Pathophysiology

What is Addison’s Disease?

With Addison’s Disease, the Adrenal Glands are affected in some way which reduces their ability to produce Cortisol. These are presented in either Primary or Secondary Addison’s Disease.

Primary: This is where the ability to create Cortisol is affected directly at the site of the Adrenal Glands.

Secondary: This is where indirect means cause a reduction in Cortisol production of the Adrenal Glands

Primary Addison’s Disease can be caused by a number of pathophysiologies, these include:

  • Immune system problems (Autoimmune disorders), where the Immune system attacks the Adrenal Cortex of the Adrenal Glands. When a significant amount of the Cortex is damaged, it cannot produce enough Cortisol or Aldosterone for the body’s needs.
  • Genetics can be a contributing factor that can lead to autoimmune disorders, leading to Addison’s Disease
  • Tuberculosis can cause damage to the Adrenal Glands, along with other infections such as AIDS
  • Haemorrhage in the Adrenal Glands
  • Cancer
  • Adrenal Gland removal due to surgery
  • Adrenal Gland trauma, blunt or penetrating
  • Amyloidosis

Secondary can be caused by:

  • Pituitary gland damage resulting in a lack of ACTH which stimulates the production of Cortisol in the Adrenal Glands
  • Hypothalamus damage resulting in a lack of CRH which stimulates the production of ACTH in the Pituitary gland
  • Long-term steroid therapy canresult in secondary adrenal insufficiency due to suppression of the hypothalamic-pituitary-adrenal axis

Signs and symptoms

Addison’s Disease can manifest a wide range of different signs and symptoms, including:

  • Fatigue
  • Lethargy
  • Muscle weakness
  • Loss of appetite/Weight loss
  • Frequent urination
  • Increased thirst
  • A craving for salty foods
  • Low blood pressure when standing
  • Nausea/Vomiting
  • Diarrhoea
  • Abdo/Joint/Back/Muscle pain/cramps
  • Chronic exhaustion