Adrenal Insuficiency and Addison's Disease

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Signs and symptoms

Often the disease changes very slowly and can be difficult to diagnose because the symptoms such as tiredness, loss of energy, weight loss and nausea are very common. One very distinctive feature is the presence of darkening (pigmentation) of some areas of the skin. This darkening occurs on areas like the hands that are exposed to sun but also in the lining of the mouth, the lines or creases on the inside of the hands and any recent scars.

The most common symptoms are:

  • Weakness
  • Tiredness
  • Not eating
  • Nausea
  • Weight loss
  • Darkened skin
  • Low blood pressure, particularly on standing up (called postural or orthostatic hypotension), causing dizziness and fainting.

Addisonian crisis
This is when symptoms are severe and appear suddenly. The patient has very low blood pressure (hypotension), feels sick (nausea), vomits, has tummy (abdominal) pain and often fever without obvious cause. This is a dangerous situation and treatment with cortisol must be given immediately after taking a blood sample. Addisonian crisis can occur if there is a haemorrhage (bleed) in the adrenal glands or it can be triggered by a stressful event, including trauma, surgery or infection.

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