Running head: ADDISON’S DISEASE 1 Addison’s Disease ADDISON’S DISEASE 2 Abstract Addison’s disease is a disorder that occurs when a person’s adrenal glands produce insufficient amounts of certain hormones.
When Addison’s diseased was first discovered the endocrine system was not yet completely understood therefore the disease itself was for the most part fatal.After years of research and medical breakthroughs Addison’s disease is now a disease in which someone can live a normal life as long as a daily dose of replacement medications are being ingested. Through this concise research Addison’s disease has been examined from the time that Dr. Addison wrote his now famed article on suprarenal capsules all the way through the fairly simplistic method of treating the disease. The research covers the adrenal glands in depth to include the hormones it produces, signs and symptoms of Addison’s disease, diagnosis of Addison’s disease, and finally the treatment.ADDISON’S DISEASE 3 Adrenocortical hypofunction, chronic adrenocortical insufficiency, or primary adrenal insufficiency are all medical terms for Addison’s disease. Addison’s disease is a “disorder that occurs when the adrenal’s glands do not produce enough of their hormone” (PubMed, 2009).
Addison’s disease is named after Dr. Thomas Addison who was a renowned 19th century physician. Dr. Addison made his famed discovery while working at Guy’s Hospital in England.
He wrote an article regarding his findings in the London Medical Gazette titled, “On the Constitutional and Local Effects of Disease of the Suprarenal Capsules” (Pearce, 2004). Dr. Armand Trousseau of Paris corroborated Addison’s findings and coined the disease Addison’s Disease (Pearce, 2004). Addison’s disease can affect both male and female regardless of age. Addison’s disease occurs when the adrenal glands failed to produce enough of its hormone. The adrenal glands are small hormone secreting glands that are located atop each kidney on the retroperitoneum (MedlinePlus, 2011).There are two portions to adrenal glands, the inner part called the medulla and the outer part called the cortex. Both parts are capable of producing hormones that are critical in order for the human body to maintain a homeostasis.
The medulla produces epinephrine and norepinephrine while the cortex produces cortisol, aldosterone and testosterone. The hormones that not being produced when diagnosed with Addison’s disease are cortisol and/or aldosterone. Cortisol belongs to a class of hormone known as glucocorticoids.Glucocorticoids affect ADDISON’S DISEASE 4 almost every organ and tissue in the body and therefore it is vital for healthy living. Cortisol is used in a myriad of different ways such as helping to maintain blood pressure and heart function, slows the immune system’s inflammation response, helps balance the effects of insulin in breaking down glucose for energy, regulates proteins, carbohydrates, and fats, maintains proper arousal and sense of well-being, and most importantly is helps the body respond to stress (MedicineNet, 2011).The amount of cortisol produced is precisely balanced in order for the body to work at an optimal level. Like many other hormones the hypothalamus and pituitary glands control the secretion.
The hypothalamus sends “releasing hormones” to the pituitary gland which then in turn releases adrenocorticotropin (ACTH). ACTH is an adrenal gland stimulating hormone that when it reaches the adrenal glands the adrenal glands respond by producing cortisol. Cortisol once produced signals the pituitary to slow ACTH production (MedicineNet, 2011). The cycle works on a negative feedback system.The other hormone that can be affected if diagnosed with Addison’s disease is aldosterone. Aldosterone belongs to a class of hormones known as mineralocorticoids. Aldosterone is used to maintain blood pressure and water and salt balance in the body by helping the kidney retain salt or release potassium (MedicineNet, 2011). If the aldosterone levels fall too low the kidneys are unable to regulate sodium and water levels that result in a drop of blood volume and blood pressure.
Failure to produce sufficient levels of cortisol can happen for a couple of reasons.One reason might be due to a disorder of the adrenal glands. When the adrenal glands ADDISON’S DISEASE 5 themselves are malfunctioning that is called primary adrenal insufficiency. Another reason that cortisol production is lacking might be because not enough ACTH is being generated by the pituitary gland. The second order effect of inadequate levels of ACTH being secreted results in cortisol not being produced.When this is the case it is called secondary adrenal insufficiency (MedlinePlus, 2011). Addison’s disease affects about 1 in 100,000 people. Most diagnosed cases are caused because the adrenal cortex has been damaged over time by a person’s own immune system.
Autoimmune disorders happen when the immune system produces antibodies in order to attack the body’d own organs and tissue. When this happens organs and tissue are slowly destroyed over time. Roughly 70% of all reported cases of Addison’s disease are because of autoimmune disorders (MedicineNet, 2011). Adrenal insufficiency occurs when at least 90 percent of the adrenal cortex has been destroyed. As a result, often both glucocorticoid (cortisol) and mineralocorticoid (aldosterone) hormones are lacking.
Sometimes only the adrenal gland is affected, as in idiopathic adrenal insufficiency; sometimes other glands also are affected, as in the polyendocrine deficiency syndrome”(MedicineNet, 2011). There are many signs and symptoms that the body displays when there is an adrenal insufficiency. Below is a list of symptoms that a person my suffer from.
Chronic fatigue Muscle weakness Loss of appetiteADDISON’S DISEASE 6 Weight loss Nausea Vomiting Diarrhea Low blood pressure Hyperpigmentation Nausea, Vomiting, and Dirrhea will occur in about 50% of the victims. Low blood pressure for most people with an undiagnosed Addison’s disease will drop when standing which can lead to dizziness or fainting (MedicineNet, 2011). Since most symptons slowly progress it usually takes a significant medical event in order to seek medical attention. When this happens it is called an Addisonian crisis.Symptoms that are common during an Addisonian crisis are sharp penetrating lower back, abdomen, and leg pain as well as severe vomiting and diarrhea, dehydration, low blood pressure, and loss of consciousness (MedicineNet, 2011). If Addison’s disease goes untreated it can lead to death. If a person is suffering from any, some, or all of the symptoms from above that will give a doctor enough insight to suspect some sort of adrenal insufficiency.
However, usually abnormal blood tests results will clue a doctor in on a person’s medical condition (NADF, 2007).Regardless of what test results might hint at there is only one way to determine if a person has Addison’s disease and that is with definitive tests. “These ADDISON’S DISEASE 7 tests measure the amount of cortisol and aldosterone in the blood and urine, and document a lack of the normal increase in the levels of these two hormones after administration of ACTH given by injection. An elevated blood level of ACTH should also be found. ” (NADF, 2007).Once Addison’s disease has been identified additional tests will be conducted to find the root cause of the disease.
The treatment of Addison’s disease is fairly simple since all forms of Addison’s disease are caused by a lack of cortisol and aldosterone. The treatment simply requires these hormones to be replaces with similar steroids. Cortisol is replaced orally by hydrocortisone or cortisone acetate, Aldosterone is replaced by a synthetic steroid called fludrocortisones. Doses of these medications are adjusted to a person’s size and any other pre-existing medical conditions.Once a person is diagnosed with Addison’s disease and are on medication they can never stop the medication (NADF, 2007). A person can live a normal life if proper replacement medication is taken daily as well as avoidance of dehydration and use of extra medication during an illness. Additionally a person with Addison’s disease with modern medical breakthroughs has a normal life expectancy. ADDISON’S DISEASE 8 Reference Eckman, Ari.
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