Symptoms of Addison’s disease

Addison's disease can be difficult to detect at first, because early symptoms are similar to symptoms of many other health conditions.

Initial symptoms of Addison's disease can include:

• fatigue (lack of energy or motivation)
• lethargy (abnormal drowsiness or tiredness)
• muscle weakness
• low mood (mild depression) or irritability
• loss of appetite and unintentional weight loss
• the need to urinate frequently
• increased thirst
• craving for salty foods

Dehydration can also be an early sign of Addison’s disease. It's caused by lack of the hormone aldosterone in your body, which is used to regulate the balance of salt and water.

Later symptoms

Further symptoms of Addison’s disease tend to develop gradually over months or years. However, additional strees, caused by another illness or an accident, for example, may cause your symptoms to suddenly get worse.

You may go on to develop:

• low blood pressure when you stand up, which can cause dizziness and fainting 
• feeling sick (nausea)
• vomiting
• diarrhoea
• abdominal, joint or back pain
• muscle cramps 
• chronic exhaustion, which may cause depression
• brownish discolouration of the skin, lips and gums (hyperpigmentation), particularly in the creases on your palms, on scars or on pressure points, such as your knuckles or knees
• a reduced libido (lack of interest in sex), particularly in women

Some women may also have irregular periods or miss some periods completely. Children with Addison's disease may experience puberty later than usual.

Some people with Addison's disease also develop low blood sugar (hypoglycaemia). This can cause symptoms such as difficulty concentrating, confusion, anxiety and even unconsciousness (particularly in children).

If you're experiencing symptoms of Addison's disease, see your GP so they can diagnose or rule out the condition. These symptoms will usually improve with appropriate treatment.

Adrenal crisis

If Addison’s disease is left untreated, the levels of hormones produced by the adrenal gland gradually decrease in the body. This causes your symptoms to get progressively worse and eventually lead to a life-threatening situation called an adrenal or Addisonian crisis.

During an adrenal crisis, the symptoms of Addison’s disease appear quickly and severely. This could happen when you're already experiencing initial symptoms or without any symptoms at all.

Signs of an adrenal crisis include:

• severe dehydration
• pale, cold, clammy skin
• sweating
• rapid, shallow breathing
• dizziness
• severe vomiting and diarrhoea
• severe muscle weakness
• headache
• severe drowsiness or loss of consciousness

An adrenal crisis is a medical emergency. If left untreated, it can be fatal. If you think you or someone you know with Addison’s disease is having an adrenal crisis, dial 999 for an ambulance.

If an adrenal crisis isn't treated, it can lead to a coma and death. There's also a risk your brain won't get enough oxygen if treatment is delayed, which can cause permanent disability.