Addison’s Disease – What It Is, Why It Happens, and How to Manage It

Ever felt unusually tired, dizzy, or craving salty foods? Those could be clues that your adrenal glands aren’t pulling their weight. That condition is called Addison’s disease, a type of adrenal insufficiency where the body can’t make enough cortisol (and sometimes aldosterone). Let’s break it down so you know what to look for and what steps help.

Why Your Adrenals Might Fail

The adrenals sit on top of your kidneys and release hormones that keep blood pressure steady, control stress response, and balance electrolytes. In Addison’s disease the glands get damaged – most often by an autoimmune attack, where the immune system mistakenly targets its own tissue. Less common causes include infections like tuberculosis, cancer spreading to the adrenal area, or sudden withdrawal from long‑term steroid use.

When cortisol drops, you lose a key player in the stress response. Without enough aldosterone, sodium leaks out and potassium builds up, leading to low blood pressure and that salty craving many people report.

Spotting the Signs Early

The symptoms creep in slowly, so they’re easy to miss. Typical signs include:

• Persistent fatigue or weakness that doesn’t improve with rest.
• Dizziness or light‑headedness when you stand up quickly.
• Unexplained weight loss and a loss of appetite.
• Craving salty foods or feeling unusually thirsty.
• Darkening of the skin, especially on scars, elbows, or knees (called hyperpigmentation).

If you notice several of these together, especially after a stressful event, it’s worth getting blood work done. Doctors will check cortisol levels and ACTH (the hormone that tells the adrenals to produce cortisol). A rapid ACTH stimulation test can confirm the diagnosis.

How It’s Treated

The good news: Addison’s disease is manageable with daily hormone replacement. Most men take two pills:

• A glucocorticoid such as hydrocortisone, prednisone, or cortisone acetate to replace cortisol.
• An mineralocorticoid like fludrocortisone if aldosterone production is also low.

Dosages are tailored to your weight, activity level, and how severe the deficiency is. It’s crucial to take meds at the same times each day – usually once in the morning and a smaller dose in the afternoon.

Stressful situations (illness, surgery, major injury) demand extra “stress‑dose” steroids. Your doctor will give you a plan: often double or triple your regular dose for a few days. Keep an emergency injection kit handy and wear a medical alert bracelet that says you have adrenal insufficiency.

Living with Addison’s Disease

Most men lead normal lives once they’re on the right medication. Here are practical tips to stay on top of it:

• Never skip a dose – set phone alarms if you need reminders.
• Stay hydrated, especially in hot weather or when exercising.
• Avoid sudden changes in posture; rise slowly from sitting or lying down.
• Carry a small snack with salt (pretzels, salted nuts) for quick energy and electrolyte boost.
• Schedule regular check‑ups to adjust doses as your weight or activity level changes.

If you ever feel severely dizzy, faint, or have intense stomach pain, treat it like an emergency. Take a double dose of hydrocortisone and seek medical help right away – these could be signs of an adrenal crisis, which needs immediate treatment.

Bottom Line

Addison’s disease may sound scary, but with proper diagnosis and daily hormone replacement it’s a condition you can control. Recognize the subtle symptoms, get tested early, and stick to your medication plan. If you keep an eye on stress doses and have an emergency kit, you’ll be prepared for anything that comes your way.