Addison's disease is a complex endocrine disease that provokes malfunction of the adrenal glands, as a result of which hormones, in particular cortisol, aldosterone and androgens, completely stop being produced in the gland. Pathology can be caused by both external factors: the adrenal cortex or the anterior pituitary gland of the brain is damaged due to trauma, surgery, removal of tumors, and hereditary factors. The nature of the second, hereditary cause of Addison's disease is not fully understood. The risk group for the development of pathology includes carriers of HIV infection, tuberculosis patients, people suffering from drug addiction, as well as patients who have undergone kidney transplants, who have cysts and neoplasms.
The symptoms and causes of Addison's disease were described by the English physician Thomas Addison (pictured) back in 1855. He first found the connection betweendamage to the adrenal cortex and pathological manifestations of the disease, such as increased fatigue, changes in skin pigmentation. These symptoms of Addison's disease appear in combination.
A little about the role of hormones
The adrenal glands are paired organs located in the abdominal cavity. Their malfunctioning is the cause of Addison's disease. Normally, the adrenal glands produce three types of hormones: cortisol, aldosterone, and androgens. Yes … it is male sex hormones that play an important role here. It turns out that androgens, contrary to popular belief, affect not only the development of male secondary sexual characteristics.
They are actively involved in lipid metabolism, control cholesterol levels, have antibacterial and anabolic effects, are involved in the synthesis of proteins in all tissues and organs in both women and men. Lack of hormones can lead to infertility, diabetes, impaired perception and confusion, psychosis. Cortisol, in turn, is responsible for the absorption of nutrients from food, supports energy metabolism in the body.
Synthetic cortisol is prescribed for depression or high fatigue. Lack of the hormone causes disruption of the gastrointestinal tract, weakness, cardiovascular disorders, reduces blood glucose levels to a critical level, increases insulin sensitivity, and causes a persistent feeling of fatigue.
Aldosterone regulates the optimal balance of sodium and potassium in the body, its lack negatively affectswater-s alt metabolism, jeopardizes the human circulatory and cardiovascular systems, the heart muscle loses mass, arrhythmia occurs, pressure decreases.
Where to expect trouble
The pathogenesis of Addison's disease is quite extensive. In most cases, adrenal dysfunction is caused by complications after suffering serious diseases, such as tuberculosis, syphilis, brucellosis, amyloidosis, scleroderma, tumors of various nature, inflammation or purulent infections, in some cases, exposure to radiation.
Only in 30% of cases Addison's disease, or bronze, occurs under the influence of hereditary factors. The disease most often affects people between the ages of 30 and 50 of both sexes. The frequency of diseases is one case per hundred thousand. This is how Addison's disease manifests itself, a photo of the adrenal glands is presented in the article.
A pathological change in water-s alt metabolism is observed in the body, the content of chlorine and sodium decreases, the concentration of potassium increases, hypoglycemia develops, the concentration of lymphocytes and eosinophils in the blood increases.
The first indicative test that can confirm the diagnosis is a blood test for adrenocorticotropic hormone. It is he, as the conductor of the orchestra, who controls the work of the adrenal glands, stimulating the secretion of substances by them. If there is no ACTH in the blood, then the disease is practically confirmed.
Addison's disease occurs for a number of reasons:
- Causes associated with direct damage to the cortexadrenal glands: diseases, infections, mechanical damage, atrophy.
- Disorders of the pituitary gland, when its anterior lobe does not produce the hormone already known to us - adrenocorticotropic.
- Taking synthetic corticosteroids. They are used as maintenance therapy for various autoimmune disorders, to prevent tissue rejection during organ transplantation. And also with psoriasis, arthritis, lupus erythematosus. The body gets used to getting a portion of "sweet" for free and stops its production on its own. Over time, this can lead to complete atrophy of the gland.
Addison's disease and its symptoms
- A person is worried about constant fatigue, weakness, feeling unwell. And all these symptoms only intensify during the day. It comes to the point that the patient cannot get out of bed.
- Quick weight loss. Muscle mass is lost primarily as a result of impaired electro-hydrolytic metabolism of creatine and creatinine.
- Digestion is disturbed: constipation, then diarrhea occur, the patient is tormented by pain in the abdomen. Frequent bouts of nausea.
- The color of the skin is changing. Lemon yellow to dirty brown spots appear. Fingers darken, mucous membranes, hair may even darken.
- A person is tormented by bouts of shortness of breath, the heartbeat quickens. This is due to some pathological decrease in the heart (and we know that this is also a muscle), heart failure occurs, rhythm disturbance. The pressure dropsanemia develops, dizziness is not uncommon.
- Body temperature is often below normal. People are constantly freezing, catching cold.
- Decreased libido.
- Depression, memory and attention disorders, sleep disturbance.
- I have a temper and irritability.
- Cravings for sour or s alty foods, constant thirst.
- Lower blood glucose.
- Irregular menstruation (women).
- Development of impotence (in men).
- Increased neuromuscular excitability due to an excess of phosphates.
- Possible tremor or impaired sensation in the extremities caused by an excess of potassium. Swallowing problems (dysphagia) may occur.
Important! When to get tested
Symptoms of Addison's disease may sometimes not be acute. The patient does not have a fever, there are no sudden changes in the state of he alth. Symptoms, seemingly unrelated to each other, are attributed to fatigue or nervous strain, colds, poisoning, etc. This disease does not “hit” in any one area or system of the body, it affects imperceptibly in several directions. Therefore, it can often take years from the first signs to the correct diagnosis.
Is there a threat to life?
Sometimes, in the absence of any symptoms, the disease can manifest itself suddenly and in an acute form - a person's blood pressure and blood sugar levels drop sharply, which most often leads to fainting and even coma. Cause of death in Addison's disease - failure to provide assistance duringattack. This condition is known in medicine as Addisonian crisis. A protracted cold, trauma, blood loss, surgery, adrenal vein thrombosis, adrenal artery embolism or hemorrhage in the tissues of the organ can “start” it.
Signs of an Addisonian crisis:
- Dizziness and loss of consciousness.
- Sharp pain in the abdomen, back or legs.
- Dehydration due to severe vomiting and diarrhea.
- Sudden drop in blood pressure.
- Reduce glucose levels.
- Confusion.
- Excess potassium in the blood.
- Change in the color of the skin, the presence of specific spots.
This condition is especially dangerous if a person does not even suspect about the disease and begins self-medication, which in most cases does not bring relief, especially if the skin with Addison's disease has not yet changed pigmentation, as in the photo.
In this case, a timely diagnosis can save a person's life. Sometimes this condition occurs in patients who are aware of their diagnosis, but for some reason do not receive treatment, or the doses of synthetic hormonal drugs do not correspond to the required ones. As you know, the intake of synthetic hormones contributes to the “addiction of the body”, and it begins to reduce the production of its own, even in minimal doses. Periodically, to control the hormonal background and adjust therapy, it is necessary to repeat the tests.
Emergency
Intravenousthe introduction of hydrocortisone, saline and dextrose allows you to stop the crisis. Resuscitation teams are supplied with such drugs in full. Further, the patient is necessarily hospitalized in a hospital, either in the endocrinology department, or, in life-threatening cases, in the intensive care unit. In addition to the dose of hormones, the patient undergoes a number of procedures to normalize the water and electrolyte balance, as well as normalize blood sugar levels.
There are three main degrees of the course of the disease, depending on the condition of the person and the clinical picture.
- Easy degree. The manifestation of symptoms is not so pronounced. To alleviate the condition, it is enough to follow a potassium-free diet, increase the intake of sodium or regular s alt and ascorbic acid.
- Medium degree. Usually this form of the disease occurs most often. Hormone therapy is prescribed with drugs containing cortisone, hydrocortisone, prednisone.
- Heavy form. Usually the course of the disease is complicated by Addison's crises. Lifelong therapy is prescribed with the above drugs, as well as drugs containing deoxycorticosterone.
When making a correct diagnosis of bronze (Addison's) disease, an endocrinologist usually excludes other diseases with similar manifestations. And there are many of them: melanosis, hemochromatosis, malaria, kidney tuberculosis, scleroderma, and even arsenic poisoning. In any case, one blood test is not enough. The doctor will definitely prescribe a number of procedures, having studied the medical history and interviewing the patient.
Specific studies in disease
- Detailed blood test. First of all, the doctor is interested in the levels of the following substances: potassium, chloride and sodium.
- A blood test for the presence of ACTH, as well as the hormones cortisol and aldosterone.
- Injection of adrenocorticotropic hormone. The specialist takes blood twice, before and after the procedure. The goal is to provoke a reaction of the adrenal glands to a portion of the hormone. If the adrenal function is normal, then the concentration of steroids in the blood immediately increases. If the lesion of the gland is critical, then there will be no changes associated with an increase in cortisol.
- Insulin test for hypoglycemia. On the contrary, he studies the reaction of the pituitary gland to an increase in blood sugar levels. The laboratory assistant makes several samples over a certain period of time. If the patient is he althy, then after the intervention of ACTH, the glucose level decreases, and the adrenal glands immediately begin to produce cortisol. If there is no increase in hormones in the blood, then the problem is in the pituitary gland. To confirm the diagnosis, an MRI of the brain is performed.
- Computed tomography of the adrenal glands. The doctor examines their size, looks for visual changes, swelling or inflammation.
Addison's disease treatment tactics
The patient, if the diagnosis is confirmed, is shown hormone therapy. Treatment of Addison's disease is carried out both in courses and for life. Doses are selected by the endocrinologist individually depending on the patient's condition, stage of the disease and the presence ofcomorbidities.
In the case of a chronic course, patients are usually prescribed pills containing synthetic hormones or corticosteroids.
Drug list:
- "Florinef" - synthetic aldosterone.
- "Cortinef" - synthetic cortisol, or hydrocartisone.
- Drugs - androgen substitutes - "Dehydroepiandrosterone".
If a person cannot take oral therapy, for example, because of vomiting, the doctor prescribes injections.
An important rule of recovery is self-control
How do people live with Addison's disease? The most important condition for the success of any therapy is the desire and responsibility of the patient.
Even if your appearance changes a lot, it can be beneficial. As did Winnie Harlow - suffering from a genetic disease similar in manifestations to Addison's disease. She has become a world-famous model and is not at all shy about herself, on the contrary, she is proud.
Unfortunately, for Addison patients, life is divided into two parts - "before" and "after". This applies to the mode of work, diet and even sleep. Those who work on weekends will have to give up overtime, otherwise the disease will reappear.
Among other things, you should refrain from alcohol and nicotine. The human body is already experiencing a considerable chemical load.
You need to change your diet. First of all, the menu should be as useful and high-calorie as possible. It is necessary to enrich the body with vitamins, especially A, E andC, as well as the necessary amount of animal protein and amino acids, in particular tyrosine. It helps to synthesize adrenaline. Particular attention should be paid to foods rich in potassium, it is better to exclude them altogether.
Forbidden foods: potatoes, dried apricots, raisins, peas, beans, mushrooms, dried fruits, coffee, nuts and other rich in potassium.
Recommended foods: vegetables, cereals, meat broths, watermelon, pumpkin, sea fish and dairy products. It is important to include more s alt in the diet, as well as meat and seafood. So-called "fast" carbohydrates (sugar, honey, jam) are allowed, and currants and rose hips, as well as brewer's yeast, are best suited to maintain the level of vitamins B and C.
Unconventional Therapy
Teas and infusions in folk medicine have always had special properties. Old recipes for liver or kidney teas have been passed down from generation to generation. There are a number of recipes that stimulate the adrenal glands.
- Infusion of geranium leaves. For cooking, the leaves are torn into small pieces, brewed with a glass of boiling water. The plant is rich in radium, which promotes the restoration of the gland. Take the infusion warm after meals.
- Field horsetail. Available, grows in almost every forest, and a useful source of ascorbic acid and carbohydrates. It has a pronounced anti-inflammatory and tonic properties. Dry crushed leaves are brewed in the ratio - 1 teaspoon per glass of water. Taken two to three times a day afterfood.
- Tincture of snowdrop leaves. It is necessary to take 80 snowdrops, pour half a liter of vodka. Put in the sun. Wait 40 days. Take 20 drops daily before meals thrice daily.
- Decoction of bearberry and wild rosemary. A mixture of dry herbs 1: 1 pour one and a half cups of boiling water. Cool down. Drink half a glass once or twice a day before meals.
It is important to understand that traditional medicine is only an adjunct therapy in the treatment of Addison's disease. Infusions and teas only alleviate the patient's condition, they do not remove the causes, but support the work of the adrenal gland to the extent possible at this stage of the course of the disease. In any case, the endocrinologist is obliged to give advice on how to use these plants in each case, to choose an adequate dose and course of their use.
In general, with proper and timely treatment of patients with Addison's disease, its manifestations may become invisible to the environment: acquaintances, friends. The only amendment is not to interrupt the treatment on your own, to undergo examinations and only then adjust the volume of therapy together with specialists. Remissions can be short-lived and the consequences can be severe.
In general, if the recommendations of the attending physician and substitution therapy are followed, the life expectancy of patients with this diagnosis does not differ from he althy people.
