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<link rel="alternative" hreflang="en" href="https://medlineplus.gov/ency/article/000378.htm"/><meta property="og:title" content="Addison disease: MedlinePlus Medical Encyclopedia"/><meta property="og:url" content="https://medlineplus.gov/ency/article/000378.htm"/><meta property="twitter:title" content="Addison disease: MedlinePlus Medical Encyclopedia"/><meta name="twitter:card" content="summary_large_image"/><meta name="description" content="Addison disease is a disorder that causes the adrenal glands to not produce enough hormones."/><meta itemprop="description" name="description" content="Addison disease is a disorder that causes the adrenal glands to not produce enough hormones."/><meta property="og:description" content="Addison disease is a disorder that causes the adrenal glands to not produce enough hormones."/><meta property="twitter:description" content="Addison disease is a disorder that causes the adrenal glands to not produce enough hormones."/><meta property="og:image" content="https://medlineplus.gov/images/share_ency_1.jpg"/><meta property="og:image" content="https://medlineplus.gov/images/share_ency_2.jpg"/><meta property="og:image" content="https://medlineplus.gov/images/share_ency_3.jpg"/><meta property="twitter:image" content="https://medlineplus.gov/images/share_ency_1.jpg"/>
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</div><div><span>Addison disease</span></div></div>
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<article><div id="d-article"><div class="page-info"><div class="page-title"><a name="start" id="start">
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</a><h1 class="with-also" itemprop="name">Addison disease</h1>
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</noscript></div><div class="main"><div id="ency_summary"><p>Addison disease is a disorder that causes the <a test="test" href="./002219.htm">adrenal glands</a> to not produce enough hormones.</p></div><section><div class="section"><div class="section-header"><div class="section-title"><h2>Causes</h2></div><div class="section-button"><button type="submit" aria-controls="section-1" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-1"><p>The adrenal glands are small hormone-releasing organs located on top of each kidney. They are made up of an outer portion, called the cortex, and an inner portion, called the medulla.</p><p>The cortex produces 3 hormones:</p><ul><li>Glucocorticoid hormones (such as cortisol) maintain sugar (glucose) control, blood pressure, decrease (suppress) <a test="test" href="./000821.htm">immune response</a>, and help the body respond to stress.</li><li>Mineralocorticoid hormones (such as aldosterone) regulate sodium, water and potassium balance.</li><li>Sex hormones, androgens (male) and estrogens (female), affect sexual development and sex drive. </li></ul><p>Addison disease results from damage to the adrenal cortex. The damage causes the cortex to produce hormone levels that are too low.</p><p>This damage may be caused by the following:</p><ul><li>The immune system mistakenly attacking the adrenal glands (<a test="test" href="./000816.htm">autoimmune disease</a>)</li><li>Infections such as <a test="test" href="./000077.htm">tuberculosis</a>, <a test="test" href="./000594.htm">HIV</a>, or fungal infections</li><li>Hemorrhage into the adrenal glands</li><li>Tumors </li></ul><p>Risk factors for the autoimmune type of Addison disease include other autoimmune diseases:</p><ul><li>Swelling (inflammation) of the thyroid gland that often results in reduced thyroid function (<a test="test" href="./000371.htm">chronic thyroiditis</a>)
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</li><li>Thyroid gland produces too much thyroid hormone (<a test="test" href="./000356.htm">overactive thyroid</a>, <a test="test" href="./000358.htm">Graves disease</a>)
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</li><li>Itchy rash with bumps and blisters (<a test="test" href="./001480.htm">dermatitis herpetiformis</a>)
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</li><li>Parathyroid glands in the neck do not produce enough parathyroid hormone (<a test="test" href="./000385.htm">hypoparathyroidism</a>)
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</li><li>Pituitary gland does not produce normal amounts of some or all of its hormones (<a test="test" href="./000343.htm">hypopituitarism</a>)
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</li><li>Autoimmune disorder that affects the nerves and the muscles they control (<a test="test" href="./000712.htm">myasthenia gravis</a>)
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</li><li>Body does not have enough healthy red blood cells (<a test="test" href="./000569.htm">pernicious anemia</a>)
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</li><li>Testicles cannot produce sperm or male hormones (<a test="test" href="./000395.htm">testicular failure</a>)</li><li><a test="test" href="./000305.htm">Type I diabetes</a></li><li>Loss of brown color (pigment) from areas of the skin (<a test="test" href="./000831.htm">vitiligo</a>)
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</li></ul><p>Certain rare genetic defects may also cause adrenal insufficiency.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Symptoms</h2></div><div class="section-button"><button type="submit" aria-controls="section-2" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-2"><p>Symptoms of Addison disease may include any of the following:</p><ul><li>Abdominal pain</li><li>Chronic diarrhea, nausea, and vomiting<br/></li><li>Darkening of the skin</li><li><a test="test" href="./000982.htm">Dehydration</a></li><li>Dizziness when standing up</li><li>Low-grade fever</li><li>Low blood sugar</li><li>Low blood pressure, especially with a change in body position</li><li>Extreme <a test="test" href="./003174.htm">weakness</a>, <a test="test" href="./003088.htm">fatigue</a>, and slow, sluggish movement</li><li>
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Darker skin on the inside of the cheeks and lips (buccal <a test="test" href="./002264.htm">mucosa</a>)</li><li>Salt craving (eating food with a lot of added salt)</li><li>Weight loss with reduced appetite </li></ul><p>Symptoms may not be present all the time. Many people have some or all of these symptoms when they have an infection or other stress on the body. Other times, they have no symptoms.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Exams and Tests</h2></div><div class="section-button"><button type="submit" aria-controls="section-3" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-3"><p>Your health care provider will perform a physical exam and ask about the symptoms. </p><p>Blood tests will likely be ordered and may show:</p><ul><li>Increased <a test="test" href="./003484.htm">potassium</a></li><li>Low <a test="test" href="./003693.htm">cortisol level</a></li><li>Low <a test="test" href="./003481.htm">sodium level</a></li><li>Low pH</li><li>Normal testosterone and estrogen levels, but low DHEA level</li><li>High <a test="test" href="./003649.htm">eosinophil count</a></li></ul><p>Additional laboratory tests may be ordered.</p><p>Other tests may include:</p><ul><li><a test="test" href="./003815.htm">Abdominal x-ray</a></li><li><a test="test" href="./003789.htm">Abdominal CT scan</a></li><li>Cosyntropin (ACTH) stimulation test
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</li></ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Treatment</h2></div><div class="section-button"><button type="submit" aria-controls="section-4" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-4"><p>Treatment with replacement corticosteroids and mineralocorticoids will control the symptoms of this disease. These medicines usually need to be taken for life. </p><p>Never skip doses of your medicine for this condition because life-threatening reactions may occur.</p><p>Your provider may tell you to increase your dosage for a short time because of:</p><ul><li>Infection</li><li>Injury</li><li>Stress</li><li>Surgery </li></ul><p>During an extreme form of adrenal insufficiency, called <a test="test" href="./000357.htm">adrenal crisis</a>, you must inject hydrocortisone right away. Treatment for low blood pressure is usually needed as well.</p><p>Some people with Addison disease (or family members) are taught to give themselves an emergency injection of hydrocortisone during stressful situations. Always carry medical ID (card, bracelet, or necklace) that says you have adrenal insufficiency. The ID should also say the type of medicine and dosage you need in case of an emergency. </p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Outlook (Prognosis)</h2></div><div class="section-button"><button type="submit" aria-controls="section-5" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-5"><p>With hormone therapy, many people with Addison disease are able to lead a nearly normal life.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Possible Complications</h2></div><div class="section-button"><button type="submit" aria-controls="section-6" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-6"><p>Complications can occur if you take too little or too much adrenal hormone.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>When to Contact a Medical Professional</h2></div><div class="section-button"><button type="submit" aria-controls="section-7" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-7"><p>Contact your provider if:</p><ul><li>You are unable to keep your medicine down due to vomiting.</li><li>You have stress such as infection, injury, trauma, or dehydration. You may need to have your medicine adjusted.</li><li>Your weight increases over time.</li><li>Your ankles begin to swell.</li><li>You develop new symptoms.</li><li>While taking treatment, you develop signs of a disorder called <a test="test" href="./000410.htm">Cushing syndrome</a></li></ul><p>If you have symptoms of adrenal crisis, give yourself an emergency injection of your prescribed medicine. If it is not available, go to the nearest emergency room or call 911 or the local emergency number.</p><p>Symptoms of adrenal crisis include:</p><ul><li>Abdominal pain</li><li>Difficulty breathing</li><li>Dizziness or lightheadedness</li><li><a test="test" href="./007278.htm">Low blood pressure</a></li><li>Reduced level of consciousness </li></ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Alternative Names</h2></div><div class="section-button"><button type="submit" aria-controls="section-Alt" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-Alt"><p>Adrenocortical hypofunction; Chronic adrenocortical insufficiency; Primary adrenal insufficiency; Addison's disease</p></div></div></section><section><div class="section sec-mb"><div class="section-header"><div class="section-title"><h2>Images</h2></div><div class="section-button"><button type="submit" aria-controls="section-tnails" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-Ref"><p>Bornstein SR, Allolio B, Arlt W, et al. Diagnosis and treatment of primary adrenal insufficiency: an Endocrine Society clinical practice guideline. <em>J Clin Endocrinol Metab</em>. 2016;101(2):364-389. PMID: PMC4880116 <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4880116/" target="_blank">www.ncbi.nlm.nih.gov/pmc/articles/PMC4880116/</a>.</p><p>Newell-Price JDC, Auchus RJ. The adrenal cortex. In: Melmed S, Auchus RJ, Goldfine AB, Koenig RJ, Rosen CJ, eds. <em>Williams Textbook of Endocrinology</em>. 14th ed. Philadelphia, PA: Elsevier; 2020:chap 15.</p><p>Nieman LK. Adrenal cortex. In: Goldman L, Cooney KA, eds. <em>Goldman-Cecil Medicine</em>. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 208.</p></div></div></section>
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<section><div class="section"><div class="section-header"><div class="section-title"><h2>Review Date 5/12/2023</h2></div><div class="section-button"><button type="submit" aria-controls="section-version" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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<div id="section-version" class="section-body"><p>Updated by: Sandeep K. Dhaliwal, MD, board-certified in Diabetes, Endocrinology, and Metabolism, Springfield, VA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. </p>
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