Adrenal Insufficiency (Addison Disease): Symptoms, Testing and When to Be Seen

What it involves

MedlinePlus explains that the adrenal glands sit just above the kidneys, and their outer layer makes hormones that help the body respond to stress and regulate blood pressure and water and salt balance. Addison disease happens when the adrenal glands do not make enough of these hormones, usually because the immune system damages them.

Who this is for

• Adults with fatigue that worsens over time and no clear cause.
• Patients with unexplained weight loss, muscle weakness or low blood pressure.
• People who notice patchy or darkening skin.
• Anyone whose blood work showed low sodium or high potassium and who wants to know why.

What to expect

• Questions about energy, weight, appetite, dizziness, salt cravings, medicines and past steroid use
• A blood pressure check, including sitting and standing, and a skin exam
• Blood work, which the practice offers, for sodium, potassium and sugar, with hormone testing as a provider decides
• A referral to an endocrinologist for confirmation and treatment

What it can feel like

The summary names weight loss, muscle weakness, fatigue that gets worse over time, low blood pressure, and patchy or dark skin. People may also feel faint when they stand, lose their appetite or feel sick to the stomach. These signs build slowly and look like many other problems, so the condition is often missed for a long time. The fatigue guide, the unintentional weight loss guide and the low blood pressure guide describe the more common explanations.

Why it happens

A problem with the immune system usually causes Addison disease, according to MedlinePlus: the immune system mistakenly attacks your own tissues and damages the adrenal glands. Other causes include infections and cancer. The potassium test page also links the condition to high potassium in the blood, which the high potassium guide explains, and low sodium can accompany it, as the low sodium guide describes.

How it is checked

MedlinePlus says lab tests can confirm that you have Addison disease. A primary care visit starts with your history, blood pressure and routine blood work for sodium, potassium and blood sugar, as in the basic metabolic panel guide, and low blood sugar is discussed in the low blood sugar guide. The specialized hormone tests that confirm the diagnosis are arranged by referral to an endocrinologist rather than done at the practice.

Treatment is lifelong

MedlinePlus says that if you do not treat it, it can be fatal, and that you will need to take hormone pills for the rest of your life. If you have Addison disease, you should carry an emergency ID that says you have the disease, lists your medicines and says how much you need in an emergency. A primary care provider helps monitor blood pressure, salt balance and general health with the endocrinologist. Never stop these medicines abruptly.

Other reasons for adrenal problems

Long-term use of steroid medicines can also make the body depend on them, so stopping suddenly can cause similar symptoms. That is one more reason never to stop a prescribed steroid on your own, and to tell every provider which medicines you take. Thyroid problems can look alike, as the thyroid care page explains. A provider sorts through these possibilities with your history and blood work rather than a symptom list alone.

When to get urgent help

Call 911 or go to the ER for severe weakness, fainting, repeated vomiting, severe belly pain, confusion or very low blood pressure, particularly if you have been diagnosed with Addison disease or take steroid medicines. Make an appointment for fatigue and weakness that keep getting worse over weeks, darkening skin or unexplained weight loss. The fainting guide covers when a faint needs urgent attention. Same-day visits and walk-ins are welcome.

Sources

• MedlinePlus: Addison Disease (Adrenal Insufficiency)
• MedlinePlus: Potassium Blood Test