Symptoms

Since the function of the adrenal glands is disturbed in Addison’s disease, the production of various hormones is impaired. The typical symptoms become noticeable when about 90% of the adrenal cortex is already destroyed. Cortisol, aldosterone and the sex hormones can no longer be produced in sufficient quantities.

In contrast, the concentration of ACTH, a hormone of the pituitary gland in the brain, which stimulates hormone production in the adrenal glands, is significantly increased. The lack of aldosterone as a mineral corticoid leads to a drop in blood pressure (hypotension) due to the loss of sodium and water (dehydration). In addition, there is an increase in potassium in the blood.

In those affected, the salt deficiency manifests itself in an increased hunger for salty foods. The lack of cortisol as a stress hormone leads to a feeling of weakness, nausea and weight loss. The blood sugar level also drops (hypoglycaemia).

In addition, excessive tanning of the skin (hyperpigmentation) occurs, which is triggered by the increased release of ACTH. As the production of the sex hormones is also impaired, women often suffer from a lack of axillary and pubic hair and men suffer from potency problems. In infants, a loss of function of the adrenal glands is noticeable as a stop in growth.

In an extreme emergency it can also lead to a complete hormonal derailment, the so-called Addison crisis. It can lead to a life-threatening metabolic derailment and requires immediate intensive medical treatment. Hyperpigmentation of the skin is found in primary adrenal insufficiency.

It is caused by the increased amount of ACTH. This results from the precursor proopiomelanocortin or POMC for short. POMC is also the precursor of a hormone that acts on the melanocytes in the skin. The melanocytes are skin cells that are responsible for the coloring or color of the skin. Thus, an increased release of POMC or ACTH leads to a stronger stimulation of the melanocytes and subsequently to hyperpigmentation or “darkening” of the skin.