Addison's disease Matenga a Addison

You have 2 adrenal glands, which are just above your kidneys. They release 2 hormones — cortisol and aldosterone.

Cortisol, which is also known as the stress hormone, has many roles in your body. It controls your:

• blood pressure
• immune system by affecting inflammation
• blood glucose (sugar) levels.

Aldosterone controls the balance of salt and water in your body.

Addison's disease happens when your adrenal glands are damaged and no longer make enough of these important hormones. It is most often caused by your body's immune system mistakenly destroying the cells in your adrenal gland. We do not know why this happens.

Symptoms of Addison's disease usually come on slowly. They include:

• tiredness
• poor appetite
• weight loss
• dizziness (especially when you stand up)
• feeling sick (nausea)
• runny poos (diarrhoea)
• throwing up (vomiting)
• changes in skin colour — dark patches or sometimes lightening of your skin (vitiligo).

Sometimes your adrenal glands can fail suddenly. This is known as an Addisonian crisis and can be life threatening.

An Addisionian crisis can be caused by:

• damage to your adrenal glands
• dehydration
• infection
• suddenly stopping some types of steroid medicines.

In an Addisionian crisis, symptoms will appear rapidly. These may include:

• confusion
• low blood pressure
• loss of consciousness
• severe pain in your tummy, lower back or legs.

If your healthcare provider thinks you might have Addison's disease, you will need a blood test to measure your cortisol and aldosterone levels.

You might also need a scan such as a CT scan or MRI scan.

Scans and x-rays

Your healthcare provider will prescribe steroid tablets to replace the cortisol and aldosterone. You will need to take them every day for the rest of your life. Usually, you will take hydrocortisone and fludrocortisone.

Hydrocortisone — My Medicinesexternal link

Fludrocortisone — My Medicinesexternal link

• Take your medicines exactly as prescribed. Call your healthcare provider if you think you are having a problem with your medicine.
• Weigh yourself regularly, especially if you have not felt like eating or you have been throwing up. Weigh yourself at the same time each day and wear the same clothes. Let your healthcare provider know if you are losing weight or throwing up often.
• Do not reduce salt in your diet. You may need to add extra salt to your food during hot and humid weather or after exercise to replace salt lost through sweating.
• You can consider wearing a medical alert bracelet or pendant so medical staff know how to treat you in an emergency. Search online for 'medical bracelets NZ' to find medical bracelet suppliers.

Find more information about your condition and links to support groups on the Adrenal Insufficiency New Zealand website.

Adrenal Insufficiency New Zealandexternal link

Cortisol is your body’s 'stress hormone' and when you are unwell you need higher levels to help you recover.

It is important that you make a plan with your healthcare provider for managing your medication when you are unwell. Keep the plan handy. 

If you have a mild illness, adjust your medications as explained in your plan. It is likely you will need to increase your hydrocortisone medication.

If you are throwing up (vomiting) or have runny poos (diarrhoea), you might not absorb the hydrocortisone medication. Your plan should tell you what to do with your medication. You will need to contact your healthcare provider if the vomiting or diarrhoea continues.

You should contact your healthcare provider urgently if:

• you are not getting better
• you feel very unwell
• your Addison's disease symptoms are getting worse.

You may need to have a hydrocortisone injection or be admitted to hospital. 

You do not need to take extra fludrocortisone when you are unwell.