Addisons Newspaper Article

The following article was written by Dr Cindy Pan. It appeared in body+soul in The Sunday Telegraph on July 30, 2006

Addison's disease is a rare hormonal disorder that is potentially life-threatening but it can be managed.

Addison's disease, named after Dr Thomas Addison, who first identified the condition in 1849, is a rare hormonal disorder affecting around one in every 100,000 people.

It's also referred to as chronic adrenal insufficiency, since sufferers' adrenal glands produce insufficient amounts of certain hormones, in particular cortisol and sometimes aldersterone too.

People of all ages and sexes can be affected.

The symptoms can develop quickly (especially in children or teenagers) or they may creep up gradually over many years. In some cases the symptoms may be ignored until an illness or accident causes them to dramatically worsen, in what is called an Addisonian crisis.

Once diagnosed, the problem can be managed by replacing or substituting the hormones that are deficient.

What are the symptoms?

Typical symptoms are chronic worsening muscle fatigue and muscle weakness, poor appetite and weight loss. There may also be nausea, vomiting and diarrhoea, low blood pressure and dizziness or fainting.

Another characteristic feature is hyperpigmentation or dark tanning of the skin or mucous membranes.
Other symptoms may include irritability and depression, as well as cravings for salt or salty foods. In women, periods may become irregular or even stop.

Low blood sugar or hypoglycaemia and dehydration may also occur. In severe cases, there may be mental confusion or even loss of consciousness.

Addisonian crisis

In an Addisonian crisis, sufferers may experience a sudden onset of violent pain in the abdomen, back and legs, along with nausea, vomiting and diarrhoea. There may be acute lowering of blood pressure, low blood pressure and rapid heart rate, mental confusion and possibly loss of consciousness.

Untreated, such a crisis can be fatal. People who have been diagnosed with Addison's disease should carry a card and wear a bracelet or necklet with information on what to do in the case of accidents and medical emergencies and carry emergency treatment in the form of injectable hydrocortisone.

What causes it?

The problem may be primarily due to a disorder of the adrenal glands or it may be due to a problem with the pituitary gland.
One of the most common causes is an autoimmune disorder.

How is it diagnosed?

There are various hormonal tests that can be done to confirm the diagnosis as well as attempt to determine the cause. You may also need imaging done to your adrenal and pituitary glands.

How is it treated?

Your doctor will prescribe hormones to replace the ones that are deficient. The doses will be tailored according to your needs and your doctor will also teach you how to make adjustments in dosages in times of illness or stress.
Ideally, those close to you should also learn a little about your condition, in particular how to manage an Addisonian crisis. Fortunately, with good care, Addison's disease need not rule your life, and so long as you take your medication, there is virtually nothing you cannot do.

Permission to reprint kindly given by Dr Cindy Pan and Milissa Deitz, editor body+soul, The Sunday Telegraph July 30, 2006