible for the increased production of melanocytes in the skin. Ultimately, this chain of processes leads to more melanocytes being present in the skin, meaning that they produce more melanin, i.e. dark pigment, in the skin. This is why patients with untreated Addison's disease often have bronze-colored skin.

How is adrenal insufficiency diagnosed?

If a patient complains of one or more of the aforementioned symptoms, a blood test is first carried out. This can often provide information as to whether there is an adrenal insufficiency because the sodium and potassium levels in the blood change when there is a hormone deficiency. There are also specific blood tests that measure the cortisol level in the blood before and after an adrenal-stimulating hormone is given. These tests determine whether the adrenal gland is capable of producing more cortisol or if the cause lies outside the adrenal gland. To subsequently identify the cause of the insufficiency, blood can be tested for antibodies against adrenal tissue. If such antibodies are found, a diagnosis of Addison's disease can be made.

How is Addison’s disease treated?

Patients with Addison's disease generally only require medication to treat the missing hormones in the form of tablets. This mainly involves hydrocortisone and sometimes also fludrocortisone, which is converted in the body to cortisol and aldosterone, among other things. One major complication of Addison's disease is the Addisonian crisis. It describes a condition in which patients with Addison's disease have an acutely increased hormone requirement that should be treated as quickly as possible. Triggers for this include stressful situations, infections, or the abrupt discontinuation of previously taken hormones. Symptoms include fever, vomiting, diarrhea, circulatory problems, and severe dehydration. If these symptoms occur, a doctor should be consulted as soon as possible.

Can Addison’s disease be cured?

No, Addison's disease cannot be cured, although it can be very well managed. Since Addison's disease is mostly triggered by an autoimmune reaction against the adrenal tissue, it is considered an autoimmune disease. Unfortunately, it is not yet possible to stop the body from producing these antibodies against the adrenal gland. Nevertheless, by administering these hormones in the form of tablets, it is possible to lead a largely normal and completely symptom-free life.

Which doctor can diagnose adrenal insufficiency?

The field of endocrinology in medicine deals with disorders of the body's hormone balance. Accordingly, diagnosis and treatment usually take place after a referral from a general practitioner to an endocrinologist. Endocrinology is a subspecialty of internal medicine, which includes internists.

Anyone in need of a doctor would expect the best possible medical care for themselves. Therefore, patients are looking for the most suitable clinic for their needs. Since this is not an objective decision and a respectable doctor would refrain from claiming to be the best, patients must trust the experience of a doctor.

We can help you find an appropriate expert for your condition. All the doctors and clinics listed have undergone extensive review and have been verified by us for their outstanding expertise in the field of Addison’s disease. They are looking forward to and are ready to address your questions and treatment requests.