Addison's Disease

What is Addison's Disease?

Addison's disease is a rare condition where your adrenal glands stop making enough hormones. Your adrenal glands sit on top of each kidney. They produce cortisol and aldosterone, two hormones your body needs to function properly. Cortisol helps your body respond to stress and regulates blood sugar. Aldosterone controls your blood pressure and balances sodium and potassium levels.

When your adrenal glands fail, your body struggles to manage stress, blood pressure, and metabolism. This happens gradually in most cases. Your pituitary gland tries to fix the problem by making more ACTH, a hormone that tells your adrenals to work harder. But damaged adrenal glands cannot respond. The result is low cortisol and aldosterone with high ACTH levels in your blood.

About 1 in 100,000 people develop Addison's disease each year. It can affect anyone at any age. Most cases develop slowly over months or years. Without treatment, the condition can become life threatening. But with proper hormone replacement therapy, most people live normal, active lives.

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Symptoms

Extreme fatigue and weakness that gets worse over time
Weight loss without trying and decreased appetite
Low blood pressure that causes dizziness when standing
Darkening of skin, especially on scars, skin folds, and pressure points
Salt cravings and increased thirst
Nausea, vomiting, and diarrhea
Muscle and joint pain
Irritability and depression
Low blood sugar levels
Loss of body hair or sexual dysfunction in women

Symptoms often develop slowly and can be vague at first. Many people ignore early signs because they feel like general tiredness. Some people have no obvious symptoms until a stressful event triggers an adrenal crisis, a medical emergency.

Causes and risk factors

Addison's disease happens when your immune system attacks your adrenal glands. This autoimmune reaction destroys the outer layer of the glands over time. About 70% of cases in the United States result from autoimmune disease. Other causes include tuberculosis, infections, cancer that spreads to the adrenal glands, and bleeding into the adrenal glands. Certain genetic conditions can also damage the adrenal glands.

Your risk increases if you have other autoimmune conditions like type 1 diabetes or thyroid disease. Having family members with autoimmune disorders also raises your risk. Some medications that treat fungal infections can interfere with cortisol production. Surgical removal of the adrenal glands or damage during surgery can cause the condition. In children, genetic disorders affecting adrenal development are the most common cause.

How it's diagnosed

Doctors diagnose Addison's disease through blood tests that measure hormone levels. The ACTH stimulation test is the most reliable diagnostic tool. Your doctor measures cortisol levels before and after you receive synthetic ACTH. If your adrenal glands are damaged, cortisol levels stay low even after stimulation. Blood tests also check ACTH levels, which are typically high when you have Addison's disease. Your doctor will measure electrolytes like sodium, potassium, and chloride because these are often abnormal.

Rite Aid offers testing for key biomarkers that can help detect Addison's disease. Our panel measures cortisol, ACTH, DHEA, aldosterone, and electrolytes. These tests can reveal hormone imbalances before symptoms become severe. Regular monitoring helps you and your doctor track treatment effectiveness. Early detection through blood testing allows you to start treatment sooner and avoid complications.

Treatment options

Hormone replacement therapy with hydrocortisone or prednisone to replace cortisol
Fludrocortisone to replace aldosterone and balance electrolytes
Increased salt intake, especially during hot weather or exercise
Eating small, frequent meals to maintain stable blood sugar
Carrying emergency injectable hydrocortisone for adrenal crisis
Wearing medical alert jewelry that identifies your condition
Increasing medication doses during illness, injury, or stress
Regular blood tests to monitor hormone and electrolyte levels
Working with an endocrinologist who specializes in hormone disorders
Learning to recognize signs of adrenal crisis and when to seek emergency care

Frequently asked questions

Addison's disease is primary adrenal insufficiency, meaning the problem is in the adrenal glands themselves. Secondary adrenal insufficiency occurs when the pituitary gland fails to make enough ACTH. Both conditions cause low cortisol, but Addison's disease also causes low aldosterone. The distinction matters because treatment approaches differ slightly between the two types.

Addison's disease cannot be cured, but it can be managed effectively with lifelong hormone replacement therapy. Most people with properly managed Addison's disease live normal, active lives. Treatment replaces the hormones your adrenal glands no longer produce. You will need to take medication daily and adjust doses during times of stress or illness.

An adrenal crisis is a life threatening emergency that happens when cortisol levels drop too low. Symptoms include severe weakness, confusion, pain, vomiting, and loss of consciousness. You can prevent it by taking medications as prescribed, increasing doses during illness or stress, and seeking immediate medical care if you cannot keep medications down. Always carry emergency injectable hydrocortisone.

Most doctors recommend blood tests every 3 to 6 months after your condition is stable. Testing checks cortisol levels, ACTH, and electrolytes like sodium and potassium. More frequent testing may be needed when adjusting medication doses or if you have symptoms. Regular monitoring helps ensure your hormone replacement therapy is working properly.

Low aldosterone levels cause your kidneys to lose sodium in your urine. Your body craves salt to try to replace what is being lost. This craving is a natural response to low sodium levels. People with Addison's disease typically need to eat more salt than the average person, especially during hot weather or exercise.

Stress does not make Addison's disease worse, but it increases your body's need for cortisol. Since your adrenal glands cannot produce more cortisol when stressed, you need to increase your medication dose. Physical stress from illness, injury, or surgery requires higher doses. Your doctor will teach you how to adjust your medication during stressful times.

Addison's disease itself is not usually inherited directly. However, you can inherit a tendency toward autoimmune diseases, which cause most cases. If you have family members with autoimmune conditions, your risk increases slightly. Some rare genetic syndromes that affect the adrenal glands can be passed down through families.

Take your missed dose as soon as you remember, unless it is almost time for your next dose. Do not take double doses to make up for a missed one. Missing one dose occasionally is usually not dangerous if you feel well. However, missing multiple doses can lead to symptoms or even an adrenal crisis.

Yes, you can exercise with Addison's disease, but you need to take precautions. Drink plenty of fluids and consume extra salt before and after workouts. You may need to increase your cortisol dose on days you exercise intensely. Start slowly and pay attention to how your body responds. Stop and rest if you feel dizzy, weak, or nauseated.

Proper cortisol replacement therapy should not cause weight gain if doses are correct. Your doctor prescribes the lowest dose that replaces what your body needs, not excess amounts. High doses of cortisol medication can cause weight gain and other side effects. Regular blood tests help ensure your dose is right for your body.