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Addison's Disease And Blood Sugar

High-calorie Glucose-rich Food Attenuates Neuroglycopenic Symptoms In Patients With Addisons Disease

High-calorie Glucose-rich Food Attenuates Neuroglycopenic Symptoms In Patients With Addisons Disease

Context/Objective: Patients with Addisons disease often suffer from fatigue, faintness, lack of concentration, and memory deficits, i.e. symptoms reminiscent of those of neuroglycopenia. Suspecting that a lack of central nervous glucose contributes to these symptoms, we examined whether they can be attenuated by the intake of palatable food rich in glucose (comfort food) in these patients and, furthermore, whether comfort food reduces hypothalamus-pituitary-adrenal axis activity as observed in animal studies. Design/Setting/Patients/Outcome: Ten Addison patients with primary adrenal insufficiency and acutely discontinued cortisol substitution and 10 matched healthy controls each participated in two experimental sessions in which they were offered a free-choice high-calorie buffet (comfort food) and green salad, respectively, after a mental stress test. Neuroglycopenic and autonomic symptoms, cognitive function (short-term memory, attention), and hormones of the sympathoadrenal system (ACTH, cortisol, catecholamines) were assessed throughout the sessions. Results: Scores of neuroglycopenic symptoms were persistently higher in Addison patients than in controls and were improved by comfort food in comparison to salad (P < 0.04), whereas control subjects did not show such changes. Attention was generally reduced in patients as compared to controls (P < 0.05) and was slightly improved by comfort food, as was memory (each P < 0.07). Sympathoadrenal hormone concentrations remained unaltered. Conclusions: High-calorie comfort food reduces symptoms of neuroglycopenia in Addison patients, suggesting that Addisons disease is associated with a deficit in cerebral energy supply that can partly be alleviated by intake of palatable food. It will be important to investigate whether ad Continue reading >>

Adrenal Insufficiency & Addison's Disease

Adrenal Insufficiency & Addison's Disease

Adrenal Insufficiency & Addison's Disease Adrenal Insufficiency & Addison's Disease Adrenal insufficiency is an endocrine, or hormonal, disorder that occurs when the adrenal glands do not produce enough of certain hormones. The adrenal glands are located just above the kidneys. Adrenal insufficiency can be primary or secondary. Addisons disease, the common term for primary adrenal insufficiency, occurs when the adrenal glands are damaged and cannot produce enough of the adrenal hormone cortisol. The adrenal hormone aldosterone may also be lacking. Addisons disease affects 110 to 144 of every 1 million people in developed countries.1 Secondary adrenal insufficiency occurs when the pituitary glanda pea-sized gland at the base of the brainfails to produce enough adrenocorticotropin (ACTH), a hormone that stimulates the adrenal glands to produce the hormone cortisol. If ACTH output is too low, cortisol production drops. Eventually, the adrenal glands can shrink due to lack of ACTH stimulation. Secondary adrenal insufficiency is much more common than Addisons disease. Adrenal hormones, such as cortisol and aldosterone, play key roles in the functioning of the human body, such as regulating blood pressure; metabolism, the way the body uses digested food for energy; and the bodys response to stress. In addition, the body uses the adrenal hormone dehydroepiandrosterone (DHEA) to make androgens and estrogens, the male and female sex hormones. Cortisol belongs to the class of hormones called glucocorticoids, which affect almost every organ and tissue in the body. Cortisols most important job is to help the body respond to stress. Among its many tasks, cortisol helps maintain blood pressure and heart and blood vessel function slow the immune systems inflammatory responsehow the b Continue reading >>

Adrenal Insufficiency (addison's Disease)

Adrenal Insufficiency (addison's Disease)

Overview Addisons disease is a rare endocrine, or hormonal disorder that affects about 1 in 100,000 people. It occurs in all age groups and afflicts men and women equally. The disease is characterized by weight loss, muscle weakness, fatigue, low blood pressure, and sometimes darkening of the skin in both exposed and non-exposed parts of the body. Addisons disease occurs when the adrenal glands do not produce enough of the hormone cortisol and in some cases, the hormone aldosterone. For this reason, the disease is sometimes called chronic adrenal insufficiency, or hypocortisolism. Cortisol is normally produced by the adrenal glands, located just above the kidneys. It belongs to a class of hormones called glucocorticoids, which affect almost every organ and tissue in the body. Scientists think that cortisol has possibly hundreds of effects in the body. Cortisol's most important job is to help the body respond to stress. Among its other vital tasks, cortisol: helps maintain blood pressure and cardiovascular function; helps slow the immune systems inflammatory response; helps balance the effects of insulin in breaking down sugar for energy; and helps regulate the metabolism of proteins, carbohydrates, and fats. Because cortisol is so vital to health, the amount of cortisol produced by the adrenal's is precisely balanced. Like many other hormones, cortisol is regulated by the brains hypothalamus and the pituitary gland, a bean-sized organ at the base of the brain. First, the hypothalamus sends "releasing hormones" to the pituitary gland. The pituitary responds by secreting other hormones that regulate growth, thyroid and adrenal function, and sex hormones such as estrogen and testosterone. One of the pituitarys main functions is to secrete ACTH (adrenocorticotropin), a horm Continue reading >>

Addison's Disease | You And Your Hormones From The Society For Endocrinology

Addison's Disease | You And Your Hormones From The Society For Endocrinology

Cortisol controls blood sugar levels and is essential to maintaining normal body function ( metabolism ).It is released by the adrenal glands throughout the day but its production increases in times of illness or injury.Aldosterone is essential to keeping a normal level of salt and water in the bloodstream to maintain blood pressure. Adrenal androgens control some body hair growth in women but have little importance in men. Addison's disease is caused by the destruction of the cortex of each adrenal gland. This means that the adrenal gland cannot produce the hormones glucocorticoids (especially cortisol), mineralocorticoids (especially aldosterone) and sex steroids.People with Addison's disease develop symptoms as a result of this loss of adrenal hormones. By far the most common cause of Addisons disease is autoimmunity. This is known as autoimmune Addisons disease. Normally the bodys immune system attacks invading viruses and bacteria to defend the body. In cases of autoimmunity, the immune system makes a mistake, attacking and destroying the adrenal cortex as if it was an infection. Rare causes of Addisons disease include infections such as tuberculosis, removal of the adrenal glands by surgery, bleeding into the adrenal glands (for instance after abdominal injuries), and genetic defects such as adrenoleukodystrophy. The pituitary gland produces hormones that cause the adrenal gland to produce its hormones. If the pituitary gland stops working properly, this can cause 'secondary' adrenal insufficiency - in other words, the adrenal glands stop working, not because they are diseased, but because the pituitary gland has stopped telling them to produce their hormones. What are the signs and symptoms of Addisons disease? The signs and symptoms of Addisons disease usually Continue reading >>

Addison's Disease - Nadf

Addison's Disease - Nadf

The Facts You Need To Know Download Fact Sheet Addisons disease is a severe or total deficiency of the hormones made in the adrenal cortex, caused by its destruction. There are normally two adrenal glands, located one above each kidney. The adrenal glands are really two endocrine (ductless or hormone producing) glands in one. The inner part of the adrenal gland (called the medulla) produces epinephrine (also called adrenaline) which is produced at times of stress and helps the body respond to fight or flight situations by raising the pulse rate, adjusting blood flow, and raising blood sugar. However, the absence of the adrenal medulla and epinephrine does not cause disease. In contrast, the outer portion of the adrenal gland, the cortex, is more critical. The adrenal cortex makes two important steroid hormones, cortisol and aldosterone. Cortisol mobilizes nutrients, modifies the bodys response to inflammation, stimulates the liver to raise the blood sugar, and also helps to control the amount of water in the body. Aldosterone regulates salt and water levels which affects blood volume and blood pressure. Cortisol production is regulated by another hormone, adrenocorticotrophic hormone (ACTH), made in the pituitary gland which is located just below the brain. Classical Addisons disease results from a loss of both cortisol and aldosterone secretion due to the near total or total destruction of both adrenal glands. This condition is also called primary adrenal insufficiency. If ACTH is deficient, there will not be enough cortisol produced, although aldosterone may remain adequate. This is secondary adrenal insufficiency, which is distinctly different, but similar to Addisons disease, since both include a loss of cortisol secretion. When Dr. Thomas Addisons first described Continue reading >>

Addison Disease - Hormonal And Metabolic Disorders - Merck Manuals Consumer Version

Addison Disease - Hormonal And Metabolic Disorders - Merck Manuals Consumer Version

(Addison's Disease; Primary or Chronic Adrenocortical Insufficiency) By Ashley B. Grossman, MD, Emeritus Professor of Endocrinology, University of Oxford; Fellow, Green-Templeton College; Professor of Neuroendocrinology, Barts and the London School of Medicine; Consultant NET Endocrinologist, Royal Free Hospital, London In Addison disease, the adrenal glands are underactive, resulting in a deficiency of adrenal hormones. Addison disease may be caused by an autoimmune reaction, cancer, an infection, or some other disease. A person with Addison disease feels weak, tired, and dizzy when standing up after sitting or lying down and may develop dark skin patches. Doctors measure sodium and potassium in the blood and measure cortisol and corticotropin levels to make the diagnosis. People are given corticosteroids and fluids. Addison disease can start at any age and affects males and females about equally. In 70% of people with Addison disease, the cause is not precisely known, but the adrenal glands are affected by an autoimmune reaction in which the bodys immune system attacks and destroys the adrenal cortex. In the other 30%, the adrenal glands are destroyed by cancer, an infection such as tuberculosis, or another identifiable disease. In infants and children, Addison disease may be due to a genetic abnormality of the adrenal glands. When the adrenal glands become underactive, they tend to produce inadequate amounts of all of the adrenal hormones. Thus, Addison disease affects the balance of water , sodium , and potassium in the body, as well as the bodys ability to control blood pressure and react to stress. In addition, loss of androgens, such as dehydroepiandrosterone (DHEA), may cause a loss of body hair in women. In men, testosterone from the testes more than makes up Continue reading >>

Worried About Addison's Disease?

Worried About Addison's Disease?

The following clinical and laboratory features suggest an adrenal crisis which is life threatening and requiring urgent treatment Dehydration, abnormally high blood pressure or shock which is out of proportion to the severity of current illness Nausea and vomiting with a history of weight loss and anorexia Severe abdominal pain mimicking acute disease or injury to an internal organ Unexplained lack of glucose in the blood sugars Investigations including abnormally low sodium levels; higher than usual potassium levels, higher than usual calcium levels or higher than usual white blood cells called eosinophils Other autoimmune endocrine deficiencies such as hypothyroidism or type I diabetes, or family history of organ specific autoimmune endocrine diseases. For those with Addisons disease treatment is normally through the medication hydrocortisone which, taken in divided doses during the day, replaces the cortisol your body is not making. Usually fludrocortisone is added to treat the associated mineralocorticoid deficiency. It is essential that patients carry a warning card or MedicAlert bracelet to warn medical staff that steroid treatment is required in a medical emergency. They also need to be aware of sick day rules and know to increase their dose if they feel unwell for any reason usually ill enough to take to their bed - or at the time of surgery. For those in an adrenal crisis (which is the second most common cause of death in patients with known Addisons disease and accounts for 15% of patients with this disease) urgent treatment with hydrocortisone injections and intravenous rehydration with fluids are essential. An emergency hydrocortisone injection kit can be prescribed by your GP which is important if you are going abroad. Developed by the Addisons Disease sel Continue reading >>

Addison's Disease | Cleveland Clinic

Addison's Disease | Cleveland Clinic

Home / Health Library / Disease & Conditions / Addison's Disease Addisons disease is a disorder in which the adrenal glands do not produce enough of the hormones cortisol and aldosterone. Addisons disease is caused by an autoimmune response, in which the bodys immune system assaults its own organs and tissues. Treatment includes hormones similar to those made by the adrenal glands. Overview Diagnosis and Tests Management and Treatment Outlook / Prognosis Living With Addisons disease is a disorder in which the adrenal glands which sit on top of the kidneys do not produce enough of the hormones cortisol and aldosterone. (Hormones are chemicals that control the function of tissues or organs.) Cortisol helps the body respond to stress , including the stress of illness, injury, or surgery. It also helps maintain blood pressure, heart function, the immune system, and blood glucose (sugar) levels. Aldosterone affects the balance of sodium and potassium in the blood, which in turn controls the amount of fluid the kidneys remove as urine, which affects blood volume and blood pressure. Addisons disease is also called primary adrenal insufficiency. A related disorder, secondary adrenal insufficiency, occurs when the pituitary, a small gland at the base of the brain, does not secrete enough adrenocorticotropic hormone (ACTH), which activates the adrenal glands to produce cortisol. In the United States, Addisons disease affects 1 in 100,000 people. It occurs in both men and women equally and in all age groups, but is most common in the 30-50 year-old age range. Addisons disease is caused by an autoimmune response, which occurs when the bodys immune system (which protects it from infection) assaults its own organs and tissues. With Addisons disease, the immune system attacks the out Continue reading >>

Addisons Disease | Causes, Symptoms Treatment | Patient

Addisons Disease | Causes, Symptoms Treatment | Patient

Addison's disease is a condition in which your adrenal glands do not make enough of certain hormones (adrenal insufficiency). The condition is named after a Dr Thomas Addison who first described it in 1855. Addison's disease is rare. Just over 8,000 people in the UK have Addison's disease at any one time. Most cases first develop in people aged between 30 and 50. However, it can occur at any age. What are the adrenal glands and what do they do? You have two small adrenal glands that lie just above each kidney. Each adrenal gland has an outer part (adrenal cortex) and an inner part (adrenal medulla). Cells in the adrenal glands make various hormones. A hormone is a chemical which is made in one part of the body but passes into the bloodstream and has effects on other parts of the body. Cells in the outer part of the adrenals (adrenal cortex) make the hormones cortisol and aldosterone. The amount of cortisol that is made is controlled by another hormone called adrenocorticotrophic hormone (ACTH). ACTH is made in a small gland that lies just under the brain (the pituitary gland). This in turn is stimulated by another hormone which is produced by another part of the brain, called the hypothalamus. ACTH passes into the bloodstream, is carried to the adrenal glands and stimulates the adrenal glands to make cortisol. Cortisol is a hormone that is vital for health. It has many functions which include: Helping to balance the effect of insulin in regulating the blood sugar level. Aldosterone helps to regulate salts in the blood and helps to control blood pressure. Cells in the inner part of the adrenals (adrenal medulla) make the hormones adrenaline (epinephrine) and noradrenaline (norepinephrine). These have various actions throughout the body. What are the causes of Addison's Continue reading >>

Addison's Disease

Addison's Disease

Print Overview Addison's disease is a disorder that occurs when your body produces insufficient amounts of certain hormones produced by your adrenal glands. In Addison's disease, your adrenal glands produce too little cortisol and often insufficient levels of aldosterone as well. Also called adrenal insufficiency, Addison's disease occurs in all age groups and affects both sexes. Addison's disease can be life-threatening. Treatment for Addison's disease involves taking hormones to replace the insufficient amounts being made by your adrenal glands, in order to mimic the beneficial effects produced by your naturally made hormones. Symptoms Addison's disease symptoms usually develop slowly, often over several months, and may include: Extreme fatigue Weight loss and decreased appetite Darkening of your skin (hyperpigmentation) Low blood pressure, even fainting Salt craving Low blood sugar (hypoglycemia) Nausea, diarrhea or vomiting Abdominal pain Muscle or joint pains Irritability Depression Body hair loss or sexual dysfunction in women Acute adrenal failure (addisonian crisis) Sometimes, however, the signs and symptoms of Addison's disease may appear suddenly. In acute adrenal failure (addisonian crisis), the signs and symptoms may also include: Pain in your lower back, abdomen or legs Severe vomiting and diarrhea, leading to dehydration Low blood pressure Loss of consciousness High potassium (hyperkalemia) and low sodium (hyponatremia) When to see a doctor See your doctor if you have signs and symptoms that commonly occur in people with Addison's disease, such as: Darkening areas of skin (hyperpigmentation) Severe fatigue Unintentional weight loss Gastrointestinal problems, such as nausea, vomiting and abdominal pain Lightheadedness or fainting Salt cravings Muscle or joi Continue reading >>

Addison's Disease - Nord (national Organization For Rare Disorders)

Addison's Disease - Nord (national Organization For Rare Disorders)

Addison's disease is a rare disorder characterized by inadequate production of the steroid hormones cortisol and aldosterone by the two outer layers of cells of the adrenal glands (adrenal cortex). The symptoms of classic Addison's disease, also known as primary adrenal insufficiency, result from the insufficient production of these two hormones, cortisol and aldosterone. Major symptoms include fatigue, gastrointestinal abnormalities, and changes in skin color (pigmentation). Behavior and mood changes may also occur in some individuals with Addison's disease. Increased excretion of water and low blood pressure (hypotension) can lead to extremely low concentrations of water in the body (dehydration). The symptoms of Addison's usually develop slowly, but sometimes can develop rapidly, a serious condition called acute adrenal failure. In most cases, Addison's disease occurs when the body's immune system mistakenly attacks the adrenal glands causing slowly progressive damage to the adrenal cortex. The symptoms of Addisons disease can vary from one individual to another. Symptoms usually develop slowly over time and are usually vague and common to many conditions (nonspecific). This often leads to delays in the proper diagnosis of Addisons disease. In rare cases, the symptoms of Addisons disease can develop rapidly causing a condition called acute adrenal failure. Fatigue is the most common symptom of Addisons disease. Another common initial symptom of Addisons disease is the development of patches of skin that are darker than the surrounding skin (hyperpigmentation). This discoloration most commonly occurs near scars, by skin creases such as the knuckles, and on the mucous membranes such as the gums. Skin abnormalities can precede the development of other symptoms by month Continue reading >>

Addison's And Low Blood Sugar

Addison's And Low Blood Sugar

Hi, I'm new to the group. Diagnosed a few weeks ago with primary Addison's - went from a cortisol level of 9 to a 10 after the ACTH test. Had been feeling tired, digestive problems, skin pigmentation, and, get this, weight gain, especially around the abdomen with pain in the left side. Sat for a half hour and paid over 180.00 for this endo to prescribe 30mg of HC a day, tell me to stay hydrated and eat extra salt. Went back a couple of weeks later with heart palpitations, they couldn't remember the name of the cardiologist I went to! Told them I still felt really weak and have been monitoring my blood sugar when I feel weak. Every morning it is under 100,usually in the 90s and after testing throughout the day, drinking coffee full of sugar etc. it never goes above 125. I know that's not too low, but still don't know why I still feel so crappy. I tried taking 10-10-10 of my HC, to keep my energy up. I was up all night last Friday, throwing up with sharp stomach pains. I don't think I was in a crisis, rested all day Saturday and Sunday and feel a little better, just drained. Any suggestions for a better endo doc in so cal? VIP Member | 10 years on site | 4351 posts When/how are you taking the HC? Its important to dose for diurnal patterns. 10/10/10 isnt it. Try something like 20/7.5/2.5 synced with meals, but make the last dose around 5PM. (First dose about 10 mins before food and next two 10 mins after) HC/cortisol is catabolic or raises blood sugar. Feeling crappy isnt always caused by low (or high) BG. If you have for real primary you may be staying dehydrated and thus low BP because you may not have just lost cortisol but aldosterone as well. Thats why the salt but it may not be enough.. Measure your BP and HR. Elevated HR tends to be come from dehydration and the lo Continue reading >>

Schmidt Syndrome

Schmidt Syndrome

Schmidt syndrome refers to the combination of autoimmune adrenal insufficiency (Addison’s disease) with autoimmune hypothyroidism and/or type 1 diabetes mellitus (T1DM), and is part of a larger syndrome known as autoimmune polyendocrine syndrome type II or polyglandular autoimmune syndrome type II (PAS II). The term Schmidt syndrome is sometimes used interchangeably with PAS II. PAS II is a polygenic disorder which may include autoimmune thyroid disease (hypothyroidism or hyperthyroidism), T1DM, Addison’s disease, primary hypogonadism, and less commonly hypoparathyroidism or hypopituitarism. More common than other polyglandular autoimmune disorders[2]. Associated non-endocrine autoimmune conditions may be present including vitiligo, celiac disease, alopecia, pernicious anemia, myasthenia gravis, idiopathic thrombocytopenic purpura, Sjogren’s syndrome, and rheumatoid arthritis. Schmidt Syndrome: 1:20,000 prevalence in general population with 3:1 ratio of females to males affected[7] Peak incidence: 3rd - 4th decade of life Familial clustering with multiple family members often affected Autosomal dominant inheritance with variable penetrance. Associated with certain HLA antigens HLA-DR3, HLA-DR4, non HLA gene M-ICA and CTLA-4[2][8]. Among patients with T1DM, < 1% of patients have Addison’s disease, whereas 2-5% have autoimmune thyroid disease (mainly hypothyroidism) and up to 5% have celiac disease[7]. Up to 33% may have thyroid autoantibodies and 12% have transglutaminase autoantibodies[5] Type 1 diabetes patients who developed autoimmune thyroid disease had an interval of 13.3 +/- 11.8 years between first and second endocrinopathies with variable interval seen in development of other autoimmune conditions[6]. Diagnosis of component disorders of PAS II is the sam Continue reading >>

Goals

Goals

Background My name is Glenn Kardel. I have polyglandular autoimmune syndrome type II, frequently referred to as Schmidt's syndrome. The classic manifestations of this syndrome are adrenal insufficiency plus autoimmune thyroid disease and/or insulin dependent diabetes mellitus. I have all three of the above conditions: Addison's disease, hypothyroidism, and type I diabetes. Addisons and hypothyroidism are treated with oral hormone replacement medications. Type I diabetes is the most serious and difficult to control of the three conditions. Treatment usually involves balancing insulin therapy administered through injections or a pump, diet, and exercise with the goal of maintaining normal blood sugar levels. Having Addison's disease in conjunction with type I diabetes presents a significant additional challenge to maintaining normal blood sugar levels. The adrenal gland plays an important role in controlling blood sugar. It produces a glucocorticoid hormone, cortisol, that causes the liver to release internal stores of glucose and reduce glucose uptake in peripheral cells when blood sugars drop below normal levels. The goal is to counteract the drop in blood sugar. Addison's patients usually take steroids (hydrocortisone, prednisone) to replace the cortisol that's not produced by their adrenal gland. These steroids have a side effect of increasing blood sugar and also don't perfectly mimic the natural action and production cycle of cortisol. The net effect of all of this is that type I diabetics with Addison's disease will experience more variable and extreme blood sugar levels. The patient who isn't prepared to handle these changes in their diabetes will face a very risky situation. After I was diagnosed with Addisons and started taking hydrocortisone, I started to have Continue reading >>

Addison’s Disease Causes

Addison’s Disease Causes

Adrenal insufficiency—when your adrenal glands don’t produce enough of the hormone cortisol—can be caused by a primary adrenal gland disorder (this is called Addison’s disease or primary adrenal insufficiency). Alternatively, adrenal insufficiency can be caused by a deficiency of the adrenocorticotropin hormone (ACTH). ACTH stimulates the adrenal glands to produce cortisol, so if there’s too little ACTH, you may have low levels of cortisol (this is called secondary adrenal insufficiency). Much more rare—but still a possible cause of adrenal insufficiency—is an injury to the hypothalamus, a gland in the brain that produces releasing and inhibiting hormones (hormones that tell the other endocrine glands to start and stop production). A hypothalamic injury can lead to a corticotrophin-releasing hormone (CRH) deficiency. CRH is what tells the pituitary gland to produce ACTH, which then stimulates cortisol production in the adrenal glands. A CRH deficiency can lead to an ACTH deficiency—and then to adrenal insufficiency. Primary Adrenal Insufficiency: Addison’s Disease The outer layer of the adrenal glands is called the adrenal cortex. If the cortex is damaged, it may not be able to produce enough cortisol. A common cause of primary adrenal insufficiency is an autoimmune disease that causes the immune system to attack healthy tissues. In the case of Addison’s disease, the immune system turns against the adrenal gland(s). There are some very rare syndromes (several diseases that occur together) that can cause autoimmune adrenal insufficiency. Autoimmune Polyendocrine Syndrome Autoimmune polyendocrine syndrome (APS) is a rare cause of Addison’s disease. Sometimes referred to as multiple endocrine deficiency syndrome, APS is further categorized as type 1 o Continue reading >>

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