Addison Disease is a disease that is caused by the deficiency of circulating glucocorticosteroids and mineral corticoids (aldosterone) hormones as a result of disease of the adrenal glands. The causes of Addison Disease are: Auto-immune disease (Type 1 PGA – Poly-glandular Autoimmune Syndrome) of the adrenals with destruction of the adrenal parenchyma Tuberculosis of the adrenal glands Adrenal tumors that may be benign or malignant Rare causes are hemorrhage, infarction, and infiltrative diseases The increased pigmentation especially in areas not exposed to the sun (such as buccal mucosa and palmar creases) and loss of weight can suggest the diagnosis of Addison Disease This is due to excess pituitary production of ACTH which has melanocytes producing properties. There is also sparse growth of axillary and pubic hairs. Electrolytes especially sodium is low, potassium and urea nitrogen is high ACTH stimulation test with impaired corticoid response is required to confirm diagnosis Plasma cortisol is low (< 3mcg/dL) and do not rise with ACTH stimulation Addison crisis is treated by intravenous normal saline and hydrocortisone 100mg every eight hours Treatment must be done before laboratory confirmation of diagnosis because of the danger of coma Chronic Addison disease requires replacement of glucocorticosteroids: Hydrocortisone 30mg daily (two thirds in the morning, one third in the evening) Cortisone acetate 37.5 mg daily or Fludrocortisones 0.05 to 0.2 mg daily DHEA 50mg orally in the morning Adequate salt intake is important for normal fluid and electrolyte balance. Addison crisis patients have excellent recovery with appropriate treatment Chronic Addison disease patients also recovered well with replacement therapy. Care is needed when there is trauma, infection and surgery TABLE OF CONTENT Introduction Chapter 1 Addison Disease Chapter 2 Interesting Facts about Adrenal Fatigue Chapter 3 Treatment of Adrenal Fatigue Chapter 4 Adrenal Fatigue Chapter 5 Adrenal Tumors Chapter 6 Adrenal Crisis Chapter 7 Cushing Syndrome Epilogue