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Thursday, August 6, 2020

Addison’s Disease: Causes, Symptoms and Complications

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Addison’s disease is a disease that occurs due to the inability of the adrenal glands to produce sufficient amount of hormones such as aldosterone and cortisol. It is a very rare and uncommon endocrine disorder. Another name for Addison’s disease is primary adrenal insufficiency or hypocortisolism.

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Normally, there is a pair of glands that sits on the two kidneys in the body and they are called adrenal glands. These adrenal glands usually produce hormones such as cortisol and aldosterone. These hormones carry out very important functions in the body. These hormones are part of the endocrine system hence their functions are felt in almost every organ in the body.

Every adrenal gland is composed of two parts namely; the cortex of the adrenal gland and the medulla of the adrenal gland. The medulla is found inside the adrenal gland while the cortex otherwise known as the adrenal cortex is the outer covering of the adrenal gland. Both the medulla and the cortex produce hormones.

The hormones produced by the medulla are adrenaline-like hormones which are known as epinephrine and norepinephrine. While the adrenal cortex produces a range of hormones such as mineralocorticoids, glucocorticoids, and androgens (which are the male sex hormones).

Cortisol which is a very important hormone in the body belongs to the group of adrenal hormones known as the glucucorticoids. These hormones affect every organ in the body. This is the hormones that deals with the stress level in the body.

The major importance of cortisol in the body is to help the body respond to stress and likewise help reduce its stress level. Other important things that cortisol does to the body includes the following:

  • helps regulate and maintain the body’s blood pressure and likewise helps regulate the body’s cardiovascular functions
  • helps regulate the response of the immune system to inflammatory problems. It does this by reducing the response of the body’s immune system to these inflammatory diseases.
  • helps to counter balance the effects of insulin while there is the digestion of carbohydrates most especially in breaking down sugar so as to derive energy.
  • cortisol also helps regulate appropriately the metabolism and breakdown of proteins, carbohydrates and fats and oil in the body.

The amounts of cortisol in the body must be regulated and appropriately balanced so that there can be a balanced effect that must be gotten in the body so as to maintain the body’s internal environment so that one can have maximum health and body functions.

Just like most hormones found within the body, the level of cortisol is regulated by the hypothalamus most especially by the pituitary gland. The way it is regulated is more like in a circular pattern such that the hypothalamus sends out signals to the pituitary gland by releasing hormones.

This signal or releasing hormones are to instruct the pituitary gland to secrete important hormones in response to the body’s need at that time. One of the important hormones secreted by the pituitary gland is known as ACTH (Adrenocorticotropic hormone).

The function of this hormone is to stimulate the adrenal gland in order to secrete hormones such as cortisol and aldosterone. When the cortex of the adrenal gland receives this instruction from the pituitary gland via the ACTH hormone, it begins to respond by the production of mainly cortisol and aldosterone (in little quantities).

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To complete this cycle, once the cortisol is produced and secreted into the blood stream, there are markers in the blood that will indicate the presence of cortisol hence sending signals to the pituitary gland so as to stop the secretion of ACTH and hence stop the production of aldosterone and cortisol.

You may be wondering then what the exact function of aldosterone is. Aldosterone helps in the regulation and maintenance of blood pressure by regulating the salt and water levels in the blood.

Aldosterone does this by helping the kidney to excrete potassium and retain sodium which is needed by the body for many activities. Aldosterone is although unlike cortisol belongs to a group of adrenal hormones known as mineralocorticoid.

When there is a decrease in the production of the hormone aldosterone from the adrenal cortex, the kidneys won’t be able to regulate the levels of both salt and water appropriately in the blood. This will therefore cause a severe decrease in the levels of blood volume and invariably in the blood pressure of the body of the individual.

Addison’s disease is caused by an autoimmune reaction gotten due to the lack of production of both cortisol and aldosterone. There are two different causes of Addison’s disease and they are:

Primary adrenal insufficiency

Primary Adrenal insufficiency is caused by a disorder in the adrenal glands themselves most especially due to a disorder in the adrenal cortex. Over 70% of Addison’s disease is caused by the gradual destruction of the cells found in the adrenal cortex by the person’s very own immune system.

Primary adrenal sufficiency is caused when over 90% of the portion of the adrenal cortex is severely damaged. And then as a result of this destruction, there is a severe decrease in the amount of glucocorticoids and also in the amount of mineralocorticoids produced by the body.

Sometimes, it could only be the adrenal cortex and gland that is affected, and this occurs in a situation called idiopathic adrenal insufficiency. In some other cases however, it is not only the adrenal gland that is affected, if this occurs it is known as poly endocrine deficiency syndrome.

One of the major causes of primary adrenal insufficiency is tuberculosis. The other possible causes of primary adrenal insufficiency are infections such as fungal infections, cancer that spreads to the adrenal glands from another part of the body, amyloidosis and also the removal of the adrenal glands surgically.

Secondary Adrenal insufficiency

Secondary Adrenal insufficiency occurs as a result of a damage to the pituitary gland that produces the hormone ACTH. This will ultimately affect the production of cortisol but not so much the production of aldosterone.

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This kind of adrenal disease may occur when a person who has always been on glucocorticoids such as prednisone for a long time suddenly stops taking it. The effects of glucocorticoids are to block the release of the hormone Cortico-tropin releasing hormone and the function of this hormone is to increase the level of cortisol.

If there is a sudden withdrawal, the body will still think that there is enough cortisol in the body and hence suppress the release of ACTH and therefore no release of cortisol. If the pituitary gland is damaged, there will be no release of ACTH which will ultimately lead to no release of cortisol and aldosterone.

People who have the following symptoms may have Addison’s disease. They include:

  1. Severe Muscle weakness
  2. Severe tiredness and body fatigue
  3. Dark coloration of the skin
  4. Reduced appetite and decreased weight loss
  5. Severe hypotension
  6. Low blood sugar levels
  7. Sores in the mouth otherwise known as scurvy
  8. Nausea
  9. Depression
  10. Expressions of severe irritability.

Once the symptoms of Addison disease are not treated quickly, there will be complications. The most important complication of Addison’s disease is adrenal crisis otherwise known as Addisonian crisis.

Adrenal crisis occurs when there is a collection of symptoms occurring simultaneously which indicates severe adrenal insufficiency caused by cortisol deficiency. This is a really serious and severe condition which if left untreated could become life threatening.

The crisis can be triggered by traumatic events such as a car crash, severe dehydration and malnutrition, severe infection or an injury can cause Addisonian crisis. Once a person is experiencing any of these symptoms, the person should visit an endocrinologist or a physician who can properly diagnose and treat you appropriately.

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Disclaimer: This article is purely informative & educational in nature and should not be construed as medical advice. Please use the content only in consultation with an appropriate certified medical or healthcare professional.

Deborah Akinola
Wirter, poet and public speaker

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