National Center for Advancing and Translational Sciences Genetic and Rare Diseases Information Center, a program of the National Center for Advancing and Translational Sciences

Addison's disease

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Other Names:
Addison disease; Adrenal hypoplasia; Hypoadrenocorticism familial; Addison disease; Adrenal hypoplasia; Hypoadrenocorticism familial; Adrenal aplasia; Adrenal gland hypofunction See More
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Addison's disease is a chronic disease that occurs when the adrenal glands do not produce enough (or any) of the hormones cortisol and aldosterone.[1][2] Symptoms can vary from person to person but usually develop slowly over time, and are often non-specific at first.[2] However, sometimes symptoms occur suddenly and cause a life-threatening condition called acute adrenal failure, also known as an acute adrenal crisis or Addisonian crisis.[2][3]

Common symptoms of Addison's disease include fatigue, loss of appetite, and abdominal pain and nausea. Some people also experience mood or behavior changes. Other signs and symptoms of Addison's disease that may develop include dark patches of skin (hyperpigmentation), vitiligo, muscle weakness or pain, dehydration, and low blood pressure.[2][3]

An acute adrenal crisis is a medical emergency which can lead to shock or kidney failure if not treated promptly. A crisis may cause sudden weakness, severe pain (in the back, abdomen, or legs), vomiting and diarrhea, and low blood pressure which can lead to fainting. A crisis may  be triggered when a person with Addison's disease is under stress, such as during an accident, surgery, or severe illness.[2][3]

In most cases, Addison's disease is caused by damage to the adrenal cortex (the outer part of the adrenal gland) due to an autoimmune reaction. In these cases, a person may not develop symptoms for months or years. This may be referred to as autoimmune Addison's disease, or primary adrenal insufficiency. If the adrenal glands do not produce hormones despite being undamaged (such as due to ACTH deficiency), it is referred to as secondary adrenal insufficiency. Less common causes of Addison's disease include repeated infections, cancer that spreads to the adrenal glands, CMV associated with HIV/AIDS, and amyloidosis. Tuberculosis remains a major cause in developing countries, but is no longer a major cause in the United States. Rarely, Addison’s disease runs in families and may be due to a genetic predisposition.[2][3]

Addison's disease may be diagnosed based on symptoms, blood and urine tests that evaluate adrenal function, chest X-rays, and/or a CT scan to look at the size and characteristics of the adrenal glands.[1][2][3] Treatment ideally should  be managed by an endocrinologist who specializes in adrenal diseases. Daily treatment typically includes medicines (tablets) that replace the hormones cortisol and aldosterone. Treatment for an adrenal crisis may include intravenous hydrocortisone, fluids, and electrolytes, as well as drugs that normalize blood pressure.[2][3] People with Addison's disease should carry a medical ID that states the disease and emergency instructions.[2][3] An example is provided by the National Adrenal Diseases Foundation. With proper treatment and avoidance of dehydration, people with Addison's disease can avoid having crises and have a normal life expectancy.[3]
Last updated: 3/19/2018

This table lists symptoms that people with this disease may have. For most diseases, symptoms will vary from person to person. People with the same disease may not have all the symptoms listed. This information comes from a database called the Human Phenotype Ontology (HPO) . The HPO collects information on symptoms that have been described in medical resources. The HPO is updated regularly. Use the HPO ID to access more in-depth information about a symptom.

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Medical Terms Other Names
Learn More:
HPO ID
100% of people have these symptoms
Decreased circulating cortisol level
Low blood cortisol level
0008163
80%-99% of people have these symptoms
Abdominal pain
Pain in stomach
Stomach pain
[ more ] 		0002027
Anorexia 0002039
Constipation 0002019
Diarrhea
Watery stool
0002014
Failure to thrive
Faltering weight
Weight faltering
[ more ] 		0001508
Fatigue
Tired
Tiredness
[ more ] 		0012378
Hyperpigmentation of the skin
Patchy darkened skin
0000953
Increased circulating ACTH level
High blood corticotropin levels
0003154
Muscle weakness
Muscular weakness
0001324
Nausea and vomiting 0002017
Weight loss 0001824
30%-79% of people have these symptoms
Androgen insufficiency 0008226
Decreased circulating aldosterone level
Low blood aldosterone level
0004319
Decreased urinary potassium 0012364
Hyperkalemia
Elevated serum potassium levels
0002153
Hyperkalemic metabolic acidosis 0005976
Hyperuricemia
High blood uric acid level
0002149
Hyponatremia
Low blood sodium levels
0002902
Increased circulating renin level
Elevated blood renin level
0000848
Normocytic anemia 0001897
Renal salt wasting
Loss of salt in urine
0000127
5%-29% of people have these symptoms
Adrenal calcification 0010512
Adrenal hypoplasia
Small adrenal glands
0000835
Arthralgia
Joint pain
0002829
Celiac disease 0002608
Decreased female libido
Decreased female sex drive
0030018
Delayed puberty
Delayed pubertal development
Delayed pubertal growth
Pubertal delay
[ more ] 		0000823
Dry skin 0000958
Generalized bone demineralization 0006462
Hashimoto thyroiditis 0000872
Hypercalcemia
High blood calcium levels
Increased calcium in blood
[ more ] 		0003072
Hypoglycemia
Low blood sugar
0001943
Hypoparathyroidism
Decreased parathyroid hormone secretion
0000829
Orthostatic hypotension
Decrease in blood pressure upon standing up
0001278
Premature ovarian insufficiency
Early menopause
Premature menopause
Premature ovarian failure
[ more ] 		0008209
Salt craving 0030083
Seizure 0001250
Sparse axillary hair
Limited armpit hair
Little underarm hair
[ more ] 		0002215
Type I diabetes mellitus
Type 1 diabetes
Type I diabetes
[ more ] 		0100651
Vertigo
Dizzy spell
0002321
Vitiligo
Blotchy loss of skin color
0001045
1%-4% of people have these symptoms
Primary testicular failure 0008720
Thiamine-responsive megaloblastic anemia 0004860
Thymoma 0100522
Percent of people who have these symptoms is not available through HPO
Abnormality of skin pigmentation
Abnormal pigmentation
Abnormal skin color
Abnormal skin pigmentation
Abnormality of pigmentation
Pigmentary changes
Pigmentary skin changes
Pigmentation anomaly
[ more ] 		0001000
Abnormality of the cardiovascular system
Cardiovascular abnormality
0001626
Adrenal insufficiency 0000846
Apnea 0002104
Autosomal recessive inheritance 0000007
Cyanosis
Blue discoloration of the skin
0000961
Feeding difficulties in infancy 0008872
Vomiting
Throwing up
0002013
Showing of 53 |
Last updated: 7/1/2020

If you need medical advice, you can look for doctors or other healthcare professionals who have experience with this disease. You may find these specialists through advocacy organizations, clinical trials, or articles published in medical journals. You may also want to contact a university or tertiary medical center in your area, because these centers tend to see more complex cases and have the latest technology and treatments.

If you can’t find a specialist in your local area, try contacting national or international specialists. They may be able to refer you to someone they know through conferences or research efforts. Some specialists may be willing to consult with you or your local doctors over the phone or by email if you can't travel to them for care.

You can find more tips in our guide, How to Find a Disease Specialist. We also encourage you to explore the rest of this page to find resources that can help you find specialists.

Healthcare Resources

Related diseases are conditions that have similar signs and symptoms. A health care provider may consider these conditions in the table below when making a diagnosis. Please note that the table may not include all the possible conditions related to this disease.

Conditions with similar signs and symptoms from Orphanet
Secondary adrenal insufficiency needs to be eliminated. Causes include pituitary tumors, lymphatic hypophystitis, pituitary tuberculosis and sarcoidosis, all of which are differential diagnoses. Infiltrative disorders and other causes of CPAI should be excluded and include tuberculosis (see this term), fungal infections and AIDS-associated opportunistic infections. Genetic disorders, tumors, and treatment with certain drugs are other less common causes of CPAI.
Visit the Orphanet disease page for more information.

Research helps us better understand diseases and can lead to advances in diagnosis and treatment. This section provides resources to help you learn about medical research and ways to get involved.

Clinical Research Resources

  • The Centers for Mendelian Genomics program is working to discover the causes of rare genetic disorders. For more information about applying to the research study, please visit their website.
  • ClinicalTrials.gov lists trials that are related to Addison's disease. Click on the link to go to ClinicalTrials.gov to read descriptions of these studies.

    Please note: Studies listed on the ClinicalTrials.gov website are listed for informational purposes only; being listed does not reflect an endorsement by GARD or the NIH. We strongly recommend that you talk with a trusted healthcare provider before choosing to participate in any clinical study.

Patient Registry

  • The Autoimmune Registry supports research for Addison's disease by collecting information about patients with this and other autoimmune diseases. You can join the registry to share your information with researchers and receive updates about participating in new research studies. Learn more about registries.

Support and advocacy groups can help you connect with other patients and families, and they can provide valuable services. Many develop patient-centered information and are the driving force behind research for better treatments and possible cures. They can direct you to research, resources, and services. Many organizations also have experts who serve as medical advisors or provide lists of doctors/clinics. Visit the group’s website or contact them to learn about the services they offer. Inclusion on this list is not an endorsement by GARD.

Organizations Supporting this Disease

Organizations Providing General Support

Living with a genetic or rare disease can impact the daily lives of patients and families. These resources can help families navigate various aspects of living with a rare disease.

Community Resources

  • The Job Accommodation Network (JAN) has information on workplace accommodations and disability employment issues related to this condition. JAN is a service of the Office of Disability Employment Policy in the U.S. Department of Labor.

These resources provide more information about this condition or associated symptoms. The in-depth resources contain medical and scientific language that may be hard to understand. You may want to review these resources with a medical professional.

Where to Start

In-Depth Information

  • Medscape Reference provides information on this topic. You may need to register to view the medical textbook, but registration is free.
  • The Merck Manual for health care professionals provides information on Addison's disease.
  • The Monarch Initiative brings together data about this condition from humans and other species to help physicians and biomedical researchers. Monarch’s tools are designed to make it easier to compare the signs and symptoms (phenotypes) of different diseases and discover common features. This initiative is a collaboration between several academic institutions across the world and is funded by the National Institutes of Health. Visit the website to explore the biology of this condition.
  • Online Mendelian Inheritance in Man (OMIM) is a catalog of human genes and genetic disorders. Each entry has a summary of related medical articles. It is meant for health care professionals and researchers. OMIM is maintained by Johns Hopkins University School of Medicine. 
  • Orphanet is a European reference portal for information on rare diseases and orphan drugs. Access to this database is free of charge.
  • PubMed is a searchable database of medical literature and lists journal articles that discuss Addison's disease. Click on the link to view a sample search on this topic.

Questions sent to GARD may be posted here if the information could be helpful to others. We remove all identifying information when posting a question to protect your privacy. If you do not want your question posted, please let us know.

  1. Betterle C, Garelli S, Presotto F, Furmaniak J. From Appearance of Adrenal Autoantibodies to Clinical Symptoms of Addison's Disease: Natural History. Front Horm Res. 2016; 46:133-145.
  2. Addison’s Disease. National Organization for Rare Disorders (NORD). 2018; https://rarediseases.org/rare-diseases/addisons-disease/#supporting-organizations.
  3. Emergency ID & Medical Information. National Adrenal Diseases Foundation. http://www.nadf.us/tools-for-life/emergency-id-medical-information/. Accessed 3/19/2018.