Addison maintenance · Sodium and potassium ion levels maintenance

Addison Disease:

This
is endocrine disorder which results in case when adrenal glands don’t work
properly and don’t produce enough hormone which is cortisol. Adrenal glands
consist of two parts cortex and medulla, cortex is the outer part and medulla
is the inner part. Cortex and medulla both produce hormones for metabolism.  Dehydroepiandrosterone is also another hormone
helps in the production of estrogen and testosterone.  

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Types of Addison disease:

Addison
disease is a disease which has two conditions, one is the Primary adrenal insufficiency production of cortisol and
aldosterone doesn’t take place in sufficient amount. Other one is the Secondary adrenal insufficiency which
takes place due to the insufficient production of ACTH from pituitary gland.
ACTH stimulates the production of the cortisol.

Secondary
adrenal insufficiency is the common one.

Adrenal Hormones:

There
are a couple of adrenal hormones but I have listed two hormones which are
relevant to this disease.

Cortisol hormone
is produced by adrenal gland and it is a glucocorticoid hormone. Importance of
cortisol can be measured by taking this thing in account that this hormone is
present in almost all cells of the body.  There are several functions associated with
cortisol, which are following responds to the stress

·        
Efficiently
use food for body

·        
Regulating
metabolism

·        
Control
blood pressure

·        
Maintains
heart beat

Aldosterone
is produced by adrenal glands and is mineralocorticoid hormone. Several
functions are performed by this hormone which are following

·        
Blood pressure
maintenance

·        
Sodium
and potassium ion levels maintenance

 If this hormone gets affected by some other
foreign cells and its performance changes and secretion pattern gets disturbed
than it can cause serious problems some of them are following;

·        
Hyponatremia

·        
Hyperkalemia

 

Causes Associated with
Addison’s Disease:

If
we talk about the causes of addison’s disease than there are a couple of causes
but main causes are given below, one is Autoimmune disorder In this
disorder the main guard of the body which is the immune system which prevent
the body against harmful bacteria, viruses and other harmful germs but in this
case immune system make antibodies against the cells which produce cortisol and
aldosterone which is not a good thing because in this case immune system kill
the cells which are important for the body and useful for the body.

1.      Infections

Some
diseases may lead to the Addison’s disease. Tuberculosis is a disease which
destroy lungs and by destroying that this disease also effects the nearly
located adrenal glands. Due to the destruction of adrenal glands production of
cortisol and aldosterone gets disturbed and leads to the Addison’s disease.

What
are the Symptoms of Addison’s Disease:

This is a disease which develops slowly
through several years and in this way, it is difficult to diagnose it because
symptoms are not that much prominent. In most of the cases this disease becomes
prominent due to some other diseases, like when people go to the doctor for
other diseases they get to know that they are having this disease developing
slowly in them. Symptoms are following.

 

1.     
Abdominal
Pain

2.     
Chronic
Fatigue

3.     
Loss of
Apetite

4.     
Muscle
weakness

5.     
Weigh
loss

6.     
Diarrhea

7.     
Nausea,
vomiting

8.     
Seating

9.     
Headache

Diagnosis
of Addison’s Disease:

Diagnosis of this disease is hard because of
its slow development and it is also a challenge for doctors to diagnose this.
To do so doctor needs to through the family’s medical history and also needs to
do blood, urine tests. If these tests show that there is the low production of cortisol
than there is need to do imaging which further ensure or confirm this disease.

         

The picture which is given above is showing
the three-order loop for the production of the cortisol. This will tell you
what tests you need to perform. Doctor need to perform tests for CRH, ACTH and
the cortisol as well. The tests which are essential in order to diagnose this
disease are following;

      ACTH
Stimulating Test:

This is the test in which patient gets
synthetic ACTH dose. Cortisol level in the blood and urine of the person is
measured. Samples are drawn before injecting the ACTH and after the dosage of
ACTH. The results for the normal person is that cortisol level will increase
right after injecting the ACTH but if that person is suffering from the Addison
disease than there will be a very little change in the cortisol level in fact
there will be no increase in the cortisol level. If cortisol level remains same
as it was before the dosage of ACTH than it means person has Addison’s disease.

CRH Stimulating Test:

When ACTH stimulating test shows that person
has the Addison’s disease than doctor will ask to perform other test which is
known as the CRH stimulating test. A person’s sample are drawn but after the
administration of the CRH into the person’s body. Samples are drawn after 30,
60, 90, 120 minutes of administration of the CRH. Few results can be deduced
that ACTH is producing but cortisol is not getting stimulated, other is that
ACTH is not getting produced and other thing is that hypothalamus or pituitary
if affected and not producing required hormones.

Primary adrenal insufficiency diagnosis:

·        
Blood
antibodies test

·        
Tuberculin
skin test

·        
Ultrasound
of abdomen

       Secondary adrenal insufficiency is diagnosis:

·        
CT Scan

·        
Hormonal
blood tests

·        
Magnetic
Resonance Imaging (MRI)

Treatment of Addison’s Disease:

Like many other diseases there can be many
treatments for a single disease. Treatment depends on the condition. What do
the condition meant in this context is that if there is a condition where the
production of something is affected than that can be covered by using medicine
but if there is a problem with gland than surgery can repair that or change
that.

1.      Diet
and Nutrition:

A
person suffering from this disease and is aldosterone deficient can have a
simple and easy treatment and that is eating the stuff which is rich in iodine
salt. Consuming salt can treat this problem. This medicine is very easy to
consume unlike other bitter medicines but one thing should be kept in mind that
doctor must check your aldosterone level so that he must know that how much you
need to consume because excess of salt is also bad. So, one treatment is that consuming
salt to balance the aldosterone level.

 High sodium diet

Food enriched with
calcium and vitamin D

 

2.      Stress
due to Adrenal insufficiency must be monitored:

Stress? Stress is a condition which can ruin the many good moments and
can make you take wrong decisions no matter how wise you are but in this case
we are going to see that how stress can affect our health in this disease and
how monitoring the stress can proves useful for curing this disease. Monitoring
stress can be very useful. Whenever a person takes stress cortisol produce
insufficiently. So stress should be monitored so that when a person feels
himself or herself stressed, they could engage themselves in the activities
which can relax themselves and their cortisol level will stay balanced and
everything will be alright.

Stress level of the body must be monitored

3.      Hormone
Replacement

Hormone replacement is an effective
treatment. It takes place when a specific gland is not producing a specific
hormone or producing it insufficiently. Simple way treat this situation is that
replace the hormone with the hormone which can perform the same function than
everything will be alright. In this case we are dealing with cortisol hormone,
so the hormones which can replace the cortisol are given below.

Hormones which replace cortisol are
corticosteroids i.e. dexamethasone, hydrocortisone, or prednisone. These
hormones are supposed to take daily and 3 times every day. This is an ideal
process to replace the hormone according to the doctors.

In the case of Aldosterone, it can be
replaced by mineralocorticoid (fludrocortisone acetate). This also has a standard
procedure and that is person needs to take these hormones two times a day.

 Hormonal Replacement

 

 

 

 

 

 

 

 

 

 

 

 

References:

https://adrenalfatiguesolution.com/addisons-disease/https://adrenalfatiguesolution.com/addisons-disease/

https://www.mayoclinic.org/diseases-conditions/addisons-disease/symptoms-causes/syc-20350293

https://www.nhs.uk/conditions/addisons-disease/