Hello

Hello Sheila,

Yes. Addison's disease is an autoimmune condition. It is similar to type 1 Diabetes in that respect. This means that for some reason, which is not fully understood, your immune system has "gone into overdrive" and attacked itself, resulting in these deficiencies. I hope that you are adept in managing you Diabetes, so I will focus on the Addison's Disease for a moment. This is a problem in producing the steroids that our bodies naturally produce when we are under physical or psychological stress. There are essentially two types of these steroids (mineralo- and gluco- corticosteroids) both of these are secreted from a small gland situated just above the kidneys, under the direction of Adreno-corticotrophic homone secreted from the pituitary gland (which is sort of front/centre and just under the brain between your eyebrows and about the size of a pea.

We have two natural steroid peaks - one just before we wake up in the morning and one around 4.00pm in the afternoon (this is why we go to sleep after lunch!). They are our "get up and go" hormones. In general terms, they keep our blood pressure up, help to keep our body fluids in balance, help to reduce inflammatory processes in the body etc. and we need them to live, especially when things start to go wrong....

Insufficient natural steroids, for whatever reason (and essentially there are two) cause the following types of problems (and I guess you are aware of these) - weight loss, muscular weakness, extreme fatigue, abnormalities in the body fluids (which can be seen on blood testing), low blood pressure (fainting) etc. Strange abnormalities with skin colouring can also occur (such as looking as if you have a tan when you haven't been away - and the creases on your hands going dark). It is the problems with maintaining your blood pressure that cause the most serious problems along with the fluid abnormalities. Both of these can cause excessive pressures on the heart. Therefore, it is essential that replacement steroids are taken and they are viewed with the same degree of seriousness as you do your insulin. If you are physically ill (especially with vomiting or loose bowels) you will probably need to increase the steroid dose. This is easy enough to understand. However, the need to increase the dose may also apply when you are under severe psychological stress also - such as a bereavement, loss of a job etc. etc.

In Addison's disease the problem is caused by a primary failure of the steroid producing glands above the kidneys. However, a secondary cause of steroid insufficiency can occur further back in the process when the pituitary gland is damaged or fails, causing the "messenger hormone" ACTH to fail.

I hope this is of some help to you.

With best wishes in managing your Addison's

Many blessings,

Lesley