Adrenal and Gonads - CS2: Addisons Disease

Question 1

What are the common blood tests and findings in Addison’s Disease?

Answer 1

ACTH (Adrenocorticotropic hormone): Elevated (due to lack of cortisol feedback).

Cortisol: Low, especially in the morning.

Sodium: Low due to aldosterone deficiency.

Potassium: Elevated due to aldosterone deficiency.

Glucose: Low (hypoglycemia).

Renin: Elevated as part of the RAAS activation due to aldosterone deficiency.

Aldosterone: Low due to adrenal dysfunction.

Question 2

Which tests would be ordered for suspected Addison’s?

Answer 2

Test order:

ACTH stimulation test (Synacthen test) to confirm primary adrenal insufficiency.

Cortisol level measurement in the morning.

Electrolyte panel (particularly sodium and potassium).

Question 3

Symptoms of Addison’s Disease

Answer 3

Fatigue

Muscle weakness

Weight loss and decreased appetite

Low blood pressure (hypotension)

Hyperpigmentation (darkened skin, especially in creases like elbows and knees)

Salt cravings

Nausea, vomiting, and diarrhea

Hypoglycemia (low blood sugar)

Irritability and depression

Question 4

Treatment for Addison’s Disease

Answer 4

Glucocorticoids (e.g., Hydrocortisone or Prednisolone) – to replace cortisol.

Mineralocorticoids (e.g., Fludrocortisone) – to replace aldosterone.

Salt replacement – in cases of severe sodium loss or during stressful events.

Stress management – adjusting medication during stress, illness, or surgery.