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What's Really Behind Addison's Disease?
Published: Feb 20, 2024
Addison's disease isn't as mysterious as it once was. Find out what's really causing this rare condition and why it's more common than you might think.
The Rise of Autoimmune Disorders
Once labeled as 'idiopathic,' primary adrenal insufficiency is now known to result from an autoimmune process targeting the adrenal cortex. These immune mechanisms often overlap with other autoimmune conditions, forming polyglandular syndromes. In fact, up to 86% of patients with autoimmune primary adrenal insufficiency have specific antibodies against steroid-producing enzymes.
Infections That Could Be Culprits
Infections like tuberculosis and certain fungi can wreak havoc on the adrenal glands, leading to insufficiency. While tuberculosis was once a leading cause, improvements in its control have reduced its impact. However, in areas where fungal infections prevail, these remain significant causes of adrenal issues.
Medications and Their Side Effects
Some medications can inadvertently lead to adrenal insufficiency by inhibiting cortisol production. Drugs like etomidate and ketoconazole are known culprits. While these medications don't usually cause issues in those with normal adrenal function, patients with limited adrenal reserve may experience adverse effects.
Frequently Asked Questions
Autoimmune disease is the leading cause, responsible for 70-90% of cases.
Yes, especially in areas with high rates of certain infections like tuberculosis and fungi.
They can be, particularly in patients with limited adrenal reserve.
Yes, forming polyglandular autoimmune syndromes.
The Bottom Line
With multiple causes, addressing the root of adrenal insufficiency is key to effective management.
References
- Addison T. On the Constitutional and Local Effects of Disease of the Suprarenal Capsules, Highley, London 1855.
- Irvine WJ, Barnes EW. Adrenocortical insufficiency. Clin Endocrinol Metab 1972; 1:549.
- Zelissen PM, Bast EJ, Croughs RJ. Associated autoimmunity in Addison's disease. J Autoimmun 1995; 8:121.
This article has been reviewed for accuracy by one of the licensed medical doctors working for Doctronic. Always discuss health information with your healthcare provider.
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