Alternate Names : Primary Adrenocortical Insufficiency, Primary Adrenal Failure, Hypocortisolism
Addison disease occurs when the adrenal glands are
no longer able to produce certain hormones needed for life, such as
cortisol and aldosterone.
What is going on in the body?
There are two adrenal glands in the body, one on top
of each kidney. They produce two hormones: cortisol and aldosterone.
Cortisol is a type of hormone called a
glucocorticoid. It affects almost every organ and tissue in the body.
Experts believe cortisol may have hundreds of effects, but its main job is to help
the body respond to stress. Other vital tasks include the following.
It helps maintain blood pressure, heart function, and blood vessel function.
It helps slow the immune system's inflammation response.
It helps balance the effects of insulin in breaking down glucose for energy.
It helps control the metabolism of proteins, carbohydrates, and fats.
Cortisol is vital to health, so the body maintains a precise balance.
As with many other hormones, the hypothalamus and pituitary gland are key
to this control.
Aldosterone is a type of hormone called a mineralcorticoid.
It helps with the following functions:
maintains blood pressure
maintains water and salt balance in the body by helping the kidneys hang
on to sodium and get rid of potassium
What are the causes and risks of the disease?
Addison disease is a rare disorder that affects only about 1 in
every 100,000 people. It occurs in all age groups, and affects both men and
women equally. Addison disease may be caused by either a disorder of the
adrenal glands themselves, which is called primary adrenal insufficiency. Or,
it may be caused by inadequate secretion of ACTH by the pituitary gland.
In primary adrenal insufficiency, an autoimmune disorder
that makes the person's own immune system attack and destroy the outer layer
of the adrenal glands, called the cortex, is often at fault. When at least 90 percent
of the cortex has been destroyed, adrenal insufficiency occurs. Experts believe causes for
this type may include:
an inherited syndrome called polyendocrine deficiency syndrome, type 1 or type 2
tuberculosis, called TB
chronic infections, mainly fungal infections
that has spread from somewhere else in the body
surgical removal of the adrenal glands
Secondary adrenal insufficiency is due to a lack of ACTH, which causes the adrenal
glands to produce less cortisol. It does not affect production of aldosterone. Causes
of this type of insufficiency include:
surgical removal of the benign, known as noncancerous, tumors of the
pituitary gland linked with Cushing disease.
These tumors produce excess ACTH, and when they are removed, the
body is unable to adapt quickly
due to tumors, infections, loss of blood flow to the pituitary, radiation for
pituitary tumors, or surgical removal of parts of the hypothalamus or the