Addisons disease is caused by insufficient amounts of the hormones cortisol and aldosterone.

Both
hormones are produced in the adrenal cortex, which is located above each kidney.
Cortisol is responsible for the control of blood sugar levels, nutrient transport, the body's response to
inflammation and water balance in the body. Aldosterone stimulates the reabsorption of salts and
water in the distal kidney tubule.
The leading cause of Addisons disease until the middle of the twentieth century was damage due to
tuberculosis. Since the subsequent control (now questionable, however) of this disease by antibiotics,
one of the main causes for Addisons disease is an autoimmune condition in which the body attacks
its own tissues, including those in the adrenal cortex. Minor causes include destruction of the adrenal
tissue by cancer, other infections that may damage this area, include attack by the CMV virus, which
is AIDS related.
Addisons disease is comparatively rare; it affects about 1 in 100,000 people, and it affects men and
women equally. Because the body is unable to retain sufficient water and salt, and cannot regulate
the levels of other solutes, blood pressure and fluid retention levels are adversely affected. Symptoms
include fatigue, weight loss, nausea and diarrhoea". Blood pressure becomes low and indications of
dizziness are common. Muscle spasms can also occur, due to the lack of salts needed for nervous
impulses in the tissue. Sufferers of the disease also constantly crave salty foods. In some cases,
darkening of the skin can occur. lrritability and depression are also common,
The disease can be confirmed by testing cortisol and aldosterone levels in the blood and urine, and
by the observation of high potassium and low sodium levels in the blood. Replacing cortisol and
aldosterone with similar hormones treats it. Cortisol is generally replaced with cortisone acetate or
hydrocortisone tablets, which are taken twice daily. Aldosterone is replaced with a synthetic steroid
known as fludrocortisone (marketed as Florinef). These tablets are taken once daily. This treatment
must continue indefinitely, and patients are advised to treat any minor illnesses with salt and fluids.
An Addisonian crisis, or acute adrenal insufficiency, can occur in some cases. Symptoms include
lower back pain, diarrhoea and vomiting, low blood pressure and loss of consciousness. Unless
immediate intravenous saline and hvdrocortisone are administered, death can result.