Structural Biochemistry/Addison's Disease

What is Addison's Disease?

Addison's disease is a disorder that occurs when the adrenal glands produces insufficient amounts of particular hormones. Typically, with Addison's disease, the adrenal glads to not produce enough cortisol and aldosterone.

Addison's disease is also known as adrenal insufficiency. It can affect people of all ages and both genders. It can also be found life-threatening.

The three hormones produced by the cortex are: the glucocorticoid hormones, the mineralocorticoid hormones and sex hormones. Glucocorticoid hormones such as cortisol, maintain glucose levels and decrease immune response, while helping the body to respond to stress. Mineralocorticoid hormones such as aldosterone help regulate and balance potassium and sodium levels. Sex hormones such as androgens in males and estrogens in females, affect sex drive and work with the body during sexual development.

Causes of Addison's Disease

Addison's disease is caused by damage to the adrenal cortex, glands located just above the kidneys. The damaged adrenal cortex produces less hormones.

Addison's disease occurs when there is damage to the adrenal cortex, affecting the adrenal glands. The damage to the adrenal cortex causes the cortex to produce less of its hormones. This damage could be due to a number of incidences. For example, the immune system may mistakenly attack the adrenal glands, developing an autoimmune disease. Infections such as tuberculosis, HIV, or fungal infections may also occur. Tumors and the use of blood-thinning drugs (anticoagulants) may also cause damage to the cortex.

Symptoms of Addison's Disease

Symptoms of Addison's disease typically develop slowly over several of months. Some symptoms may include:

Muscle weakness and fatigue
Weigh loss and decreased appetite
Darkening of the skin (hyperpigmentation)
Nausea, diarrhea, or vomiting
Muscle or joint pains
Irritablity
Depression
Body hair loss or sexual dysfunction in women

Diagnosing Addison's Disease

Typically, a physician will go over with their patient about their medical history and signs and symptoms. If the doctor suspects that a patient may have Addison's disease, the patient may have to undergo some tests, such as:

Blood tests
ATCH stimulation test
Insulin-induced hypoglycemia test
CT scan or MRI

Signs and Tests

Tests showing the presence of Addison's disease may show:

Increased potassium levels
Low blood pressure
Low cortisol levels
Low serum sodium
Normal sex hormone levels

Other tests may include abdominal x-ray and abdominal CT scans.
Patients with Addison's disease may also change the results of the following tests:

17-hydroxycorticosteroids
17-ketosteroids
24-hour urinary aldosterone excretion rate
ACTH
Aldosterone
Blood eosinophil count
CO2
Cortrosyn stimulation test
Potassium test
Renin
Urine cortisol

Treatment

A patient with Addison's disease will usually be treated with oral corticosteroids to control the symptoms of the disease. Unfortunately, the patient must take these drugs for the rest of their life. A physician may change the dosage due to infection, injuries, stress, or surgery.

If one has an extreme form of adrenal insufficiency, hydrocortisone should be injected into a patient.

References