Archives of General Internal Medicine

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Perspective - Archives of General Internal Medicine (2021) Volume 5, Issue 9

Addison's disease: Adrenal insufficiency.

Elsherbiny John *

Department of Endocrinology, Emory University, Atlanta, Georgia

Corresponding Author:
Elsherbiny John
Department of Endocrinology
Emory University
E-mail: [email protected]

Accepted date: October 28th, 2021

Citation: John E. Addison's disease: Adrenal insufficiency. Arch Gen Intern Med 2021;5(9):2-3.

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Addison's disease is an infrequent disorder that occurs when your body doesn't produce sufficient of certain hormones. In Addison's disease, your adrenal glands, situated just above your kidneys, produce too little cortisol and, often, too little aldosterone. Addison's disease occurs in all age groups and both sexes, and can be lethal. Treatment includes taking hormones to replace those that are absent.


Addison's disease signs usually develop gradually, frequently over several months. Often, the ailment progresses so slowly that indications are ignored until a stress, such as illness or injury, occurs and makes indications worse. Signs and symptoms may include.

• Extreme fatigue

• Weight loss and decreased appetite

• Darkening of your skin (hyperpigmentation)

• Low blood pressure, even fainting

• Salt craving


There are 3 major categorizations for Addison’s disease: primary adrenal insufficiency and secondary adrenal insufficiency. In order to treat the disease, your doctor will essential to find out which type is responsible for your condition.

Primary adrenal insufficiency: Primary adrenal inadequacy occurs when your adrenal glands are injured so severely that they can no longer produce hormones. This kind of Addison’s disease is most frequently caused when your immune system attacks your adrenal glands. This is called an autoimmune disease. In an autoimmune disease, your body’s immune system mistakes any organ or area of the body for a virus, bacteria, or another outside invader. Further causes of primary adrenal insufficiency include:

• Prolonged administration of glucocorticoids (e.g. prednisone)

• Infections in your body

• Cancer and irregular growths (tumors)

• Certain blood diluters used to control clotting in the blood

Secondary adrenal insufficiency: Secondary adrenal insufficiency occurs when the pituitary gland (situated in your brain) can’t produce adrenocorticotropic hormone (ACTH). ACTH says the adrenal glands when to release hormones. It’s also potential to improve adrenal inadequacy if you do not take the corticosteroid medicines your doctor prescribes. Corticosteroids help control chronic health circumstances like asthma.

There are also numerous other causes of secondary adrenal insufficiency, including:

• Tumors

• Medications

• genetics

Tertiary adrenal insufficiency: The most common cause of tertiary adrenal inadequacy is unexpectedly stopping corticosteroids after taking them for a long time. Prescription doses of corticosteroids can cause advanced levels of cortisol in your blood than your body normally makes. High levels in your blood for a long time cause the hypothalamus to make less CRH. Less CRH means less ACTH, this in turn causes the adrenal glands to stop production of cortisol.


Doctor’s analyses adrenal insufficiency with blood tests. Other tests, for example computed tomography (CT) scans and magnetic resonance imaging (MRI), help find the cause of this disorder.


Doctors treat adrenal deficiency with medications that replace the hormones your body isn’t making. Your doctor will adjust your dose in different situations, such as during surgery, illness, or pregnancy; or after a serious injury.

Eating, diet, and nutrition

Some individuals with adrenal insufficiency may need a highsodium diet. Individuals who take medicines to replace cortisol also essential plenty of calcium and vitamin D. A health care expert or dietitian can tell you how much you should have.

Clinical trials

The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and other components of the National Institutes of Health (NIH) conduct and support research into many diseases and circumstances.

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