BACK TOTOP Browse A-ZSearchBrowse A-ZABCDEFGHIJKLMNOPQRSTUVWXYZ0-9 E-mail FormEmail ResultsName:Email address:Recipients Name:Recipients address:Message: Print-FriendlyBookmarksbookmarks-menuAddison diseaseAdrenocortical hypofunction; Chronic adrenocortical insufficiency; Primary adrenal insufficiency; Addison's diseaseAddison disease is a disorder that causes the adrenal glands to not produce enough hormones.Adrenal glandsThe adrenal glands are two small triangle-shaped glands in the upper abdomen. One gland is located on top of each kidney.ImageRead Article Now Book Mark Article Causes 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.The cortex produces 3 hormones:Glucocorticoid hormones (such as cortisol) maintain sugar (glucose) control, blood pressure, decrease (suppress) immune response, and help the body respond to stress. Immune responseThe immune response is how your body recognizes and defends itself against bacteria, viruses, and substances that appear foreign and harmful....ImageRead Article Now Book Mark Article Mineralocorticoid hormones (such as aldosterone) regulate sodium, water and potassium balance. Sex hormones, androgens (male) and estrogens (female), affect sexual development and sex drive. Addison disease results from damage to the adrenal cortex. The damage causes the cortex to produce hormone levels that are too low.This damage may be caused by the following:The immune system mistakenly attacking the adrenal glands (autoimmune disease) Autoimmune diseaseAn autoimmune disorder occurs when the body's immune system attacks and destroys healthy body tissue by mistake. There are more than 80 autoimmune d...ImageRead Article Now Book Mark Article Infections such as tuberculosis, HIV, or fungal infections TuberculosisPulmonary tuberculosis (TB) is a contagious bacterial infection that involves the lungs. It may spread to other organs.ImageRead Article Now Book Mark Article HIVHuman immunodeficiency virus (HIV) is the virus that causes acquired immunodeficiency syndrome (AIDS). When a person becomes infected with HIV, the ...ImageRead Article Now Book Mark Article Hemorrhage into the adrenal glands Tumors Risk factors for the autoimmune type of Addison disease include other autoimmune diseases:Swelling (inflammation) of the thyroid gland that often results in reduced thyroid function (chronic thyroiditis) Chronic thyroiditisChronic thyroiditis is caused by a reaction of the immune system against the thyroid gland. It often results in reduced thyroid function (hypothyroi...ImageRead Article Now Book Mark Article Thyroid gland produces too much thyroid hormone (overactive thyroid, Graves disease) Overactive thyroidHyperthyroidism is a condition in which the thyroid gland makes too much thyroid hormone. The condition is often called overactive thyroid.ImageRead Article Now Book Mark Article Graves diseaseGraves disease is an autoimmune disorder that leads to an overactive thyroid gland (hyperthyroidism). An autoimmune disorder is a condition that occ...ImageRead Article Now Book Mark Article Itchy rash with bumps and blisters (dermatitis herpetiformis) Dermatitis herpetiformisDermatitis herpetiformis (DH) is a very itchy rash consisting of bumps and blisters. The rash is chronic (long-term).ImageRead Article Now Book Mark Article Parathyroid glands in the neck do not produce enough parathyroid hormone (hypoparathyroidism) HypoparathyroidismHypoparathyroidism is a disorder in which the parathyroid glands in the neck do not produce enough parathyroid hormone (PTH).ImageRead Article Now Book Mark Article Pituitary gland does not produce normal amounts of some or all of its hormones (hypopituitarism) HypopituitarismHypopituitarism is a condition in which the pituitary gland does not produce normal amounts of some or all of its hormones.ImageRead Article Now Book Mark Article Autoimmune disorder that affects the nerves and the muscles they control (myasthenia gravis) Myasthenia gravisMyasthenia gravis is a neuromuscular disorder. Neuromuscular disorders involve the muscles and the nerves that control them.ImageRead Article Now Book Mark Article Body does not have enough healthy red blood cells (pernicious anemia) Pernicious anemiaAnemia is a condition in which the body does not have enough healthy red blood cells. Red blood cells provide oxygen to body tissues. There are man...ImageRead Article Now Book Mark Article Testicles cannot produce sperm or male hormones (testicular failure) Testicular failureTesticular failure occurs when the testicles cannot produce sperm or male hormones, such as testosterone.ImageRead Article Now Book Mark Article Type I diabetes Type I diabetesType 1 diabetes is a lifelong (chronic) disease in which there is a high level of sugar (glucose) in the blood.ImageRead Article Now Book Mark Article Loss of brown color (pigment) from areas of the skin (vitiligo) VitiligoVitiligo is a skin condition in which there is a loss of color (pigment) from areas of skin. This results in uneven white patches that have no pigme...ImageRead Article Now Book Mark Article Certain rare genetic defects may also cause adrenal insufficiency. Symptoms Symptoms of Addison disease may include any of the following:Abdominal pain Chronic diarrhea, nausea, and vomiting Darkening of the skin Dehydration DehydrationDehydration occurs when your body does not have as much water and fluids as it needs. Dehydration can be mild, moderate, or severe, based on how much...ImageRead Article Now Book Mark Article Dizziness when standing up Low-grade fever Low blood sugar Low blood pressure, especially with a change in body position Extreme weakness, fatigue, and slow, sluggish movement WeaknessWeakness is reduced strength in one or more muscles.Read Article Now Book Mark Article FatigueFatigue is a feeling of weariness, tiredness, or lack of energy.Read Article Now Book Mark Article Darker skin on the inside of the cheeks and lips (buccal mucosa) MucosaMucosa is moist tissue that lines certain parts of the inside of your body. It is in your: NoseMouthLungsDigestive tractUrinary and genital tracts G...ImageRead Article Now Book Mark Article Salt craving (eating food with a lot of added salt) Weight loss with reduced appetite 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. Exams and Tests Your health care provider will perform a physical exam and ask about the symptoms. Blood tests will likely be ordered and may show:Increased potassium PotassiumThis test measures the amount of potassium in the fluid portion (serum) of the blood. Potassium (K+) helps nerves and muscles communicate. It also ...ImageRead Article Now Book Mark Article Low cortisol level Cortisol levelThe cortisol blood test measures the level of cortisol in the blood. Cortisol is a steroid (glucocorticoid or corticosteroid) hormone produced by th...Read Article Now Book Mark Article Low sodium level Sodium levelThe sodium blood test measures the concentration of sodium in the blood. Sodium can also be measured using a urine test.ImageRead Article Now Book Mark Article Low pH Normal testosterone and estrogen levels, but low DHEA level High eosinophil countEosinophil countAn absolute eosinophil count is a blood test that measures the number of one type of white blood cells called eosinophils. Eosinophils become active...ImageRead Article Now Book Mark Article Additional laboratory tests may be ordered.Other tests may include:Abdominal x-ray Abdominal x-rayAn abdominal x-ray is an imaging test to look at organs and structures in the abdomen. Organs include the liver, spleen, stomach, and intestines. Wh...ImageRead Article Now Book Mark Article Abdominal CT scan Abdominal CT scanAn abdominal CT scan is an imaging method. This test uses x-rays to create cross-sectional pictures of the belly area. CT stands for computed tomog...ImageRead Article Now Book Mark Article Cosyntropin (ACTH) stimulation test Treatment Treatment with replacement corticosteroids and mineralocorticoids will control the symptoms of this disease. These medicines usually need to be taken for life. Never skip doses of your medicine for this condition because life-threatening reactions may occur.Your provider may tell you to increase your dosage for a short time because of:Infection Injury Stress Surgery During an extreme form of adrenal insufficiency, called adrenal crisis, you must inject hydrocortisone right away. Treatment for low blood pressure is usually needed as well.Adrenal crisisAcute adrenal crisis is a life-threatening condition that occurs when there is not enough cortisol. This is a hormone produced by the adrenal glands...ImageRead Article Now Book Mark Article 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. Outlook (Prognosis) With hormone therapy, many people with Addison disease are able to lead a nearly normal life. Possible Complications Complications can occur if you take too little or too much adrenal hormone. When to Contact a Medical Professional Contact your provider if:You are unable to keep your medicine down due to vomiting. You have stress such as infection, injury, trauma, or dehydration. You may need to have your medicine adjusted. Your weight increases over time. Your ankles begin to swell. You develop new symptoms. While taking treatment, you develop signs of a disorder called Cushing syndromeCushing syndromeCushing syndrome is a disorder that occurs when your body has a high level of the hormone cortisol.ImageRead Article Now Book Mark Article 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.Symptoms of adrenal crisis include:Abdominal pain Difficulty breathing Dizziness or lightheadedness Low blood pressure Low blood pressureLow blood pressure occurs when blood pressure is much lower than normal. This means the heart, brain, and other parts of the body may not get enough...ImageRead Article Now Book Mark Article Reduced level of consciousness Open ReferencesReferencesBornstein SR, Allolio B, Arlt W, et al. Diagnosis and treatment of primary adrenal insufficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2016;101(2):364-389. PMID: PMC4880116 www.ncbi.nlm.nih.gov/pmc/articles/PMC4880116/.Newell-Price JDC, Auchus RJ. The adrenal cortex. In: Melmed S, Auchus RJ, Goldfine AB, Koenig RJ, Rosen CJ, eds. Williams Textbook of Endocrinology. 14th ed. Philadelphia, PA: Elsevier; 2020:chap 15.Nieman LK. Adrenal cortex. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 208.AllVideoImagesTogEndocrine glands - illustration Endocrine glands release hormones (chemical messengers) into the bloodstream to be transported to various organs and tissues throughout the body. For instance, the pancreas secretes insulin, which allows the body to regulate levels of sugar in the blood. The thyroid gets instructions from the pituitary to secrete hormones which determine the rate of metabolism in the body (the more hormone in the bloodstream, the faster the chemical activity; the less hormone, the slower the activity).Endocrine glandsillustrationEndocrine glands - illustration Endocrine glands release hormones (chemical messengers) into the bloodstream to be transported to various organs and tissues throughout the body. For instance, the pancreas secretes insulin, which allows the body to regulate levels of sugar in the blood. The thyroid gets instructions from the pituitary to secrete hormones which determine the rate of metabolism in the body (the more hormone in the bloodstream, the faster the chemical activity; the less hormone, the slower the activity).Endocrine glandsillustration Tests for Addison disease 24-hour urinary aldosterone excretion testAldosterone blood testRelated Information Adrenal glands(Special Topic)Immune response(Special Topic)Pulmonary tuberculosis(Condition)Autoimmune disorders(Condition)Type 1 diabetes(Condition)Hypoparathyroidism(Condition)Hypopituitarism(Condition)Pernicious anemia(Condition)Graves disease(Condition)Chronic thyroiditis (Hashimoto disease)(Condition)Diabetes - type 1 - InDepth(In-Depth)Anemia - InDepth(In-Depth) Review Date: 5/12/2023 Reviewed 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. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. No warranty of any kind, either expressed or implied, is made as to the accuracy, reliability, timeliness, or correctness of any translations made by a third-party service of the information provided herein into any other language. © 1997- A.D.A.M., a business unit of Ebix, Inc. Any duplication or distribution of the information contained herein is strictly prohibited. © 1997- All rights reserved. A.D.A.M. content is best viewed in IE9 or above, Firefox and Google Chrome browser.Content is best viewed in IE9 or above, Firefox and Google Chrome browser.
Addison diseaseAdrenocortical hypofunction; Chronic adrenocortical insufficiency; Primary adrenal insufficiency; Addison's diseaseAddison disease is a disorder that causes the adrenal glands to not produce enough hormones.Adrenal glandsThe adrenal glands are two small triangle-shaped glands in the upper abdomen. One gland is located on top of each kidney.ImageRead Article Now Book Mark Article Causes 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.The cortex produces 3 hormones:Glucocorticoid hormones (such as cortisol) maintain sugar (glucose) control, blood pressure, decrease (suppress) immune response, and help the body respond to stress. Immune responseThe immune response is how your body recognizes and defends itself against bacteria, viruses, and substances that appear foreign and harmful....ImageRead Article Now Book Mark Article Mineralocorticoid hormones (such as aldosterone) regulate sodium, water and potassium balance. Sex hormones, androgens (male) and estrogens (female), affect sexual development and sex drive. Addison disease results from damage to the adrenal cortex. The damage causes the cortex to produce hormone levels that are too low.This damage may be caused by the following:The immune system mistakenly attacking the adrenal glands (autoimmune disease) Autoimmune diseaseAn autoimmune disorder occurs when the body's immune system attacks and destroys healthy body tissue by mistake. There are more than 80 autoimmune d...ImageRead Article Now Book Mark Article Infections such as tuberculosis, HIV, or fungal infections TuberculosisPulmonary tuberculosis (TB) is a contagious bacterial infection that involves the lungs. It may spread to other organs.ImageRead Article Now Book Mark Article HIVHuman immunodeficiency virus (HIV) is the virus that causes acquired immunodeficiency syndrome (AIDS). When a person becomes infected with HIV, the ...ImageRead Article Now Book Mark Article Hemorrhage into the adrenal glands Tumors Risk factors for the autoimmune type of Addison disease include other autoimmune diseases:Swelling (inflammation) of the thyroid gland that often results in reduced thyroid function (chronic thyroiditis) Chronic thyroiditisChronic thyroiditis is caused by a reaction of the immune system against the thyroid gland. It often results in reduced thyroid function (hypothyroi...ImageRead Article Now Book Mark Article Thyroid gland produces too much thyroid hormone (overactive thyroid, Graves disease) Overactive thyroidHyperthyroidism is a condition in which the thyroid gland makes too much thyroid hormone. The condition is often called overactive thyroid.ImageRead Article Now Book Mark Article Graves diseaseGraves disease is an autoimmune disorder that leads to an overactive thyroid gland (hyperthyroidism). An autoimmune disorder is a condition that occ...ImageRead Article Now Book Mark Article Itchy rash with bumps and blisters (dermatitis herpetiformis) Dermatitis herpetiformisDermatitis herpetiformis (DH) is a very itchy rash consisting of bumps and blisters. The rash is chronic (long-term).ImageRead Article Now Book Mark Article Parathyroid glands in the neck do not produce enough parathyroid hormone (hypoparathyroidism) HypoparathyroidismHypoparathyroidism is a disorder in which the parathyroid glands in the neck do not produce enough parathyroid hormone (PTH).ImageRead Article Now Book Mark Article Pituitary gland does not produce normal amounts of some or all of its hormones (hypopituitarism) HypopituitarismHypopituitarism is a condition in which the pituitary gland does not produce normal amounts of some or all of its hormones.ImageRead Article Now Book Mark Article Autoimmune disorder that affects the nerves and the muscles they control (myasthenia gravis) Myasthenia gravisMyasthenia gravis is a neuromuscular disorder. Neuromuscular disorders involve the muscles and the nerves that control them.ImageRead Article Now Book Mark Article Body does not have enough healthy red blood cells (pernicious anemia) Pernicious anemiaAnemia is a condition in which the body does not have enough healthy red blood cells. Red blood cells provide oxygen to body tissues. There are man...ImageRead Article Now Book Mark Article Testicles cannot produce sperm or male hormones (testicular failure) Testicular failureTesticular failure occurs when the testicles cannot produce sperm or male hormones, such as testosterone.ImageRead Article Now Book Mark Article Type I diabetes Type I diabetesType 1 diabetes is a lifelong (chronic) disease in which there is a high level of sugar (glucose) in the blood.ImageRead Article Now Book Mark Article Loss of brown color (pigment) from areas of the skin (vitiligo) VitiligoVitiligo is a skin condition in which there is a loss of color (pigment) from areas of skin. This results in uneven white patches that have no pigme...ImageRead Article Now Book Mark Article Certain rare genetic defects may also cause adrenal insufficiency. Symptoms Symptoms of Addison disease may include any of the following:Abdominal pain Chronic diarrhea, nausea, and vomiting Darkening of the skin Dehydration DehydrationDehydration occurs when your body does not have as much water and fluids as it needs. Dehydration can be mild, moderate, or severe, based on how much...ImageRead Article Now Book Mark Article Dizziness when standing up Low-grade fever Low blood sugar Low blood pressure, especially with a change in body position Extreme weakness, fatigue, and slow, sluggish movement WeaknessWeakness is reduced strength in one or more muscles.Read Article Now Book Mark Article FatigueFatigue is a feeling of weariness, tiredness, or lack of energy.Read Article Now Book Mark Article Darker skin on the inside of the cheeks and lips (buccal mucosa) MucosaMucosa is moist tissue that lines certain parts of the inside of your body. It is in your: NoseMouthLungsDigestive tractUrinary and genital tracts G...ImageRead Article Now Book Mark Article Salt craving (eating food with a lot of added salt) Weight loss with reduced appetite 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. Exams and Tests Your health care provider will perform a physical exam and ask about the symptoms. Blood tests will likely be ordered and may show:Increased potassium PotassiumThis test measures the amount of potassium in the fluid portion (serum) of the blood. Potassium (K+) helps nerves and muscles communicate. It also ...ImageRead Article Now Book Mark Article Low cortisol level Cortisol levelThe cortisol blood test measures the level of cortisol in the blood. Cortisol is a steroid (glucocorticoid or corticosteroid) hormone produced by th...Read Article Now Book Mark Article Low sodium level Sodium levelThe sodium blood test measures the concentration of sodium in the blood. Sodium can also be measured using a urine test.ImageRead Article Now Book Mark Article Low pH Normal testosterone and estrogen levels, but low DHEA level High eosinophil countEosinophil countAn absolute eosinophil count is a blood test that measures the number of one type of white blood cells called eosinophils. Eosinophils become active...ImageRead Article Now Book Mark Article Additional laboratory tests may be ordered.Other tests may include:Abdominal x-ray Abdominal x-rayAn abdominal x-ray is an imaging test to look at organs and structures in the abdomen. Organs include the liver, spleen, stomach, and intestines. Wh...ImageRead Article Now Book Mark Article Abdominal CT scan Abdominal CT scanAn abdominal CT scan is an imaging method. This test uses x-rays to create cross-sectional pictures of the belly area. CT stands for computed tomog...ImageRead Article Now Book Mark Article Cosyntropin (ACTH) stimulation test Treatment Treatment with replacement corticosteroids and mineralocorticoids will control the symptoms of this disease. These medicines usually need to be taken for life. Never skip doses of your medicine for this condition because life-threatening reactions may occur.Your provider may tell you to increase your dosage for a short time because of:Infection Injury Stress Surgery During an extreme form of adrenal insufficiency, called adrenal crisis, you must inject hydrocortisone right away. Treatment for low blood pressure is usually needed as well.Adrenal crisisAcute adrenal crisis is a life-threatening condition that occurs when there is not enough cortisol. This is a hormone produced by the adrenal glands...ImageRead Article Now Book Mark Article 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. Outlook (Prognosis) With hormone therapy, many people with Addison disease are able to lead a nearly normal life. Possible Complications Complications can occur if you take too little or too much adrenal hormone. When to Contact a Medical Professional Contact your provider if:You are unable to keep your medicine down due to vomiting. You have stress such as infection, injury, trauma, or dehydration. You may need to have your medicine adjusted. Your weight increases over time. Your ankles begin to swell. You develop new symptoms. While taking treatment, you develop signs of a disorder called Cushing syndromeCushing syndromeCushing syndrome is a disorder that occurs when your body has a high level of the hormone cortisol.ImageRead Article Now Book Mark Article 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.Symptoms of adrenal crisis include:Abdominal pain Difficulty breathing Dizziness or lightheadedness Low blood pressure Low blood pressureLow blood pressure occurs when blood pressure is much lower than normal. This means the heart, brain, and other parts of the body may not get enough...ImageRead Article Now Book Mark Article Reduced level of consciousness Open ReferencesReferencesBornstein SR, Allolio B, Arlt W, et al. Diagnosis and treatment of primary adrenal insufficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2016;101(2):364-389. PMID: PMC4880116 www.ncbi.nlm.nih.gov/pmc/articles/PMC4880116/.Newell-Price JDC, Auchus RJ. The adrenal cortex. In: Melmed S, Auchus RJ, Goldfine AB, Koenig RJ, Rosen CJ, eds. Williams Textbook of Endocrinology. 14th ed. Philadelphia, PA: Elsevier; 2020:chap 15.Nieman LK. Adrenal cortex. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 208.