Addison’s disease , also known as adrenal insufficiency, is a very rare disease that occurs as a result of the body’s inability to produce certain hormones sufficiently. In Addison’s disease, which is seen in one out of every 100,000 people, glucocorticoid (cortisol) and mineralocorticoid (aldosterone) hormones decrease in the blood due to the secretion insufficiency of the adrenal glands located just above the kidneys.
What causes Addison’s disease?
There are two types of Addison’s disease: primary adrenal insufficiency and secondary adrenal insufficiency. About 70% of primary adrenal insufficiency is due to an autoimmune process. Other causes such as adrenal gland damage, tuberculosis, various bacterial, viral and fungal infections, adrenal gland bleeding and metastasis of cancer to the adrenal glands can also cause primary adrenal gland failure. Secondary adrenal insufficiency occurs due to a decrease in the production of the pituitary hormone ACTH (adrenocorticotropic hormone). Cortisol production is not stimulated in ACTH deficiency due to a pituitary tumor or another cause. In secondary adrenal insufficiency, aldosterone production is usually unaffected.
What are the symptoms of Addison’s disease?
The symptoms of Addison’s disease vary depending on the hormone that is deficient. In order to better understand the symptoms of the disease, it is necessary to know the functions of these hormones. Cortisol is a stress-induced hormone secreted by the adrenal glands. In other words, its most important task is to help the body respond to stress. It also helps the body regulate its use of protein, carbohydrates and fats. It maintains blood pressure and cardiovascular function and controls inflammation. Aldosterone, on the other hand, is a steroid hormone that is secreted from the outer part of the adrenal glands (cortex), has an effect on the removal of potassium from the kidney and the reabsorption of sodium, and provides the adjustment of the electrolyte balance in the body. When aldosterone levels drop drastically, the kidneys cannot keep salt and water levels in balance.
Addison’s disease symptoms usually develop slowly over a period of several months. The disease progresses so slowly that some of its symptoms are ignored until a stressor, such as illness or injury, occurs and the symptoms become more pronounced and worse. The main symptoms of Addison’s disease can be listed as follows;
- Weight loss and severe loss of appetite
- fasting hypoglycemia
- Darkening (pigmentation) on the oral mucosa and skin, especially in surgical scars, nipples and genital areas
- Low blood pressure and fainting caused by it
- Increased need for salt
- low blood sugar (hypoglycemia)
- Nausea, diarrhea or vomiting
- Stomach ache
- Pain in muscles or joints
- state of being angry
- Depression or other behavioral disorders
- Decreased sweating
- Reduction in armpit and genital hair, especially in women
How is Addison’s disease diagnosed?
For the diagnosis of Addison’s disease, the specialist doctor first listens to the patient’s story and examines the clinical findings. When in doubt, various laboratory tests are performed to determine whether the patient has Addison’s disease and to differentiate between primary and secondary adrenal insufficiency. Tests to evaluate the patient’s electrolyte balance, blood sugar level and kidney functions are also necessary to determine the cause of the disease and to guide the treatment. In some cases, alternative tests such as an insulin-induced hypoglycemia test, a low-dose ACTH stimulation test, a long-term ACTH stimulation test, or a glucagon stimulation test may be ordered.
How is Addison’s disease treated?
Because adrenal insufficiency causes a lack of functional hormones for the body, doctors often prescribe hormone replacement to treat Addison’s disease. This is done once or twice daily with hydrocortisone tablets, a steroid hormone. If necessary, aldosterone can be replaced with a synthetic steroid, fludrocortisone acetate, which is taken orally once a day. These drugs should be increased especially during times of stress, infection, surgery or injury. Hormone therapy is usually successful. Once treatment is successful, people with Addison’s disease can lead a fairly normal life. However, it is recommended that they always carry a doctor alert bracelet and emergency ID card, and keep a small supply of medication at work or school.
What is the Addison’s disease diet?
A healthy and stress-free lifestyle is vital in Addison’s disease. In people with this disease, diet affects the patient’s health as well as their susceptibility to the disease. Therefore, a nutritious and balanced diet should be adopted. If you have this disease, a few tips to remember are as follows:
- Fatigue is one of the most common symptoms of Addison’s disease, but under no circumstances should stimulants, energy drinks, soda or coffee be resorted to. These drinks are highly stimulating to the adrenaline glands due to their high caffeine content. In addition, the stimulants and excess sugar contained in these drinks damage the adrenal glands. These warnings also apply to cigarettes and tobacco products.
- Prepared food products containing carbohydrates and refined sugar should also be avoided as much as possible. If you have diabetes as well as Addison’s disease, these foods can upset your insulin levels more than normal. Especially when blood sugar is low, these foods increase the symptoms of Addison’s disease.
- There has been a lot of discussion about whether salt is beneficial or harmful for Addison’s patients. The truth is that; salt or sodium is needed in the right diet. Since low blood sugar is one of the main symptoms of this disease, salt and sodium are of particular importance. Getting enough sodium helps keep blood sugar at a certain level. However, you should take care to obtain this need from high-quality sources. Examples of these sources are Himalayan salt and sea salt.
- Do not ignore your craving for salt. This may be due to a real need. If you sweat a lot, add a little more salt to your food and drink more fluids, especially water.
- Excessive stress can cause serious damage to the body by triggering the disease. In stressful times, take care to consume more foods containing vitamin C. Antidepressants also help boost your immune system and also help your body better adapt to stress. Thus, it prevents further damage to your adrenaline glands. However, the use of antidepressants must be made with the recommendation of a specialist psychiatrist.
- Intake of B vitamins stimulates the production of certain hormones and neurotransmitters, conductors that transmit impulses from our nervous system. To get more B vitamins, you can increase your consumption of village eggs, shellfish, sardines and salmon.
- Zinc is important not only for a well-functioning immune system, but also for the production of hormones that help fight stress. You can get zinc from seafood, snacks, beans, spinach and mushrooms. Magnesium calms the nervous system. Avocado, cowpea, banana, yogurt, cookies and spinach are among the rich sources of magnesium.
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