Addison's disease

Addison's disease is primary adrenal insufficiency: damaged adrenal glands produce too little cortisol and often too little aldosterone. It can cause fatigue, weight loss, low blood pressure, and life-threatening adrenal crisis.

Cortisol: A steroid hormone that helps regulate metabolism, immune activity, and the body's response to stress. Its deficiency causes many symptoms and prevents an adequate response to physiological stress.
Cosyntropin stimulation test: A test that measures cortisol before and after synthetic adrenocorticotropic hormone is administered. An inadequate cortisol response supports adrenal insufficiency.
Autoimmune adrenalitis: Immune-mediated inflammation and destruction of the adrenal cortex. It is the most common cause of Addison's disease in many countries.
Secondary adrenal insufficiency: Cortisol deficiency caused by inadequate pituitary production of adrenocorticotropic hormone. Unlike Addison's disease, it originates in the pituitary and usually preserves aldosterone production.
Hyperpigmentation: Darkening of the skin or mucous membranes caused by increased melanin deposition. Excess ACTH-related signaling can cause characteristic darkening in primary adrenal insufficiency.
Aldosterone: A mineralocorticoid hormone that regulates sodium and potassium balance and helps maintain blood volume and blood pressure. Low levels cause sodium loss, potassium retention, and falling blood pressure in many cases.
Plasma ACTH test: A blood test measuring adrenocorticotropic hormone, the pituitary signal that stimulates cortisol production. High ACTH alongside low cortisol points toward primary adrenal failure.
Tuberculosis: An infectious disease caused by Mycobacterium tuberculosis, which can affect multiple organs. Adrenal tuberculosis can destroy hormone-producing tissue and cause primary adrenal insufficiency.
Tertiary adrenal insufficiency: Cortisol deficiency caused by inadequate hypothalamic signaling, often after prolonged glucocorticoid use. Its upstream cause and typically preserved aldosterone distinguish it from primary adrenal failure.
Hyponatremia: An abnormally low concentration of sodium in the blood. Aldosterone deficiency promotes sodium loss, contributing to low blood sodium.

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