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Addison's disease, known as "primary adrenal insufficiency" or "Addison's syndrome", happens when the adrenal or adrenal glands, which are located at the top of the kidneys, stop producing the hormones cortisol and aldosterone, which are responsible for controlling stress, blood pressure and reduce inflammation. Thus, the lack of these hormones can lead to weakness, hypotension and a feeling of general tiredness. Better understand what cortisol is and what it is for.
This disease can happen in people of any age, men or women, but it is more common between 30 and 40 years old, and can be caused by several factors, such as prolonged use of medications, infections or autoimmune diseases, for example.
The treatment of Addison's disease is determined by the endocrinologist based on the assessment of symptoms and the dosage of hormones through a blood test and usually involves supplementation of the hormone.
Main symptoms
Symptoms appear as hormone levels decrease, which may include:
- Abdominal pain;
- Weakness;
- Fatigue
- Nausea;
- Slimming;
- Anorexia;
- Spots on the skin, gums and folds, called skin hyperpigmentation;
- Dehydration;
- Postural hypotension, which corresponds to dizziness when standing up, and fainting.
Because it does not have specific symptoms, Addison's disease is often confused with other diseases, such as anemia or depression, which leads to a delay in the correct diagnosis.
How to confirm the diagnosis
The diagnosis is made through clinical, laboratory and imaging tests, such as tomography, magnetic resonance imaging and tests to check the concentration of sodium, potassium, ACTH and cortisol in the blood. In some cases, it may be necessary to perform the ACTH stimulation test, in which the cortisol concentration is measured before and after the application of the synthetic ACTH injection. See how the ACTH exam is done and how to prepare for it.
The diagnosis of Addison's disease is usually made in more advanced stages, because the wear of the adrenal or adrenal glands occurs slowly, making it difficult to identify the initial symptoms.
Possible causes
Addison's disease is usually caused by autoimmune diseases, in which the immune system starts to attack the body itself, which can interfere with the function of the adrenal glands. However, it can also be caused by the use of medications, fungal infections, viruses or bacteria, such as blastomycosis, HIV and tuberculosis, for example, in addition to neoplasms.
How the treatment is done
The treatment for Addison's disease aims to replace hormonal deficiency through medication, so that the symptoms disappear. Some of these medications include:
- Cortisol or hydrocortisone;
- Fludrocortisone;
- Prednisone;
- Prednisolone;
- Dexamethasone.
The treatment is carried out according to the recommendation of the endocrinologist and must be carried out for a lifetime, since the disease has no cure, however with treatment it is possible to control the symptoms. In addition to treatment with the use of medications, a diet rich in sodium, calcium and vitamin D, helps fight symptoms, and should be indicated by a nutritionist.