Symptoms and causes


Addison's disease symptoms usually develop slowly, often over several months, and may include:

  • Extreme fatigue
  • Weight loss and decreased appetite
  • Darkening of your skin (hyperpigmentation)
  • Low blood pressure, even fainting
  • Salt craving
  • Low blood sugar (hypoglycemia)
  • Nausea, diarrhea or vomiting
  • Abdominal pain
  • Muscle or joint pains
  • Irritability
  • Depression
  • Body hair loss or sexual dysfunction in women

Acute adrenal failure (addisonian crisis)

Sometimes, however, the signs and symptoms of Addison's disease may appear suddenly. In acute adrenal failure (addisonian crisis), the signs and symptoms may also include:

  • Pain in your lower back, abdomen or legs
  • Severe vomiting and diarrhea, leading to dehydration
  • Low blood pressure
  • Loss of consciousness
  • High potassium (hyperkalemia) and low sodium (hyponatremia)

When to see a doctor

See your doctor if you have signs and symptoms that commonly occur in people with Addison's disease, such as:

  • Darkening areas of skin (hyperpigmentation)
  • Severe fatigue
  • Unintentional weight loss
  • Gastrointestinal problems, such as nausea, vomiting and abdominal pain
  • Lightheadedness or fainting
  • Salt cravings
  • Muscle or joint pains

Your doctor can help determine whether Addison's disease or some other medical condition may be causing these problems.


Addison's disease results when your adrenal glands are damaged, producing insufficient amounts of the hormone cortisol and often aldosterone as well. These glands are located just above your kidneys. As part of your endocrine system, they produce hormones that give instructions to virtually every organ and tissue in your body.

Your adrenal glands are composed of two sections. The interior (medulla) produces adrenaline-like hormones. The outer layer (cortex) produces a group of hormones called corticosteroids, which include glucocorticoids, mineralocorticoids and male sex hormones (androgens).

Some of the hormones the cortex produces are essential for life — the glucocorticoids and the mineralocorticoids.

  • Glucocorticoids. These hormones, which include cortisol, influence your body's ability to convert food fuels into energy, play a role in your immune system's inflammatory response and help your body respond to stress.
  • Mineralocorticoids. These hormones, which include aldosterone, maintain your body's balance of sodium and potassium to keep your blood pressure normal.
  • Androgens. These male sex hormones are produced in small amounts by the adrenal glands in both men and women. They cause sexual development in men, and influence muscle mass, libido and a sense of well-being in both men and women.

Primary adrenal insufficiency

Addison's disease occurs when the cortex is damaged and doesn't produce its hormones in adequate quantities. Doctors refer to the condition involving damage to the adrenal glands as primary adrenal insufficiency.

The failure of your adrenal glands to produce adrenocortical hormones is most commonly the result of the body attacking itself (autoimmune disease). For unknown reasons, your immune system views the adrenal cortex as foreign, something to attack and destroy.

Other causes of adrenal gland failure may include:

  • Tuberculosis
  • Other infections of the adrenal glands
  • Spread of cancer to the adrenal glands
  • Bleeding into the adrenal glands, which may present as adrenal crisis without any preceding symptoms.

Secondary adrenal insufficiency

Adrenal insufficiency can also occur if your pituitary gland is diseased. The pituitary gland makes a hormone called adrenocorticotropic hormone (ACTH), which stimulates the adrenal cortex to produce its hormones. Inadequate production of ACTH can lead to insufficient production of hormones normally produced by your adrenal glands, even though your adrenal glands aren't damaged. Doctors call this condition secondary adrenal insufficiency.

Another more common cause of secondary adrenal insufficiency occurs when people who take corticosteroids for treatment of chronic conditions, such as asthma or arthritis, abruptly stop taking the corticosteroids.

Addisonian crisis

If you have untreated Addison's disease, an addisonian crisis may be provoked by physical stress, such as an injury, infection or illness.

Nov. 10, 2015
  1. Addison disease. Merck Manual Professional Version. Accessed Oct. 12, 2015.
  2. Adrenal insufficiency and Addison's disease. National Institute of Diabetes and Digestive Health and Kidney Disease. Accessed Oct. 12, 2015.
  3. Hay WW, et al. Endocrine disorders. In: Current Diagnosis & Treatment: Pediatrics. 22nd ed. New York, N.Y.: McGraw-Hill Education; 2014. Accessed Oct. 12, 2015.
  4. Nieman LK. Clinical manifestations of adrenal insufficiency in adults. Accessed Oct. 12, 2015.
  5. Adrenal diseases — Addison's disease. National Adrenal Diseases Foundation. Accessed Oct. 12, 2015.
  6. Nieman LK. Treatment of adrenal insufficiency in adults. Accessed Oct. 12, 2015.
  7. Nieman LK. Causes of primary adrenal insufficiency (Addison's disease). Accessed Oct. 12, 2015.