What Causes Addison’s Disease?

Autoimmune disease sign

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  • There is some evidence that some people with certain genes are more prone to autoimmune disorders, and therefore have a higher risk of Addison’s disease
  • There are also medications that can hinder or affect hormone production, such as anesthetic drugs or antifungals, and potentially lead to this disease

Addison's disease can be subdivided into two classifications: primary adrenal insufficiency, which is what's really generally defined as "Addison's disease," and secondary adrenal insufficiency.

Primary adrenal insufficiency happens when your adrenal glands are so severely damaged that they can no longer produce hormones. Meanwhile, secondary adrenal insufficiency happens when your pituitary gland, found in your brain, can no longer produce adrenocorticotropic hormone (ACTH). This hormone is responsible for telling your adrenal glands when to release the hormones they produce.1 These two types of Addison's disease can actually have different potential triggers, which are discussed below.

Autoimmune Diseases May Play a Role in Addison's Disease

Problems with the immune system are the most common causes of over 80 percent of primary adrenal insufficiency in developed countries.2 In the U.K., this accounts for 70 to 90 percent of Addison's disease cases.3

Your immune system is responsible for producing antibodies that help guard you against disease-causing bacteria, germs and viruses that enter your body. However, if you have an autoimmune disorder and this defense system is not working properly, the antibodies produced work against the body instead, and attack healthy tissues.

In the case of Addison's disease, it's the adrenal glands' surface that is affected, and the cells that produce aldosterone and cortisol are destroyed. If 90 percent of your adrenal cortex is destroyed, then you can no longer produce the said hormones. The root of autoimmune disorders is still unknown. In addition, having this problem can also expose you to other autoimmune diseases, such as vitiligo, pernicious anemia and thyroid disease.4

Infections May Lead to Addison's Disease, Too

Infections such as AIDS and fungal infections that can spread to your adrenal glands may cause Addison's disease. Another common example is tuberculosis (TB). This bacterial infection usually affects the lungs, but can also spread to other parts of your body, including your adrenal glands.5 When Dr. Thomas Addison first discovered the disease in 1849, TB was actually the main culprit.6

Is Addison's Disease Hereditary?

There is some evidence that some people with certain genes are more prone to autoimmune disorders, and therefore have a higher risk of Addison's disease. It's still unclear as to how these genetic factors can lead to Addison's and trigger other conditions, but if a close relative or family member suffers from an autoimmune disorder, it might mean that you have an increased risk of Addison's disease. These illnesses include:7

Causes of Secondary Adrenal Insufficiency

Chronic steroid use is the most common culprit of this type of Addison's disease. Steroids, which work similarly to cortisol, are usually prescribed by conventional physicians to manage other illnesses like rheumatoid arthritis, asthma and ulcerative colitis.

When taken for prolonged periods, such as weeks or months, the adrenal and pituitary glands' production of natural cortisol and ACTH stop. Thus, when the steroid treatment is abruptly stopped, your body will lack these hormones, producing secondary adrenal insufficiency.8

The surgical removal of the pituitary gland may also lead to this illness. This is usually done when there are noncancerous tumors affecting the pituitary, which are then prompting it to overproduce ACTH — this is actually known as Cushing's syndrome.  Changes in the pituitary gland, such as when it decreases in size or loses blood flow, may lead to secondary adrenal insufficiency as well.9

Other Potential Causes of Addison's Disease

Aside from the ones mentioned above, there are other lesser known causes of Addison's disease, such as:10

  • Cancer cells spreading to the adrenal glands
  • A hemorrhage in the adrenal glands, usually caused by meningitis or severe sepsis
  • Adrenalectomy, or the surgical removal of adrenal glands
  • Adrenoleukodystrophy (ALD) — this is a rare, life-limiting, inherited condition that affects not only the adrenal glands but also the nerve cells in the brain. It's most commonly seen in young boys
  • Amyloidosis — this is a condition wherein there is a buildup of amyloid, a protein created by your bone marrow cells, in your adrenal glands, causing them damage

There are also medications that can hinder or affect hormone production, such as anesthetic drugs or antifungals, and potentially lead to this disease.11

MORE ABOUT ADDISON'S DISEASE

Addison's Disease: Introduction

What Is Addison's Disease?

Addison's Disease Symptoms

Addison's Disease Causes

Addison's Disease in Children

Addison's Disease Test

Addison's Disease Treatment

Addison's Disease Prevention

Addison's Disease Diet

Addison's Disease FAQ



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