Addison's Disease

Known Symptoms

Common symptoms: Fatigue, weight loss, anorexia, nausea, abdominal pain, salt craving, and hyperpigmentation (especially in sun-exposed areas, skin folds, and mucous membranes).
Red-flag/severe symptoms:
- Hypotension (especially orthostatic), syncope.
- Hyponatremia, hyperkalemia.
- Adrenal crisis: Acute hypotension, severe vomiting/diarrhoea, confusion, fever, and loss of consciousness-requires immediate medical intervention.

Known Causes

⁠Clinical assessment: History and physical exam focusing on fatigue, hyperpigmentation, hypotension, and electrolyte abnormalities.
Laboratory tests:
- Low morning serum cortisol.
- Elevated plasma adrenocorticotropic hormone (ACTH).
- ACTH stimulation test (blunted cortisol response confirms diagnosis).
- Electrolyte panels (hyponatremia, hyperkalemia).
Imaging: Abdominal CT to assess adrenal gland structure (e.g., atrophy, calcifications, masses).

Care

Pharmacological:
- Glucocorticoid replacement: Hydrocortisone or prednisone.
- Mineralocorticoid replacement: Fludrocortisone.
Non-pharmacological:
- Dietary sodium supplementation.
- Stress-dose steroid adjustment during illness, surgery, or trauma.
- Patient education on medication adherence and sick-day rules.

Care

Prevention: No known preventive measures for autoimmune cases; early treatment of infections (e.g., TB) may reduce risk.
Follow-up:
- Regular monitoring of electrolyte levels, blood pressure, and hormone levels.
- Annual assessment of replacement therapy adequacy.
- Patient counselling on emergency steroid use and medical alert identification.

Known Symptoms

Common symptoms: Fatigue, weight loss, anorexia, nausea, abdominal pain, salt craving, and hyperpigmentation (especially in sun-exposed areas, skin folds, and mucous membranes).
Red-flag/severe symptoms:
- Hypotension (especially orthostatic), syncope.
- Hyponatremia, hyperkalemia.
- Adrenal crisis: Acute hypotension, severe vomiting/diarrhoea, confusion, fever, and loss of consciousness-requires immediate medical intervention.

Known Causes

⁠Clinical assessment: History and physical exam focusing on fatigue, hyperpigmentation, hypotension, and electrolyte abnormalities.
Laboratory tests:
- Low morning serum cortisol.
- Elevated plasma adrenocorticotropic hormone (ACTH).
- ACTH stimulation test (blunted cortisol response confirms diagnosis).
- Electrolyte panels (hyponatremia, hyperkalemia).
Imaging: Abdominal CT to assess adrenal gland structure (e.g., atrophy, calcifications, masses).

Care

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Our Division of Endocrinology, Diabetes & Metabolism offers specialist, long-term care for hormone and metabolic disorders such as diabetes, thyroid disease, pituitary, adrenal and bone-health conditions. Our endocrinologists work with surgery, oncology, ophthalmology, obstetrics and transplant teams to deliver personalised diagnostic pathways (blood tests, imaging, bone density and thyroid biopsy) and tailored medical, procedural and surgical plans. Services include diabetes and lipid management, obesity and metabolic-syndrome care (with bariatric pathways), pediatric growth and puberty clinics, reproductive endocrinology and gender-affirming hormone support.

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