Addison's Disease: Causes, Symptoms, and Treatment
Medically reviewed by Achuta Uppu, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Addison's Disease?
An endocrinologist (a hormone doctor) treats Addison's disease. This doctor treats problems with the body's glands and hormones. Many people start with a primary care doctor for tests. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is Addison's disease?
Addison's disease is also called primary adrenal insufficiency. It means the adrenal glands do not make enough hormones. The adrenal glands are small organs on top of each kidney. Each gland has an outer layer called the cortex.
In Addison's disease, damage to the adrenal cortex makes hormone levels too low. Cortisol keeps sugar (glucose) and blood pressure in check and helps the body respond to stress. Aldosterone keeps sodium, water, and potassium in balance.
Symptoms
Symptoms come on slowly over time. They may be confused with other illnesses. Common symptoms include:
- Long-lasting fatigue and muscle weakness.
- Loss of appetite and weight loss.
- Abdominal pain, nausea, vomiting, or diarrhea.
- Low blood pressure that drops more when you stand. This causes dizziness or fainting.
- Craving salty foods.
- Low blood sugar.
- Irritability, depression, and joint pain.
- Darkening of the skin. It shows most on scars, skin folds, elbows, knees, knuckles, toes, lips, and the inside of the cheeks.
Sometimes symptoms appear for the first time during an adrenal crisis.
Causes and who gets it
In most cases, the immune system attacks the adrenal cortex by mistake. This is called autoimmune disease. In developed countries, autoimmune disease causes 8 or 9 of every 10 cases of Addison's disease.
Infections such as tuberculosis (TB), HIV, and fungal infections can also damage the glands. TB used to be the most common cause. Less common causes include bleeding into the glands, tumors, surgical removal of the glands, and genetic disorders. Certain medicines, such as antifungal medicines, can also cause it.
How doctors diagnose it
Diagnosis starts with your symptoms and medical history. Blood tests check for low cortisol. They may also show low sodium and high potassium.
Doctors may also use a cosyntropin (ACTH) stimulation test. ACTH is a hormone that tells the adrenals to work. Other tests may include an abdominal x-ray and an abdominal CT scan.
Treatment
Treatment replaces the missing hormones. These medicines usually need to be taken for life. Cortisol is replaced with a corticosteroid (a steroid medicine). Most often it is hydrocortisone, taken by mouth two or three times a day. Less often, doctors prescribe prednisone or dexamethasone. Aldosterone is replaced with a medicine called fludrocortisone. It helps balance sodium and fluids. Your doctor will adjust the doses to meet your body's needs.
Your body needs more hormone during physical stress. Talk with your doctor about how to adjust your dose during an illness. Get medical care right away if you have a severe infection or diarrhea, or if you are vomiting and cannot keep your pills down. These problems can lead to an adrenal crisis. Never skip doses of your medicine, because life-threatening reactions may occur.
When to see a doctor
An adrenal crisis is a medical emergency. If you have symptoms of a crisis, use your emergency injection if you have one. Whether or not you have it, call 911 right away. Crisis symptoms include abdominal pain, trouble breathing, dizziness, fainting, confusion, low blood pressure, and a low level of consciousness.
Call your doctor if you have a milder infection, an injury, or dehydration. Your dose may need adjusting. Always carry medical ID (a card, bracelet, or necklace) that says you have adrenal insufficiency.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. This kind of doctor can order blood tests, help plan sick-day care with your specialist, and check on your treatment over time.
Common questions
What is an adrenal crisis?
An adrenal crisis is an extreme form of adrenal insufficiency. If you have symptoms, use your emergency injection of prescribed medicine if you have one. Whether or not you have it, call 911 right away.
Can people live a normal life with Addison's disease?
With hormone therapy, many people with Addison disease are able to lead a nearly normal life.
What medicines treat Addison's disease?
Treatment uses replacement corticosteroids and mineralocorticoids. Cortisol is most often replaced with hydrocortisone. Aldosterone is replaced with fludrocortisone. These medicines usually need to be taken for life. Never skip doses, because life-threatening reactions may occur.
Does Addison's disease darken the skin?
Yes, it can. People with Addison's disease may also have darkening of the skin. It shows most on scars, skin folds, elbows, knees, knuckles, toes, lips, and the inside of the cheeks.
Sources
- NIDDK - Symptoms and Causes of Adrenal Insufficiency and Addison's Disease
- NIDDK - Treatment for Adrenal Insufficiency and Addison's Disease
- MedlinePlus - Addison Disease
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
