The most common cause of primary adrenal insufficiency or Addison's disease is destruction of the adrenal cortex by the body’s own immune system (autoimmunity). An inflammatory reaction or infection can also destroy the adrenal glands. In rare cases, both adrenal glands are destroyed by tumour metastases. Adrenal insufficiency can also occur when cortisone is suddenly stopped after long-term treatment. When cortisone is taken for a long time, the adrenal cortex is sometimes no longer able to produce it itself. This insufficiency is usually only temporary, but it may persist; we then call this a secondary or tertiary form of adrenal insufficiency.
Most clinical signs of primary adrenal insufficiency are non-specific and usually develop gradually over months or even years. These include severe fatigue, weight loss, (muscle) weakness, nausea and vomiting, abdominal pain, diarrhoea, dizziness, salt cravings, low blood pressure, tanned skin without sunbeds or holidays, decreased libido, psychological symptoms (including depression), inability to handle stress, onset of spontaneous hypoglycemia (low blood sugar), absence of menstrual periods.
If you suspect this, please contact your GP. Bring the results of any blood samples with you to the endocrinology consultation. You are not required to fast. An additional blood test, stimulation test and/or other tests (to determine the cause) may also be performed, e.g. CT adrenal glands. After the diagnosis, we will determine the further policy together with you. The treatment of primary adrenal insufficiency consists of taking glucocorticoids (hydrocortisone) and mineralocorticoids (fludrocortisone) tablets for life. It is vital to take these regularly. Explanation on how to prevent Addison’s will be provided at the consultation. An Addison’s pass will be given.
Your doctor will discuss the treatment options with you.
