Addison's Disease

In most cases, Addison's Disease is caused by autoimmune disorder involves with gradual destruction of adrenal gland. Adrenal gland malfunction or adrenal insufficiency is evident by noticeable decrease of cortisol level.

Cortisol is a hormone that plays an important role in stress response of our body. In addition, it maintains BP and cardiovascular function, decrease of immune responded inflammation. It also involves with insulin balance as well. Cortisol is regulated by hypothalamus-pituitary gland system that produces ACTH (adrenocorticotropic hormone). ACTH secreted by pituitary gland stimulates adrenal gland to release cortisol. This system is regulated by negative feedback system.

Addison's Disease may also affect the aldosterone production. Aldosterone is another hormone that helps kidney to retain salt, such as Na+ and K+; which in turn, regulates BP. Dysfunction of aldosterone regulation may result in significant decrease of BP and blood volume.

S/S of Addison's Disease are gradually presented: chronic and worsening fatigue, muscle weakness, weight loss, and L/O appetite. Pt. may demonstrate N/V/D, changes in skin pigmentation - darkening, and irritability and depression - secondary to decrease of salt. Pt. may crave salty food.

In its critical condition, pt. may presents with Addison's Crisis: such as sudden severe LBP, hypotension, severe N/V/D and L/O consciousness.

Dx of Addison's disease in its early stage is fairly difficult for its nature of gradual onset. If it is suspected, number of tests such as ACTH stimulation test (rapid ACTH) may be administered to confirm the condition.

Tx includes hormone therapy (replacement/substitution) - oral hydrocortisone tablet.