Addison's disease

Title

Other Names:

Addison disease; Adrenal hypoplasia; Hypoadrenocorticism familial; Addison disease; Adrenal hypoplasia; Hypoadrenocorticism familial; Adrenal aplasia; Adrenal gland hypofunction See More

Categories:

Autoimmune / Autoinflammatory diseases; Congenital and Genetic Diseases; Endocrine Diseases; Autoimmune / Autoinflammatory diseases; Congenital and Genetic Diseases; Endocrine Diseases; Female Reproductive Diseases; Kidney and Urinary Diseases; Male Reproductive Diseases See More

Summary Summary

Addison's disease is a chronic disease that occurs when the adrenal glands do not produce enough (or any) of the hormones cortisol and aldosterone.^[1]^[2] Symptoms can vary from person to person but usually develop slowly over time, and are often non-specific at first.^[2] However, sometimes symptoms occur suddenly and cause a life-threatening condition called acute adrenal failure, also known as an acute adrenal crisis or Addisonian crisis.^[2]^[3]

Common symptoms of Addison's disease include fatigue, loss of appetite, and abdominal pain and nausea. Some people also experience mood or behavior changes. Other signs and symptoms of Addison's disease that may develop include dark patches of skin (hyperpigmentation), vitiligo, muscle weakness or pain, dehydration, and low blood pressure.^[2]^[3]

An acute adrenal crisis is a medical emergency which can lead to shock or kidney failure if not treated promptly. A crisis may cause sudden weakness, severe pain (in the back, abdomen, or legs), vomiting and diarrhea, and low blood pressure which can lead to fainting. A crisis may be triggered when a person with Addison's disease is under stress, such as during an accident, surgery, or severe illness.^[2]^[3]

In most cases, Addison's disease is caused by damage to the adrenal cortex (the outer part of the adrenal gland) due to an autoimmune reaction. In these cases, a person may not develop symptoms for months or years. This may be referred to as autoimmune Addison's disease, or primary adrenal insufficiency. If the adrenal glands do not produce hormones despite being undamaged (such as due to ACTH deficiency), it is referred to as secondary adrenal insufficiency. Less common causes of Addison's disease include repeated infections, cancer that spreads to the adrenal glands, CMV associated with HIV/AIDS, and amyloidosis. Tuberculosis remains a major cause in developing countries, but is no longer a major cause in the United States. Rarely, Addison’s disease runs in families and may be due to a genetic predisposition.^[2]^[3]

Addison's disease may be diagnosed based on symptoms, blood and urine tests that evaluate adrenal function, chest X-rays, and/or a CT scan to look at the size and characteristics of the adrenal glands.^[1]^[2]^[3] Treatment ideally should be managed by an endocrinologist who specializes in adrenal diseases. Daily treatment typically includes medicines (tablets) that replace the hormones cortisol and aldosterone. Treatment for an adrenal crisis may include intravenous hydrocortisone, fluids, and electrolytes, as well as drugs that normalize blood pressure.^[2]^[3] People with Addison's disease should carry a medical ID that states the disease and emergency instructions.^[2]^[3] An example is provided by the National Adrenal Diseases Foundation. With proper treatment and avoidance of dehydration, people with Addison's disease can avoid having crises and have a normal life expectancy.^[3]

Last updated: 3/19/2018

Symptoms Symptoms

This table lists symptoms that people with this disease may have. For most diseases, symptoms will vary from person to person. People with the same disease may not have all the symptoms listed. This information comes from a database called the Human Phenotype Ontology (HPO) . The HPO collects information on symptoms that have been described in medical resources. The HPO is updated regularly. Use the HPO ID to access more in-depth information about a symptom.

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Medical Terms	Other Names	Learn More: HPO ID
100% of people have these symptoms
Decreased circulating cortisol level		0008163
80%-99% of people have these symptoms
Abdominal pain	Pain in stomach Stomach pain [ more ]	0002027
Anorexia		0002039
Constipation		0002019
Diarrhea	Watery stool	0002014
Failure to thrive	Faltering weight Weight faltering [ more ]	0001508
Fatigue	Tired Tiredness [ more ]	0012378
Hyperpigmentation of the skin	Patchy darkened skin	0000953
Increased circulating ACTH level	High blood corticotropin levels	0003154
Muscle weakness	Muscular weakness	0001324
Nausea and vomiting		0002017
Weight loss		0001824
30%-79% of people have these symptoms
Androgen insufficiency		0008226
Decreased circulating aldosterone level		0004319
Decreased urinary potassium		0012364
Hyperkalemia	Elevated serum potassium levels	0002153
Hyperkalemic metabolic acidosis		0005976
Hyperuricemia	High blood uric acid level	0002149
Hyponatremia	Low blood sodium levels	0002902
Increased circulating renin level		0000848
Normocytic anemia		0001897
Renal salt wasting		0000127
5%-29% of people have these symptoms
Adrenal calcification		0010512
Adrenal hypoplasia	Small adrenal glands	0000835
Arthralgia	Joint pain	0002829
Celiac disease		0002608
Decreased female libido	Decreased female sex drive	0030018
Delayed puberty	Delayed pubertal development Delayed pubertal growth Pubertal delay [ more ]	0000823
Dry skin		0000958
Generalized bone demineralization		0006462
Hashimoto thyroiditis		0000872
Hypercalcemia	High blood calcium levels Increased calcium in blood [ more ]	0003072
Hypoglycemia	Low blood sugar	0001943
Hypoparathyroidism		0000829
Orthostatic hypotension		0001278
Premature ovarian insufficiency	Early menopause Premature menopause Premature ovarian failure [ more ]	0008209
Salt craving		0030083
Seizures	Seizure	0001250
Sparse axillary hair	Little underarm hair	0002215
Type I diabetes mellitus	Type 1 diabetes Type I diabetes [ more ]	0100651
Vertigo	Dizzy spell	0002321
Vitiligo	Blotchy loss of skin color	0001045
1%-4% of people have these symptoms
Primary testicular failure		0008720
Thiamine-responsive megaloblastic anemia		0004860
Thymoma		0100522
Percent of people who have these symptoms is not available through HPO
Abnormality of skin pigmentation	Abnormal pigmentation Abnormal skin color Abnormal skin pigmentation Abnormality of pigmentation Pigmentary changes Pigmentary skin changes Pigmentation anomaly [ more ]	0001000
Abnormality of the cardiovascular system	Cardiovascular abnormality	0001626
Adrenal insufficiency		0000846
Apnea		0002104
Autosomal recessive inheritance		0000007
Cyanosis		0000961
Feeding difficulties in infancy		0008872
Vomiting	Throwing up	0002013

Showing of 53 |

Do you have more information about symptoms of this disease? We want to hear from you.

Last updated: 10/1/2018

Do you have updated information on this disease? We want to hear from you.

Find a Specialist Find a Specialist

If you need medical advice, you can look for doctors or other healthcare professionals who have experience with this disease. You may find these specialists through advocacy organizations, clinical trials, or articles published in medical journals. You may also want to contact a university or tertiary medical center in your area, because these centers tend to see more complex cases and have the latest technology and treatments.

If you can’t find a specialist in your local area, try contacting national or international specialists. They may be able to refer you to someone they know through conferences or research efforts. Some specialists may be willing to consult with you or your local doctors over the phone or by email if you can't travel to them for care.

You can find more tips in our guide, How to Find a Disease Specialist. We also encourage you to explore the rest of this page to find resources that can help you find specialists.

Healthcare Resources

To find a medical professional who specializes in genetics, you can ask your doctor for a referral or you can search for one yourself. Online directories are provided by the American College of Medical Genetics and the National Society of Genetic Counselors. If you need additional help, contact a GARD Information Specialist. You can also learn more about genetic consultations from Genetics Home Reference.
The Hormone Health Network has a physician referral directory comprised of endocrinologists who specialize in specific endocrine diseases, including adrenal diseases.
The Pituitary Network Association provides a list of pituitary specialists.

Related Diseases Related Diseases

Related diseases are conditions that have similar signs and symptoms. A health care provider may consider these conditions in the table below when making a diagnosis. Please note that the table may not include all the possible conditions related to this disease.

Conditions with similar signs and symptoms from Orphanet
Secondary adrenal insufficiency needs to be eliminated. Causes include pituitary tumors, lymphatic hypophystitis, pituitary tuberculosis and sarcoidosis, all of which are differential diagnoses. Infiltrative disorders and other causes of CPAI should be excluded and include tuberculosis (see this term), fungal infections and AIDS-associated opportunistic infections. Genetic disorders, tumors, and treatment with certain drugs are other less common causes of CPAI. Visit the Orphanet disease page for more information.

Conditions with similar signs and symptoms from Orphanet

Secondary adrenal insufficiency needs to be eliminated. Causes include pituitary tumors, lymphatic hypophystitis, pituitary tuberculosis and sarcoidosis, all of which are differential diagnoses. Infiltrative disorders and other causes of CPAI should be excluded and include tuberculosis (see this term), fungal infections and AIDS-associated opportunistic infections. Genetic disorders, tumors, and treatment with certain drugs are other less common causes of CPAI.

Visit the Orphanet disease page for more information.

Research Research

Research helps us better understand diseases and can lead to advances in diagnosis and treatment. This section provides resources to help you learn about medical research and ways to get involved.

Clinical Research Resources

The Centers for Mendelian Genomics program is working to discover the causes of rare genetic disorders. For more information about applying to the research study, please visit their website.
ClinicalTrials.gov lists trials that are related to Addison's disease. Click on the link to go to ClinicalTrials.gov to read descriptions of these studies.

Please note: Studies listed on the ClinicalTrials.gov website are listed for informational purposes only; being listed does not reflect an endorsement by GARD or the NIH. We strongly recommend that you talk with a trusted healthcare provider before choosing to participate in any clinical study.

Organizations Organizations

Support and advocacy groups can help you connect with other patients and families, and they can provide valuable services. Many develop patient-centered information and are the driving force behind research for better treatments and possible cures. They can direct you to research, resources, and services. Many organizations also have experts who serve as medical advisors or provide lists of doctors/clinics. Visit the group’s website or contact them to learn about the services they offer. Inclusion on this list is not an endorsement by GARD.

Organizations Supporting this Disease

Adrenal Insufficiency United
Toll-free: 1-855-AIUnite (248-6483)
E-mail: contact@aiunited.org
Website: http://aiunited.org/
Hormone Health Network
Toll-free: 800-HORMONE (1-800-467-6663)
E-mail: hormone@endocrine.org
Website: http://www.hormone.org
National Adrenal Diseases Foundation (NADF)
P.O. Box 566
Lake Zurich, IL 60047
Telephone: (847) 726-9010
E-mail: nadfsupport@nadf.us
Website: http://www.nadf.us/
Pituitary Network Association
P.O. Box 1958
Thond Oaks, CA 91358
Telephone: 805-499-9973
Fax: 805-480-0633
E-mail: info@pituitary.org
Website: http://www.pituitary.org/

Organizations Providing General Support

American Autoimmune Related Diseases Association (AARDA)
22100 Gratiot Avenue
Eastpointe, MI 48021
Toll-free: 800-598-4668
Telephone: 586-776-3900
Fax: 586-776-3903
E-mail: aarda@aarda.org
Website: https://www.aarda.org/

Do you know of an organization? We want to hear from you.

Living With Living With

Living with a genetic or rare disease can impact the daily lives of patients and families. These resources can help families navigate various aspects of living with a rare disease.

Community Resources

The Job Accommodation Network (JAN) has information on workplace accommodations and disability employment issues related to this condition. JAN is a service of the Office of Disability Employment Policy in the U.S. Department of Labor.

Learn More Learn More

These resources provide more information about this condition or associated symptoms. The in-depth resources contain medical and scientific language that may be hard to understand. You may want to review these resources with a medical professional.

Where to Start

Mayo Clinic has an information page on Addison's disease.
MedlinePlus was designed by the National Library of Medicine to help you research your health questions, and it provides more information about this topic.
The Merck Manuals Online Medical Library provides information on this condition for patients and caregivers.
The National Adrenal Diseases Foundation provides information about Addison's disease.
The National Digestive Diseases Information Clearinghouse (NDDIC), part of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), offers information on this condition. Click on the link to view information on this topic.
The National Organization for Rare Disorders (NORD) has a report for patients and families about this condition. NORD is a patient advocacy organization for individuals with rare diseases and the organizations that serve them.
The The Cleveland Clinic Web site has an information page on Addison's disease. Click on the Cleveland Clinic link to view this page.
You and Your Hormones, an education resource from the Society for Endocrinology, provides information about Addison's disease.

In-Depth Information

Medscape Reference provides information on this topic. You may need to register to view the medical textbook, but registration is free.
The Merck Manual for health care professionals provides information on Addison's disease.
The Monarch Initiative brings together data about this condition from humans and other species to help physicians and biomedical researchers. Monarch’s tools are designed to make it easier to compare the signs and symptoms (phenotypes) of different diseases and discover common features. This initiative is a collaboration between several academic institutions across the world and is funded by the National Institutes of Health. Visit the website to explore the biology of this condition.
Online Mendelian Inheritance in Man (OMIM) is a catalog of human genes and genetic disorders. Each entry has a summary of related medical articles. It is meant for health care professionals and researchers. OMIM is maintained by Johns Hopkins University School of Medicine.
Orphanet is a European reference portal for information on rare diseases and orphan drugs. Access to this database is free of charge.
PubMed is a searchable database of medical literature and lists journal articles that discuss Addison's disease. Click on the link to view a sample search on this topic.

News & Events News & Events

News

NCATS Rare Diseases Are Not Rare! Challenge
October 9, 2018
The NIH Undiagnosed Diseases Network Expands
September 26, 2018

GARD Answers GARD Answers

Questions sent to GARD may be posted here if the information could be helpful to others. We remove all identifying information when posting a question to protect your privacy. If you do not want your question posted, please let us know.

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References References

Betterle C, Garelli S, Presotto F, Furmaniak J. From Appearance of Adrenal Autoantibodies to Clinical Symptoms of Addison's Disease: Natural History. Front Horm Res. 2016; 46:133-145.
Addison’s Disease. National Organization for Rare Disorders (NORD). 2018; https://rarediseases.org/rare-diseases/addisons-disease/#supporting-organizations.
Emergency ID & Medical Information. National Adrenal Diseases Foundation. http://www.nadf.us/tools-for-life/emergency-id-medical-information/. Accessed 3/19/2018.

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