Autoimmune Diseases

What Is Addison’s Disease?

What Is Addison’s Disease?
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Published on March 7, 2025
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Addison’s disease, also called primary adrenal insufficiency, is a rare disorder that occurs when the body doesn’t make enough of two hormones called cortisol and aldosterone.

Cortisol is an essential hormone that helps your body respond to stress and regulates blood pressure, blood sugar levels, heart function, and immune system function. Aldosterone helps regulate the balance of sodium and potassium in your blood, which in turn helps regulate blood pressure.

Addison’s disease is caused by damage to the adrenal glands — two small, triangular glands that sit above the kidneys and produce cortisol, aldosterone, and, to a lesser degree, sex steroids. Symptoms can start slowly and may include extreme fatigue, weight loss, and cravings for salt, among others. Medication is needed to manage Addison’s disease. If left untreated, it can be deadly.

Graphic titled, How Addison’s Disease Affects the Body, some illustrated points include: dizziness or fainting, extreme fatigue, salt cravings, muscle weakness, body hair loss, hypoglycemia, darker skin patches, joint pain, and abdominal pain.
Addison’s disease can cause any or all of these symptoms.

Signs and Symptoms of Addison’s Disease

The symptoms of Addison’s disease may develop slowly over time, and some people miss or ignore early symptoms. The symptoms are also common to many different health issues, which can result in delayed diagnosis.

Early symptoms of Addison’s disease include:

  • Extreme fatigue that gets worse over time
  • Dizziness or fainting upon standing caused by low blood pressure
  • Muscle weakness or aches
  • Joint pain
  • Loss of body hair
  • Patches of darker skin, usually on scars, moles, gums, and skin creases
  • Bluish-black color around the mouth, nipples, vagina, scrotum, or rectum
  • Reduced hunger that results in weight loss
  • Abdominal pain
  • Low blood sugar, or hypoglycemia
  • Nausea, vomiting, or diarrhea
  • Salt cravings
  • Depression or irritable mood
  • Low sex drive or irregular menstruation in women
Sometimes the symptoms of Addison’s disease can progress quickly and lead to an adrenal crisis (Addisonian crisis), a life-threatening emergency that requires immediate medical attention. If you experience any of the following symptoms of an adrenal crisis, call 911 immediately:

  • Extreme weakness
  • Fever
  • Dehydration
  • Severe pain in the lower back, abdomen, or legs that comes on quickly
  • Changes in mental status, such as feeling restless, confused, or afraid
  • Severe vomiting or diarrhea
  • Low blood pressure
  • Fainting or loss of consciousness
Several factors can lead to an adrenal crisis, including:

  • Untreated Addison’s disease
  • Acute illness
  • Infections
  • Dehydration
  • Significant emotional distress
  • Damage to the adrenal glands from a disease or surgery
  • Abruptly stopping treatment with glucocorticoids like prednisone
  • Trauma
  • Childbirth
  • Surgery

Causes and Risk Factors of Addison’s Disease

Addison’s disease is caused by damage to the outer layer of the adrenal glands. Autoimmune diseases — conditions that happen when the body’s immune system mistakenly attacks healthy organs and tissues — are the most common cause of this damage. In the case of Addison’s disease, the immune system mistakenly attacks the adrenal glands.

Other causes of Addison’s disease may include:

  • Certain infections, such as tuberculosis or HIV
  • Cancer of the adrenal glands
  • Bleeding into the adrenal glands
  • Surgical removal of the adrenal glands, which may be done to treat another health problem
  • Genetic conditions that impact how the adrenal glands develop or function
  • Certain medications, such as some antifungals or general anesthesia medications
Most people don’t have any risk factors that boost their odds of developing Addison’s disease. In some cases, the following factors may raise a person’s risk:

  • A disease or surgery that affects the adrenal glands
  • Other autoimmune conditions that affect the endocrine system, such as type 1 diabetes or hypothyroidism
  • Amyloidosis (a condition involving buildup of amyloid proteins in vital organs, leading to damage)
  • A rare genetic disease

How Is Addison’s Disease Diagnosed?

If your healthcare provider suspects you have Addison’s disease, they may order the following tests:

  • Blood tests to check your sodium, potassium, cortisol, renin, aldosterone, and adrenocorticotropic hormone (ACTH) levels
  • ACTH stimulation test to measure the response of your adrenal glands after an injection of artificial ACTH
  • An imaging scan, such as computed tomography (CT), to determine if your adrenal glands are damaged or infected

Treatments and Medication Options for Addison’s Disease

The only treatment for Addison’s disease is medication to correct levels of cortisol and aldosterone in the body. Cortisol is replaced with a synthetic version, such as hydrocortisone (Cortef), prednisone (Prednisone Intensol, Rayos) or methylprednisolone (Medrol). Aldosterone is replaced with a synthetic version called fludrocortisone acetate.

Addison’s disease is a lifelong condition, so you’ll need to take these medications for the rest of your life.

Dosages of these medications vary from person to person, and your doctor may tell you to take more or less of them during certain times in your life. For example, if you are sick or scheduled to have surgery, your doctor may tell you to take more of these medications because more of these hormones are needed when your body is under stress.

You may also need to up your sodium intake while taking these medications, especially during heavy exercise, hot weather, or if you’re having digestive issues such as diarrhea.

It’s important for your healthcare team to closely monitor the dosages of your medication to ensure you’re not taking too much or too little. Too much hydrocortisone, for example, can lead to type 2 diabetes, obesity, or osteoporosis over time. Too much fludrocortisone can lead to high blood pressure.

As mentioned, an Addisonian crisis or adrenal crisis is a medical emergency. Treatment may involve intravenous medication or solutions such as corticosteroids, saline solution, or sugar.

Prevention of Addison’s Disease

There’s no way to prevent Addison’s disease. But there are ways to keep yourself healthy after you’re diagnosed with this condition:

  • Take your medications as prescribed to prevent complications. Missing even one day of your medications can be dangerous, so it’s a good idea to keep extra medication on you at all times.
  • Have an emergency corticosteroid medication kit with you at all times to provide the hormones you need if you begin to develop emergency symptoms. These kits include injectable corticosteroids that act fast in the body.
  • Carry a medical alert card or bracelet with you so emergency personnel will know how to help you if you ever experience extreme symptoms.
  • Attend regularly scheduled checkups and blood draws to keeps tabs on your symptoms and hormone levels and make sure you stay healthy. You need to monitor your hormone levels carefully to avoid taking too much or too little medication.

How Long Does Addison’s Disease Last?

As mentioned, Addison’s disease is a lifelong condition with no cure. But with daily medication, people with Addison’s disease often go on to live healthy, normal lives.

Complications of Addison’s Disease

Addison’s disease may lead to other issues that require medical intervention, including:

  • Adrenal crisis
  • Low blood pressure
  • Low blood sugar
  • High potassium levels in the blood

Research and Statistics: Who Has Addison’s Disease?

Addison’s disease remains a very rare condition, affecting only 1 in 100,000 people in the United States. It can affect anyone, but it’s most common in people ages 30 to 50. It’s also more commonly diagnosed in people with other autoimmune disorders, including:

The Takeaway

  • Addison’s disease is a rare condition in which the adrenal glands do not produce enough of the hormones cortisol and aldosterone, which play essential roles in various bodily functions.
  • It’s most often caused by an autoimmune condition in which the immune system mistakenly attacks and damages the adrenal glands.
  • A lifelong condition, Addison’s disease requires daily medication to ensure the body has enough cortisol and aldosterone.

Common Questions & Answers

What is the life expectancy of someone with Addison’s disease?
With treatment, people with Addison’s disease can expect to live a normal, healthy life. But without treatment, Addison’s disease can be deadly.
Addison’s disease can cause symptoms like extreme fatigue, muscle aches or weakness, joint pain, dizziness or fainting upon standing, low blood sugar, loss of body hair, patches of darker skin, nausea, vomiting, or diarrhea, among other symptoms.
Yes. The symptoms of Addison’s disease sometimes develop very slowly and may be missed or easily ignored. They’re also common to multiple other health issues. These factors can result in delayed diagnosis.
An Addisonian crisis, also known as adrenal crisis, is a medical emergency. Symptoms may include extreme weakness, dehydration, fever, severe pain in certain parts of the body, restlessness, confusion, severe vomiting or diarrhea, low blood pressure, or fainting.
Doctors usually run several tests to diagnose Addison’s disease. They may include blood tests and imaging scans, among others.

Resources We Trust

EDITORIAL SOURCES
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Resources
  1. Addison’s Disease: Symptoms & Causes. Mayo Clinic. December 21, 2024.
  2. Addison’s Disease. Cleveland Clinic. July 6, 2022.
  3. Adrenal Insufficiency (Addison’s Disease). Johns Hopkins Medicine.
  4. Adrenal Crisis. Cleveland Clinic. August 3, 2022.
  5. Elshimy G et al. Adrenal Crisis. StatPearls. September 13, 2023.
  6. Symptoms & Causes of Adrenal Insufficiency & Addison’s Disease. National Institute of Diabetes and Digestive and Kidney Diseases. September 2018.
  7. Adrenoleukodystrophy. Mayo Clinic. February 7, 2020.
  8. Addison’s Disease: Diagnosis & Treatment. Mayo Clinic. December 21, 2024.
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Anna L. Goldman, MD

Medical Reviewer

Anna L. Goldman, MD, is a board-certified endocrinologist. She teaches first year medical students at Harvard Medical School and practices general endocrinology in Boston.

Dr. Goldman attended college at Wesleyan University and then completed her residency at Icahn School of Medicine at Mount Sinai Hospital in New York City, where she was also a chief resident. She moved to Boston to do her fellowship in endocrinology at Brigham and Women's Hospital. She joined the faculty after graduation and served as the associate program director for the fellowship program for a number of years.

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Shelby House, RN, BSN, has been a registered nurse for almost 10 years. She currently serves as a nursing director for a program that provides healthcare services to underserved Missourians, specifically aiding those with mental health disorders in achieving their best state of physical health.

She received her bachelor's degree in nursing from Maryville University in Missouri. She has worked in the specialty areas of medical-surgical nursing, cardiopulmonary rehabilitation nursing, mental health nursing, and nursing leadership.

Outside of the office, Shelby enjoys spending time with her husband and two young children, volunteering in her local community, and soaking up the countryside scenery of rural America where she lives.

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