The typical symptoms of Addison’s disease are caused by a lack of vital messenger substances such as mineral corticoids and glucocorticoids. Only when over 90% of the adrenal cortex has been destroyed do the symptoms of Addison’s disease manifest themselves in their full extent. These include, among others: In the course of a so-called Addison’s disease crisis, which is a highly acute clinical picture, there are disturbances of consciousness, nausea, vomiting, diarrhea and a severe drop in blood pressure.
The Addison crisis is a life-threatening condition.
- Decreased blood pressure
- Unwanted weight loss
- Dehydration symptoms- This can manifest itself by very dry skin and mucous membranes, confusion, nausea and dizziness
- General weakness, also known as adynamic
- Pigmentation of the skin and mucous membranes
- Salt hunger is very typical for the disease
- Acidification
- Psychological changes/depression
- In women, there can be a loss of axillary and pubic hair
Addison’s disease is characterized by very low blood pressure values. This drop in blood pressure is mainly caused by two mechanisms.
In Addison’s disease, the production of so-called mineral corticoids in the adrenal cortex fails to occur. These messenger substances ensure that water from the urine is reabsorbed into the bloodstream. If this does not happen, there is a lack of volume in the bloodstream, which causes blood pressure to drop.
In addition, the production of glucocorticoids, which also affect blood pressure, is also restricted. As a result, blood pressure continues to drop, resulting in a sometimes very sharp drop in blood pressure. In an Addison crisis, i.e. an acute deficiency of glucocorticoids, a circulatory shock can even occur.
People who suffer from Addison’s disease have increased water loss. This can be explained as follows: With Addison’s disease, the production of messenger substances called mineralcorticoids is reduced. These messengers cause the urine to concentrate and water to be absorbed back into the bloodstream.
A deficiency of mineral corticoids results in increased excretion of water in the urine. The consequences are very dry skin, dry mucous membranes, a feeling of weakness and circulation problems. Headaches and nausea are also typical symptoms of this dehydration.
Addison’s disease as such can be accompanied by various gastrointestinal tract complaints. There may be nausea and abdominal pain or acute symptoms such as vomiting and diarrhea. In the course of an Addison’s disease crisis, severe diarrhea and vomiting can occur, which can lead to life-threatening fluid loss.
Especially people who suffer from a latent form of Addison’s disease, i.e. a still asymptomatic form of the disease, may, for example, enter an acute Addison’s crisis due to stress, infection or surgery. Symptoms of the gastrointestinal tract are also typical of Addison’s disease. Severe abdominal pain can occur during an Addison crisis.
These severe abdominal pains are also known in medical terminology as “acute abdominal pain“. They are accompanied by a severe painful abdominal wall which is hardened. This is also known as defensive tension.
This type of abdominal pain is caused by the metabolic situation, which is highly imbalanced in Addison’s disease. A shift in the hormone balance typically causes hyperpigmentation of the skin and mucous membranes in Addison’s disease. These manifest themselves as a brownish discoloration, which, unlike a suntan, is also found on areas of the skin not exposed to the sun.
These include the palms of the hands and feet, for example. The reduced production of cortisol leads to increased production of the melanocyte-stimulating hormone (MSH). This hormone stimulates the melanocytes of the skin to store more pigment, resulting in brownish discoloration even on skin not directly exposed to light.
Addison’s disease can lead not only to physical symptoms, but also to typical psychological abnormalities in those affected. These include above all a depressed mood, as well as general irritability and lethargy. The psychological symptoms also increase with poor physical condition or additional stress.In such situations, Addison’s disease also worsens the metabolic situation and there is an increased need for cortisol, which cannot be covered by the body’s own production.
Psychological abnormalities in Addison’s disease should therefore be taken seriously and the therapy concept should be adapted accordingly. Addison’s disease can lead to a so-called acidotic metabolic condition, which can be simply described as hyperacidity. The main reason for this is as follows: Addison’s disease is caused by a deficiency in the hormone aldosterone.
This hormone promotes the excretion of potassium in the kidney via the urine. Since aldosterone is reduced and therefore less potassium is excreted, the concentration of potassium in the body increases. Potassium causes the pH value in the blood to drop, i.e. it becomes more acidic.
This is called acidosis. This acidosis can be detected in a blood gas analysis. Hypoglycemia, also known as hypoglycemia in medical terminology, is usually only to be feared in the event of an Addison crisis.
It is caused by an acute lack of cortisol. The hormone cortisol leads to an increase in blood sugar via various mechanisms. In an Addison’s disease crisis, however, the lack of cortisol leads to a hypoglycaemic metabolic state, i.e. a greatly reduced blood sugar level.
Urinary retention is an acute emergency. Those affected are not able to urinate and complain of severe abdominal pain. Addison’s disease does not lead to urinary retention, but to reduced urine excretion in the context of the Addison crisis.
Those affected are able to urinate, but the amount of urine is reduced. This is explained by an acute circulatory shock in the context of the cortisol deficiency. In Addison’s disease, various causes can lead to acute clouding of consciousness, which can even lead to coma.
Such an acute form of Addison’s disease is also known as the Addison crisis. The cause of such a crisis is an acute lack of cortisol. Infections, increased physical exertion, surgery or other illnesses can trigger such a life-threatening crisis in Addison’s disease. Various consequences of the acute cortisol deficiency, such as a sharp drop in blood pressure and blood sugar, as well as an acute lack of fluid, ultimately lead to the clouding of consciousness and, in the worst case, to a comatose state.
