The adrenal glands are paired organs above the kidneys that synthesize hormones. The hormones regulate mineral levels in the blood, blood pressure, stress response and male and female secondary sexual characteristics. Addison's disease occurs from damage to the adrenal glands, with resulting low levels of the hormone cortisol and sometimes aldosterone. The diagnosis and treatment of diseases such as Addison's should be undertaken with the consultation of a physician or other qualified health care professional.
Causes
Addison's disease, also known as primary adrenal insufficiency, results from destruction of the cells in the adrenal gland that synthesize important hormones, according to "Pathologic Basis of Disease" by Vinay Kumar, M.D. One common cause of Addison's disease is a dysfunctional immune system that attacks the adrenal glands. Other causes include primary or metastatic tumors replacing normal adrenal tissues, or infections that destroy the tissues. There also are inherited disorders in which the adrenal glands fail to work. Another common cause is the withdrawal of medications that mimic adrenal hormones.
Symptoms
According to the National Institutes of Health, the symptoms of Addison's disease appear gradually. Some of the most common symptoms include fatigue, weight loss, loss of appetite and muscle weakness. Gastrointestinal symptoms might include nausea, vomiting and diarrhea. Other symptoms might include irregular menstruation, irritability and personality changes, a drop in blood pressure when moving from lying to standing, salt cravings, low blood sugar, sweating and headache.
Mechanism of Low Sodium
Multiple hormones are responsible for regulating sodium levels in the body. One of the main hormones is aldosterone, which is made by the adrenal gland. With the destruction of adrenal tissues, aldosterone is not synthesized. Aldosterone normally signals the kidneys to conserve sodium in the blood and release potassium into the urine. Without enough aldosterone, the kidney excretes excessive amounts of sodium into the urine.
Management of Low Sodium
Low sodium with Addison's disease should be carefully corrected. If corrected too quickly, it can lead to brain damage. The treatment can be divided into two steps, as noted by a 2004 article in "American Family Physician." Symptoms might not be present, but if they are they can include nausea, headache, fatigue and confusion or decreases in the level of consciousness. This will require immediate but slow administration of saline, which is basically salt water, composed of sodium chloride in water. The second step involves addressing the underlying cause. Drugs that mimic cortisol, aldosterone and sex steroid can be given by mouth or intravenously.
References
- "Robbins and Cotran Pathologic Basis of Disease"; Vinay Kumar et al; 8th Ed 2009
- National Institutes of Health: National Endocrine and Metabolic Diseases Information Service: Adrenal Insufficiency and Addison's Disease
- "American Family Physician"; "Management of Hyponatremia"; Kian Peng; 2004
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