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"What is Addison's disease?"
Yesterday, my mother, who's 65, was hospitalized with vomiting and back pain. The doctor said it looked like an Addisonian crisis, and he's running tests on her. What does it mean if she turns out to have Addison's disease?
Addison's disease is a disorder of the adrenal glands, which are small glands that lie above the kidneys. An endocrinologist is the type of doctor that specializes in problems with the adrenal glands. Addison's disease is referred to as an "autoimmune disease" because the patient has developed antibodies against his or her own adrenal glands. These antibodies stop the gland from producing normal levels of its hormones. You may hear doctors refer to this as "adrenal failure." The adrenal hormones are critical for keeping up one's blood pressure at a normal level, regulating the levels of sodium and potassium (electrolytes) in the blood, and producing a "stress response" to fight infections. Patients with Addison's will often have a low blood sugar due to lack of this stress hormone, which is called cortisol. Typical symptoms of Addison's disease are fatigue, nausea, vomiting, abdominal pain, feeling lightheaded or faint, fever, and having darkened skin. People who have other autoimmune problems like Type 1 diabetes or some types of thyroid disease may be more likely to develop Addison's disease. Patients with Addison's disease need to take replacement hormones on a daily basis to keep these functions normal. While hospitalized they may receive these as intravenous medications, but they can be taken as pills at home. These hormones (medications) include corticosteroids, such as prednisone or hydrocortisone, and mineralocorticoids, such as fludrocortisone. If your mother has Addison's disease, her doctor will determine which of these medications she needs. It's important to know that other medical problems can also cause adrenal dysfunction. These include infection of the adrenal glands (tuberculosis is the most common cause worldwide), having recently stopped taking corticosteroid medications, bleeding into the adrenal glands, tumors that have spread to the adrenal glands, certain medications, and problems with the pituitary gland or hypothalmus in the brain (both of which send signals to the adrenal glands). A doctor will review the patient's symptoms, risk factors, and test results to determine which of these causes is responsible for the adrenal failure.
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