Addison's disease: adrenal insufficiency
Recognizing a rare but serious disease
Dr. Léa Dumas
Endocrinologist
In simple terms
Fatigue, skin pigmentation, hypotension: clues to suspect Addison's.
Adrenal cortex destruction
Addison's disease results from primary adrenal insufficiency, most often autoimmune. Deficiency in cortisol and aldosterone.
Symptoms
Insidious onset: chronic fatigue, anorexia, weight loss, postural hypotension, abnormal pigmentation (palmar creases, scars, gums), salt cravings. Risk of acute adrenal crisis: medical emergency.
Diagnosis
Low morning cortisol, elevated ACTH, Synacthen test. Anti-21-hydroxylase antibodies. Look for other autoimmune diseases (thyroid, type 1 diabetes).
Treatments
- Hydrocortisone: 15-25 mg/day in 2-3 doses
- Fludrocortisone: 0.05-0.2 mg/day
- Dose adjustment in stress situations (rule of thirds, doubling)
- Mandatory emergency hydrocortisone kit
Education
Wear a medical alert bracelet, never skip treatment, know warning signs of adrenal crisis, train family to inject.
The words explained
Medical terms used above, in everyday language.
- Chronic
- A problem that lasts a long time, usually more than three months, and often comes back.
- Acute
- Something that starts suddenly and lasts a short time.
- Symptom
- A sign you can feel or see that something is wrong, like pain, tiredness or a rash.
- Diagnosis
- The moment a doctor identifies which illness is causing your symptoms.
- Antibody
- A protein your body makes to recognise and neutralise a specific germ.
When should you see a doctor?
- Your symptoms last more than a few weeks or keep coming back.
- They get worse quickly, or stop you doing everyday things.
- You notice sudden pain, breathing trouble, fainting or bleeding — seek urgent care.
- You already take medication and want to change anything about it.
This article explains general health information. It does not replace advice from your own doctor.
Frequently asked questions
- What is Addison's disease: adrenal insufficiency?
- Fatigue, skin pigmentation, hypotension: clues to suspect Addison's.
- What are the main symptoms or signs of Addison's disease: adrenal insufficiency?
- Common signs vary from person to person. The article above lists the symptoms to watch for, how they progress, and when they need medical attention.
- When should you see a doctor for Addison's disease: adrenal insufficiency?
- See a doctor if symptoms last more than a few weeks, get worse quickly, stop you doing everyday things, or if you notice sudden pain, breathing trouble, fainting or bleeding.
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