Dr. Paul Donohue / Your Good Health
DEAR DR. DONOHUE: I am 54. Last year, after two months in two different hospitals, I was diagnosed with Addison's disease. I have to take prednisone daily. I have gained 84 pounds, and now I have type 2 diabetes. I know Addison's has to do with the adrenal glands shutting down. To what extent do they shut down? I've been told this is fatal. Do I take medicine for the rest of my life? Please explain Addison's disease to me. - V.B.
ANSWER: Weighing in at only 1/10 ounce, each adrenal gland - one sitting above the right kidney, and one above the left kidney - performs complicated and life-maintaining jobs for the body. They produce cortisone, which guides the metabolism of sugars, proteins and fats, and limits body inflammation. They make other hormones that regulate body sodium and potassium levels and keep blood pressure from plummeting. And they make hormones like adrenalin, which keeps us on our toes when danger threatens. Adrenal-gland shutdown does kill if left untreated. Ninety percent of the glands have to be destroyed before the body begins to fall apart.
Fatigue and muscle weakness are two prominent symptoms of Addison's disease. Appetite disappears. Nausea, vomiting and weight loss are common. Blood pressure falls. Body stores of sodium become depleted, but body potassium rises.
In the old days, tuberculosis was the cause for most Addison's cases. Today, the cause is believed to be an immune attack on the glands.
Treatment for Addison's is straightforward: Replace the missing hormones. Prednisone is one often chosen. Treatment is for life. Your weight gain is not entirely due to prednisone. You are getting a dose that replaces the missing hormone, the same dose your glands would provide for you. If weight gain is a big problem, you have to increase your physical activity and decrease your calories. Weight loss will help with diabetes control.
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