disease means a lifetime of hormone pills
Dear Doctor K: I watched a documentary about President Kennedy
around the 50th anniversary of his death last year. The program
mentioned that he had something called Addison’s disease. What is
Dear Reader: Addison’s disease is a rare condition in which the
adrenal glands do not function properly. The thumb-sized adrenal glands
sit on top of the kidneys.
When working properly, they produce several hormones.
But with Addison’s disease, the adrenal glands do not make enough
Hormones are substances made by one of several glands in the body. They
travel in the blood to all parts of the body and can affect many types
of cells and organs. The adrenal gland makes three main types of
■ Glucocorticoids. These are steroid hormones. One type is
cortisol, which helps regulate blood sugar and the body’s response to
infection or stress.
These help regulate sodium, potassium, blood pressure and blood volume.
■ Androgens. These hormones are needed for normal sexual
development and ongoing sexual function.
Testosterone is the most well-known androgen. Even the adrenal glands of
females make some amount of androgens.
Addison’s disease usually results from autoimmunity: an attack on a
part of the body by the body’s immune system. This shouldn’t happen.
Our immune systems were built to attack invaders, such as invading
viruses and bacteria. They were not built to attack us. But in
autoimmune diseases such as Addison’s disease, something goes wrong.
Addison’s disease also can result from other conditions that damage
the adrenal glands. This includes infections of the glands, bleeding
into the glands or cancer that has spread to the glands.
However it is caused, Addison’s disease leads to extreme weakness,
weight loss, low blood pressure, gastrointestinal problems and darkening
of the skin.
People said President Kennedy looked thin, pale and ill when he was
Fortunately, he was diagnosed before his condition became
Diagnosing Addison’s disease can be challenging. It usually involves
measuring the blood level of adrenal hormones (such as cortisol) and of
brain hormones that stimulate the adrenal glands to produce adrenal
hormones. CT scanning to check the size of the adrenal glands may also
be used for diagnosis.
Treatment involves taking hormone pills for life.
These pills replace the hormones that the adrenal glands are not making.
For example, doctors may prescribe hydrocortisone or prednisone pills
for glucocorticoid replacement.
People with Addison’s disease should wear a medical alert bracelet to
notify medical professionals of their condition, and carry high doses of
their medicine with them. That’s because people who become very sick
(such as from an infection or a major injury) suddenly need more adrenal
hormones than normal — and more than their usual daily dose.
High doses of corticosteroids, in such situations, can save the life of
a person with the disease.
Write to Dr. Anthony Komaroff at: Dr. Anthony
Komaroff, c/o Universal Uclick, 1130 Walnut, Kansas City, MO 64106. For more information, visit