Addison’s Disease

Addison’s disease is a rare condition in which the adrenal glands do not produce enough of certain essential hormones, particularly cortisol. Without treatment, it can be life-threatening, but it is well managed with lifelong hormone replacement once diagnosed.

• Persistent fatigue and muscle weakness
• Unintentional weight loss and reduced appetite
• Low blood pressure, sometimes causing dizziness on standing
• Darkening of the skin, particularly in skin creases, scars, and areas of friction
• Craving for salty foods
• Nausea, vomiting, or abdominal pain can occur, and severe stress or illness can trigger a life-threatening adrenal crisis

• Most commonly results from autoimmune destruction of the adrenal glands.
• Can also result from infections (such as tuberculosis affecting the adrenal glands), or, less commonly, other causes of adrenal gland damage.
• Often associated with other autoimmune conditions in people with the autoimmune form.

• Diagnosed with blood tests showing low cortisol levels together with specific hormone stimulation testing, where available, to confirm the diagnosis.
• Blood electrolyte levels often show characteristic abnormalities.
• Investigation for an underlying cause, such as tuberculosis, may be considered depending on clinical context.

Lifelong hormone replacement with a corticosteroid (such as hydrocortisone) is the essential treatment, replacing the cortisol the adrenal glands can no longer produce.

The dose typically needs to be increased temporarily during illness, injury, or significant stress, following specific guidance the person is taught, since the body cannot naturally increase its own cortisol response during these times.

An adrenal crisis — triggered by illness, injury, or missed medicine — is a medical emergency requiring immediate injectable corticosteroid treatment and urgent hospital care.

People with Addison's disease are advised to carry medical identification and an emergency injection kit where available, given the risk of sudden crisis.

• Take hormone replacement medicine consistently and never stop it suddenly without medical guidance.
• Learn and follow sick-day dose adjustment guidance for illness, injury, or significant stress.
• Wear or carry medical identification indicating Addison's disease for emergency situations.
• Carry an emergency injectable corticosteroid where available and ensure family members know how to use it.
• Seek immediate emergency care for symptoms of adrenal crisis, such as severe weakness, vomiting, or collapse.