Addison's Disease

How is Addison's disease diagnosed?

To help in confirming the diagnosis, your doctor may test for:

• Cortisol and adrenocorticotrophic hormone (ACTH), renin, aldosterone, DHEAS levels
• Presence of adrenal antibodies. These antibodies attack the adrenal gland and cause the autoimmune type of Addison's disease.
• Synacthen stimulation test. Synacthen is an artificial ACTH that acts on the adrenal gland to get it to produce cortisol. To do a synacthen stimulation test, the stimulant (synacthen) will be injected into your body and will then measure the cortisol levels. In healthy people, the stimulated adrenal glands should react by producing at least a certain level of cortisol. If the cortisol levels do not achieve a certain threshold level, it usually confirms Addison's disease.
• Thyroid function test. People with Addison's disease may also have an underactive thyroid gland. Hence it would be prudent to screen for that.
• Computerised tomography (CT) or magnetic resonance imaging (MRI) scans. These scans can show the gross appearance of your adrenal glands and detect any pathologies that may cause adrenal insufficiency.

How is Addison's disease treated?

Treatment of Addison's disease involves daily steroids to substitute the lost hormones.

These medications may include hydrocortisone, prednisolone or dexamethasone and fludrocortisone. One of the first 3 may be used to replace cortisol, while the last is to replace aldosterone.

Addison's disease is sometimes curable by treating its underlying causes. However, for most cases such as autoimmune-induced Addison's disease, life-long steroid replacement is required. The medications are usually in tablet form and taken a few times daily.