Addison's Disease

The effects of adrenal insufficiency do not manifest themselves until more than 90% of the adrenal cortex has been lost. Then weakness and dizziness occur, and the skin darkens, especially on or near the elbows, knees, knuckles, lips, scars, and skin folds. These symptoms begin gradually and worsen over time.

The patient becomes irritable and depressed and often craves salty foods. Some people do not experience these progressive symptoms, but become aware of the disease during what is called an addisonian crisis. In this case, the symptoms appear suddenly and require immediate medical attention. Severe pain develops in the lower back, abdomen, or legs; vomiting and diarrhea leave the patient dehydrated. A person may become unconscious and may even die.

A doctor's examination reveals low blood pressure that becomes even lower when the patient rises from a sitting or lying position to a standing position. A blood test shows low blood sugar (hypoglycemia), low blood sodium (hyponatremia), and low levels of cortisol. Other tests are carried out to determine whether the condition is the result of adrenal insufficiency or if the low levels of cortisol are the result of problems with the hypothalamus or pituitary.