Hormones & metabolismAutoimmune/hormonalICD-10 E27.1
Addison's disease (adrenal insufficiency)
Also called: Primary adrenal insufficiency
The adrenal glands fail to make enough cortisol and aldosterone. Without treatment it can cause a life-threatening adrenal crisis.
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Causes
- Autoimmune destruction (most common)
- Tuberculosis
- Adrenal haemorrhage
- Secondary: pituitary disease or stopping long-term steroids
Risk factors
- Other autoimmune diseases
- Long-term steroid use (secondary)
Symptoms
- Fatigue and weakness
- Weight loss
- Low blood pressure and dizziness
- Salt craving
- Skin darkening
- Nausea and abdominal pain
Diagnosis — tests and examinations
- Low morning cortisol
- Short Synacthen (ACTH stimulation) test
- High ACTH and renin; adrenal antibodies
Treatment
Medicines and medical treatment
- Hydrocortisone replacement
- Fludrocortisone
- Emergency hydrocortisone injection kit
Self-care, home remedies and lifestyle
- Double steroid doses during illness (sick-day rules)
- Carry a steroid emergency card
- Medical alert bracelet
Possible complications
- Adrenal crisis (shock)
Prevention
- Not preventable; education prevents crises
Outlook
Normal life with correct replacement.
When to see a doctor
Seek emergency care for vomiting, collapse or confusion in someone with adrenal insufficiency.
Sources and further reading
These sources cover this condition. They have not been checked against every statement on this page.
Related conditions
Educational overview, not medical advice. Treatment varies by person and location. Consult a qualified health professional for diagnosis or care. Read our content and model notes and privacy information.