Addison’s Disease
Located just above each of the kidneys, the adrenal glands are responsible for manufacturing various hormones to assist in regulating the body’s myriad functions. When the adrenals are not able to create these hormones, Addison’s disease is the unfortunate result. It is a rare condition, affecting only 1 in every 100,000 people, and can be managed well with medication.
It affects in particular the production of the major hormones cortisol and aldosterone. The former assists the body in responding to stress, as well as helping to regulate the body’s utilization of fats, carbohydrates, and fat; it also helps to modify blood pressure and cardiovascular function and keep inflammation in check. The latter aids the kidneys in regulating salt and water levels throughout the body, which helps to keep blood pressure under control. Low aldosterone levels result in the kidneys’ inability to keep salt and water amounts in balance throughout the body, leading to a drop in blood pressure.
A majority of Addison’s cases stem from autoimmune disease. This happens when the immune system attacks the adrenal glands; this attack ends up destroying the outer layer of the adrenal glands. Infections such as HIV and tuberculous can also attack the adrenals, as well as cancerous cells from other parts of the body.
Though it occurs far less frequently Addison’s can also occur due to issues with either the pituitary gland or hypothalamus, which are both located in the brain. These two glands make hormones that can switch on and off the production of hormones in the rest of the body. ACTH, a pituitary hormone, acts as the switch for cortisol production in the adrenals; if ATCH levels are low, production in the adrenals remain off.
If you have Addison’s disease
The main method of treatment for Addison’s is hormone replacement, with regular use of a proscribed steroid hormone called hydrocortisone. A synthetic steroid, fludrocortisone acetate, is used for aldosterone replacement.
A Whole Health Perspective
Looking at Hodgkin’s through a Whole Health model, we explore the individual’s unique presentation from the 5 Aspects of Whole Health™ perspective.
1. Physical – Addison’s disease affects the adrenal glands, the endocrine glands responsible for the body’s response to stress, or a disruption in the homeostatic balance. In order for the body to remain in good health, one must be able to respond to stressors, which require physiological adjustment, and return to a state of balance. Whether due to primary adrenal insufficiency, or secondary sources such as pituitary gland dysfunction, if the adrenal glands cannot respond to stress and produce the hormones necessary for physiological adaptation, symptoms such as chronic fatigue, loss of appetite, nausea, weight loss, muscle weakness, changes in blood pressure and fluid balance, disruption in blood sugar, headache, and depression may occur. Because adrenal hormones assist in the production of sex hormones, women may notice changes in the menstrual cycle and may exhibit a loss of sexual drive. Adrenal crisis can occur in those with Addison’s disease as well. Acute changes in homeostasis, such as illness, injury, and/or pregnancy require a change in treatment course to assist the body in its response to these additional stressors.
Exposure to chronic stress, whether job difficulties, mental or physical illness, or traumatic experiences, disrupts the messaging system between the brain and the adrenal glands, the Hypothalamic-Pituitary-Adrenal Axis. This can further compound adrenal gland insufficiency, and contribute to the development or further pathogenesis of Addison’s disease. Chronic stress also affects the immune system, another common contributor to Addison’s disease.
A large portion of Addison’s disease is the result of an autoimmune disorder. The immune system, in this situation, recognizes parts of the body as foreign and mounts an immunological attack against them, altering their function. The immune system is susceptible to dysfunction from repeat or chronic stress, especially in cases where the stress response glands (the adrenals) are compromised. Thus, working to decrease exposure to stressors and regulate the emotional response to them is important in assisting the body to remain in a state of health. Sleep and disruption in the circadian rhythm can affect the immune system as well, and adequate sleep is required for proper stress response and overall health regulation.
Because Addison’s disease and treatment with corticosteroids can change electrolyte balance (particularly sodium and potassium), monitoring and replacing electrolytes can be guided by a physician. Adequate hydration can assist in appropriate electrolyte levels. Treatment with steroids may lead to osteoporosis and guided supplementation with calcium and vitamin D may be necessary.
Traditional Chinese Medicine may offer support to both the endocrine and immune systems.
2. Chemical/Nutritional – Nutrition and the foods/substances consumed have the ability to communicate wellness or illness to other body systems. Foods high in sugar, saturated fats, alcohol, caffeine, refined carbohydrates preservatives, artificial coloring and flavors, etc. can place further stress upon an already compromised body. Chronic illness such as Addison’s disease places significant stress upon the body, during times of stress adequate amounts of dietary cholesterol, protein, vitamins A, C, E, and B complex, essential fatty acids, and essential minerals is especially important to support adrenal gland functioning.
Additionally, nutrition has an effect on the gut microbiome, the bacteria in the gastrointestinal tract whose balance determines, in part, how food is digested and absorbed, the health of the gastrointestinal immune system, and the messages that get transmitted by the gastrointestinal nervous system to the rest of the body. Supporting healthy gut microbiota can be assisted by a diet high in fruits, vegetables, complex carbohydrates, and high quality protein, as can supplementation with pre and probiotics. Appropriate nutrition can assist the health of both the immune and adrenal/endocrine system.
3. Emotional – Emotional responses have an effect on overall health by contributing to levels of neurotransmitters and neuropeptides. These chemical messengers, as well as overall stress levels, can impact immune and endocrine system function. Learning to modulate the emotional response to stressors, and to decrease stress can lessen the demand on compromised adrenal glands, and help regulate the immune system. Examples of stress reduction techniques include yoga, guided relaxation, breathing techniques, meditation, mild exercise such a tai chi, and talking with a mental health professional. Treating co-existing mental health disorders such as depression and anxiety can decrease overall stress levels and assist in proper neurotransmitter levels.
4. Environmental – Environmental factors which may place additional demand upon the stress response system include exposure to air, soil, and water toxins, abrupt changes in weather or humidity, bright lights, loud noises, and difficult relationship dynamics at work or home. Exposure to natural outdoor environments can positively affect the stress response and immune system. Exercise programs may need to be guided by a physician to insure appropriate hydration, electrolyte balance, and steroid medication adjustment in those with Addison’s disease. Intense exercise can create further disruption in adrenal gland function.
5. Beliefs, Values and Worldview – also identified as Spirituality – Spiritual expression, whether through prayer, meditation, yoga, traditional worship, etc. has an influence on health and wellbeing, often by encouraging an understanding and connection between mind, body, and spirit. Possible feelings of isolation, living in discordance with one’s values, or inability to connect with support and the natural surroundings due to illness or other factors could increase stress and exacerbate symptoms. Finding connection between self, others, and the natural world can communicate health to the immune and endocrine systems and decrease stress during times of illness.