What is Addison's disease?

Addison’s disease is a rare disorder in which the adrenal glands stop working. The condition is also called primary adrenal insufficiency.

The body doesn't produce enough essential steroid hormones; this affects energy production, response to illness, fluid balance, and many other vital processes.

The adrenals are two small glands that sit above the kidneys. An overactive immune system usually causes Addison's disease.

The body starts to attack its own cells, damaging tissue in the adrenal gland and disrupting the production of crucial hormones including:

Aldosterone 

A hormone that helps the body regulate sodium levels, balance fluid, and control blood pressure.

DHEA 

A hormone that affects the sex hormones in both men and women.

Cortisol 

A hormone that helps the body release energy in response to illness, infection, or stress. Cortisol also acts as an anti-inflammatory, easing irritation and pain.

Rarely, adrenal damage or TB infection can also cause adrenal insufficiency and low steroid hormones. The body can’t function effectively without these essential chemical messengers.

However, regular medication can replace the missing hormones and keep you healthy and well. 

What are the symptoms of addison's disease? 

Addison's disease can affect anyone, but it's more common in women, especially between 30 and 50 years of age. The symptoms are somewhat non-specific, so they are frequently missed or mistaken for other more common illnesses.

Addison's symptoms include:

• Tiredness and lack of energy 
• Muscle weakness
• Depression and low mood
• Reduced appetite and weight loss
• Thirstiness

As the condition progresses, you may become more unwell and notice more severe symptoms.

Look out for:

• Dizziness and fainting
• Muscle cramps 
• Exhaustion and malaise
• Darkened skin, pigmented scars, and darker lips or gums

How is Addison's disease diagnosed?

The London Clinic’s world-renowned endocrinologists will take a careful history and examine you.

They will then arrange tests to look at your adrenals, your levels of hormone release, and detailed dynamic tests to assess the glands’ function.

Investigations could include:

Blood pressure analysis

Addison’s disease can cause postural hypotension, which is dizziness and low blood pressure on standing. Your blood pressure will be tested while lying down, then again, when you are upright. 

Blood tests

The endocrinologists will arrange a comprehensive range of blood tests.

As well as a simple analysis of your blood levels of sodium, potassium, and glucose, they will also arrange specialist tests to look at your cortisol, aldosterone, and adrenocorticotrophic (ACTH) hormones.

Low aldosterone and cortisol levels, together with raised ACTH, suggest the adrenal glands aren't working effectively.

They will order antibody tests to check for adrenal antibodies, which attack the glands indicating autoimmune Addison’s disease.

Some people with Addison’s disease may also have an underactive thyroid gland, so your thyroid function may also be checked.

Synacthen stimulation test

Synacthen is a synthetic copy of adrenocorticotrophic hormone (ACTH). It’s the hormone produced by the pituitary gland in the brain that stimulates the adrenal glands to release cortisol and aldosterone.

In the test, your blood is taken before and after a dose of synacthen. The team will assess your cortisol levels after 30, then 60 minutes to check that the adrenals are responding to stimulation.

Scans

Your specialist may arrange a CT scan or MRI scan of your adrenal glands in The London Clinic’s state-of-the-art imaging suite.

How is Addison's disease treated?

People with Addison's disease need regular medication to replace their steroid hormones.

The specialist endocrinologists at The London Clinic will help you get the right balance of medication to control your symptoms and live an active life.

Treatment may include:

Dietary management

The right nutrition can help maintain your energy levels, stabilise your weight, and balance the salts in your body.

 Dieticians are an integral part of the endocrinology team; they will provide bespoke advice, personal support, and a nutritional plan to help you maintain your wellbeing.

Hydrocortisone tablets

Hydrocortisone replaces the missing cortisol. You can take it as a tablet two or three times a day. 

Modified-release hydrocorstisone

The body naturally releases cortisol into the bloodstream in a rhythm that’s linked to our sleep cycle. Innovative medications can copy these natural cycles. 

Continuous subcutaneous hydrocortisone infusion or CSHI

An infusion of hydrocortisone through a pump replicates your body's natural cortisol release. The London Clinic is the only private hospital in the UK to offer this revolutionary treatment.

It provides more physiological steroid hormone levels and also improves vitality.

Fludrocortisone

This medication replaces the aldosterone.

Support and guidance

Being diagnosed with a life-long condition is difficult. At this stressful time, The London Clinic can provide support, education, and guidance every step of the way.

The expert team will work with you. They will advise you to change your medication when your body is under strain because of infection, illness, operations, or increased activity. Together we will control your Addison's disease rather than letting it control you.