The symptoms of adrenal insufficiency usually begin gradually. Chronic, worsening fatigue and muscle weakness, loss of appetite, and weight loss are characteristic of the disease. Nausea, vomiting, and diarrhoea occur in about 50 per cent of cases. Blood pressure is low and falls further when standing, causing dizziness or fainting.
Skin changes also are common in Addison's disease, with areas of hyperpigmentation, or dark tanning, covering exposed and nonexposed parts of the body. This darkening of the skin is most visible on scars; skin folds; pressure points such as the elbows, knees, knuckles, and toes; lips; and mucous membranes.
Addison's disease can cause irritability and depression. Because of salt loss, craving of salty foods is also common. Hypoglycaemia, or low blood sugar, is more severe in children than in adults. In women, menstrual periods may become irregular or stop.
Because the symptoms progress slowly, they are usually ignored until a stressful event such as an illness or an accident causes them to become worse. This is called an Addisonian crisis, or acute adrenal insufficiency. In most patients, symptoms are severe enough to seek medical treatment before a crisis occurs. However, in about 25 per cent of patients, symptoms first appear during an Addisonian crisis.
Symptoms of an Addisonian crisis include sudden penetrating pain in the lower back, abdomen, or legs; severe vomiting and diarrhoea, followed by dehydration; low blood pressure; and loss of consciousness. Left untreated, an Addisonian crisis can be fatal.
Last Reviewed: 03 June 2007