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Cortisol Deficiency
Addison's disease is a rare endocrine or hormonal disorder that
affects about 1 in 100,000 people. It occurs in all age groups and
afflicts men and women equally. The disease is characterized by
cortisol deficiency, weight loss, muscle weakness, fatigue, low
blood pressure, and sometimes darkening of the skin in both
exposed and nonexposed parts of the body.
Addison's disease occurs when the adrenal glands do not produce
enough of the hormone cortisol and in some cases, the hormone
aldosterone. For this reason, the disease is sometimes called
chronic cortisol deficiency, or hypocortisolism.
The symptoms of cortisol deficiency or adrenal insufficiency usually
begin gradually. Chronic, worsening fatigue and muscle weakness,
loss of appetite, and weight loss are characteristic of the disease.
Nausea, vomiting, and diarrhea occur in about 50 percent of cases.
Blood pressure is low and falls further when standing, causing
dizziness or fainting. Skin changes also are common in Addison's
disease, with areas of hyperpigmentation, or dark tanning,
covering exposed and nonexposed parts of the body. This
darkening of the skin is most visible on scars; skin folds; pressure
points such as the elbows, knees, knuckles, and toes; lips; and
mucous membranes.
Addison's disease can cause irritability and depression. Because of
salt loss, craving of salty foods also is common. Hypoglycemia, or
low blood sugar, is more severe in children than in adults. In
women, menstrual periods may become irregular or stop.
Because the symptoms progress slowly, they are usually ignored
until a stressful event like an illness or an accident causes them to
become worse. This is called an addisonian crisis, or acute adrenal
insufficiency or cortisol deficiency. In most patients, symptoms are
severe enough to seek medical treatment before a crisis occurs.
However, in about 25 percent of patients, symptoms first appear
during an addisonian crisis.
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