Adrenocortical hypofunction; Chronic adrenocortical insufficiency; Primary adrenal insufficiency
Addison disease is a disorder that occurs when the adrenal glands do not produce enough hormones.
The adrenal glands are small hormone-releasing organs located on top of each kidney. They are made up of an outer portion, called the cortex, and an inner portion, called the medulla.
The cortex produces 3 hormones:
Addison disease results from damage to the adrenal cortex. The damage causes the cortex to produce hormone levels that are too low.
This damage may be caused by the following:
Risk factors for the autoimmune type of Addison disease include other autoimmune diseases:
Certain rare genetic defects may also cause adrenal insufficiency.
Symptoms of Addison disease include:
Laboratory tests may show:
Additional laboratory tests may be ordered.
Other tests may include:
Treatment with replacement corticosteroids will control the symptoms of this disease. These medicines usually need to be taken for life.
Never skip doses of your medicine for this condition because life-threatening reactions may occur.
Your health care provider may increase your dosage for a short time because of:
During an extreme form of adrenal insufficiency, called adrenal crisis, you must inject hydrocortisone right away. Treatment for low blood pressure is usually needed as well.
Some people with Addison disease are taught to give themselves an emergency injection of hydrocortisone during stressful situations. Always carry medical ID (card, bracelet, or necklace) that says you have adrenal insufficiency. The ID should also say the type of medicine and dosage you need in case of an emergency.
With hormone therapy, many people with Addison disease are able to lead a nearly normal life.
Call your provider if:
If you have symptoms of adrenal crisis, give yourself an emergency injection of your prescribed medicine. If it is not available, go to the nearest emergency room or call 911.
Symptoms of adrenal crisis include:
Barthel A, Willenberg HS, Gruber M, Bornstein SR. Adrenal insufficiency. In: Jameson JL, De Groot LJ, de Kretser DM, et al, eds. Endocrinology: Adult and Pediatric. 7th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 102.
Napier C, Pearce SH. Current and emerging therapies for Addison's disease. Curr Opin Endocrinol Diabetes Obes. 2014;21(3):147-153. PMID: 24755997
Nieman LK. Adrenal cortex. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 227.
Last reviewed on: 10/28/2015
Reviewed by: Brent Wisse, MD, Associate Professor of Medicine, Division of Metabolism, Endocrinology & Nutrition, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.