The source of ACTH is suddenly removed, and replacement hormone must be taken indefinitely or until normal ACTH and cortisol production resumes. Symptoms of Adrenal Hypoactivity Since, except for postsurgical instances, the diminution of adrenal function is a very slow pathologic process, the onset of the symptoms is slow and the lack of specificity makes the diagnosis difficult. Progressive character of the symptoms helps to alert the physician when he is confronted with the symptoms of fatigue, weight loss, loss of appetite, nausea, diarrhea, vomiting, dizziness and fainting associated with low blood pressure and low sodium. Patient develops irritability, depression and craving for salt. One of the more characteristic symptoms which may call the physicians' attention to the diagnosis is marked darkening of the skin over both exposed and unexposed areas, particularly in skin creases and pressure points.
Women develop menstrual irregularities, even amenorrhea.
These are associated with suddenly occurring severe abdominal pains, diarrhea, vomiting followed by dehydration and hypotensive shock. If left untreated patient may die in adrenal crisis. Treatment of Addison disease, once the diagnosis is established, is relatively simple. It requires appropriate replacement therapy with adrenal hormones. It adversely influences the manufacture of the stress hormone, cortisol, produced by the adrenal gland, and, in the female, is associated with excessive production of androgens by the adrenal gland.