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Addison Disease

Primary Adrenal Insufficiency — Diagnosis and Lifelong Management

Written by: Saygı Hospital Health Guide Editorial Board
Published:

This content is for general information; please consult your physician for diagnosis and treatment.

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Endokrinoloji department. Book Appointment →

What is Addison Disease?

Addison disease is primary adrenal insufficiency caused by destruction of the adrenal cortex, resulting in cortisol and aldosterone deficiency.

Autoimmune adrenalitis is the leading cause in developed countries; infectious (tuberculosis, HIV), hemorrhage, and genetic causes are others.

Diagnosis relies on early-morning cortisol, ACTH (elevated), and cosyntropin (Synacthen) stimulation test showing subnormal cortisol response.

Aldosterone deficiency leads to hyponatremia, hyperkalemia, and hypovolemia; androgen loss contributes to fatigue in women.

Symptoms

Chronic fatigue, weakness, and weight loss
Hyperpigmentation of skin folds, buccal mucosa, and scars
Orthostatic hypotension and salt craving
Nausea, vomiting, abdominal pain, and diarrhea
Hyponatremia, hyperkalemia, and mild hypercalcemia on labs
Postural dizziness, depression, and decreased libido

Risk Factors

Autoimmune polyglandular syndromes (APS type 1 and 2)
Tuberculosis or other chronic infections (HIV, histoplasmosis)
Bilateral adrenal hemorrhage (anticoagulation, sepsis, Waterhouse-Friderichsen)
Bilateral adrenalectomy or infiltrative disorders (amyloidosis, metastases)
Congenital adrenal hyperplasia and adrenoleukodystrophy
Certain medications: ketoconazole, etomidate, mitotane

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Fatigue with hyperpigmentation, orthostatic symptoms, or salt craving
  • Unexplained hyponatremia with hyperkalemia
  • Acute crisis: hypotension, vomiting, abdominal pain, altered mental status

Treatment Methods

01
Hydrocortisone 15–25 mg/day divided (or equivalent prednisone) mimicking circadian rhythm
02
Fludrocortisone 50–200 mcg/day for mineralocorticoid replacement
03
Patient education on sick-day rules: double or triple dose during fever, illness, or trauma
04
Emergency injection kit (hydrocortisone 100 mg IM) and medical alert identification
05
Acute crisis management: IV hydrocortisone 100 mg bolus then 200 mg/24 h, isotonic saline with glucose, trigger treatment
06
Annual follow-up with endocrinologist; screen for associated autoimmune diseases; androgen replacement (DHEA) in selected women

Which Department to Visit?

You can visit our Endokrinoloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.