Addison's Disease

Addison’s disease is a rare hormonal disorder in which the adrenal gland is impaired and subsequently underactive, producing insufficient steroidal hormones.

Causes

The occurrence of Addison’s disease is equally likely in males and females, of any age group.

In the majority of cases, the exact cause of Addison’s disease is unknown, but it is understood that the body’s immune system attacks and damages the adrenal gland, as part of an autoimmune reaction.

In other cases, the adrenal glands are damaged by diseases such as:

·         Cancer;

·         Tuberculosis; or

·         Genetic abnormality of the glands.

Disease pathway

Loss of the adrenal gland’s ability to produce hormones does not, in itself, lead to symptoms. Rather, they are caused by the absence of essential hormones.

Aldosterone deficiency impairs the body’s ability to retain and expel sodium and potassium, respectively. Thus, when a patient consumes a large amount of water, or sweats considerably, the natural balance of minerals in the body may be disrupted dangerously.

Similarly, a shortage of cortisol prevents the body from producing carbohydrates properly, resulting in:

·         Marked increase in susceptibility to infection and inflammation;

·         Weakened muscles, especially the heart; and

·         Low blood pressure.

Symptoms and diagnosis

Symptoms appear soon after the incidence of Addison’s disease, but develop slowly. These include:

·         Fatigue;

·         Dark patches on the skin;

·         Loss of appetite and weight loss;

·         Dehydration;

·         Muscle aches;

·         Heightened sensitivity to cold; and

·         Extreme craving for high-sodium foods.

Due to the slow and somewhat subtle nature of the symptoms, doctors will often not suspect Addison’s disease initially.

Once the symptoms become more definitive, blood tests may indicate low sodium and high potassium levels. The levels of the affected hormones will also be abnormally low.

Treatment

Irrespective of its cause, Addison’s disease is potentially life-threatening, and requires treatment with artificial supplementary hormones, taken either orally, via a drip (intravenously), or through the muscles (intramuscularly).

Other drugs may be required to restore the equilibrium levels of sodium and potassium in the body.

Generally, if Addison’s disease is diagnosed and appropriate treatment given, patients are likely to survive.

Efficacy of Alternative and Other Treatments According to GRADE* Ranking:

Licorice (Glcyrhiz Gaba) [1, 2, 3, 4, 5]:

Please note, this management does NOT treat the condition itself. It may mildly help with some of the symptoms, and even then has insufficient evidence to back up this claim at present. Licorice has been shown to have potentially harmful side effects in people with high blood pressure, liver or kidney diseases)

Recommendation: No recommendation (There is insufficient evidence to support claims that licorice helps treat some symptoms addisons disease. More research is needed)

Grade of Evidence: very low quality of evidence

Neural Therapy:

Please note, this management does NOT treat the condition itself. It is proposed only as supportive symptomatic support, and even then, has insufficient evidence to back up this claim at present.

Recommendation: Weakly against (there is insufficient evidence to show that Neural Therapy helps in treating Addisons Disease in any way)

Grade of Evidence: very low quality of evidence

* www.gradeworkinggroup.org

Summary References

Treatments:

1. Ades T, Alteri R, Gansler T, Yeargin P, "Complete Guide to Complimentary & Alternative Cancer Therapies", American Cancer Society, Atlanta USA, 2009

2. Winston, David; Steven Maimes (2007). Adaptogens: Herbs for Strength, Stamina, and Stress Relief. Healing Arts Press.

3. http://www.ncbi.nlm.nih.gov/pubmed/15190039

4. http://nccam.nih.gov/health/licoriceroot/

5. http://www.nlm.nih.gov/medlineplus/druginfo/natural/patient-licorice.html