Addison's disease comes about after the adrenal glands, found above the kidneys, are no longer capable of providing enough of the chemicals cortisol and, less commonly, aldosterone.
Cortisol and Addison's Disease
Cortisol impacts just about every organ system in the body and is therefore significant for conventional bodily functions. The adrenal glands provide cortisol to assist the body in coping with mental and physical stress from disease, injury, surgery, childbirth, or other factors. Aldosterone assists the body in retaining salt and maintaining proper blood pressure.
Cortisol secretion by the adrenal organs is regulated by the central nervous system's hypothalamus and in the pituitary gland beneath the brain. The hypothalamus tells the pituitary gland to make adreno-corticotropic hormone (ACTH), which basically stimulates the adrenal organs to make cortisol. In the event the adrenal organs can't make enough cortisol, the illness is termed primary adrenocortical insufficiency, hypocortisolism, or Addison's disease.
When the hypothalamus or the pituitary gland is not functioning correctly to provide enough ACTH, the disease is termed secondary adrenocortical insufficiency. This topic focuses on primary adrenocortical insufficiency.
Causes of Addison's Disease
Addison's generally appears after the body's immune structure weakens the portion of the adrenal organs that creates cortisol and aldosterone. Addison's can also occur after the adrenal organs get destroyed by:
- Cancer that has actually spread to the adrenal organs. This is commonly observed in lung cancer patients.
- Bleeding into the adrenal organs as a side effect of heart disease medicines.
- Infections, like tuberculosis, HIV, or specific bacterial infections, like meningococcemia (brought about by meningococcal microbes in the blood).
- A few kinds of surgery or radiation therapy.
- Injury in the adrenal organs when in the late stages of pregnancy or at the delivery of the child.
- Consuming specific drugs, like large doses of ketoconazole.
Addison’s will affect patients of just about any age, including adolescents. Addison's disease initiated by the immune mechanisms destroying the adrenal gland is much more commonplace in females than in males, but when initiated by tuberculosis, it is suffered mostly by males.
Addison’s disease could also occur in the event someone takes a cortisol-like drug, such as prednisone, for an extensive period and then suddenly ceases treatment.
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References:
Dambro MR (2006). “Addison disease. In Griffith's 5-Minute Clinical Consult,” p. 14. Philadelphia: Lippincott Williams and Wilkins.
Drincic A, Anderson RJ (2007). “Adrenal insufficiency.” In RE Rakel, ET Bope , “Conn's Current Therapy 2007.” 737–740. Philadelphia: Saunders Elsevier.
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