The doctor may presume the presence of this disease based on the history of the disease, physical examination, and in the event that blood tests show high levels of potassium, low sodium levels and high levels of certain types of leukocytes.
The development of Addison's disease is due to the inability of the adrenal glands to produce enough cortisol and aldosterone hormones.
When suspected of addison's disease, blood tests are prescribed for cortisol levels. The low level of cortisol in the blood does not always indicate exactly the Addison's disease. During the day, the level of cortisol is changing: in the morning it is the highest, it decreases in the afternoon, and at night it is the lowest. Thus, the level of cortisol, normal for one time of day, may be low for another. However, cortisol levels should always be high with physical or emotional stress.
The diagnosis is usually confirmed by the ACTH stimulation test (adrenocorticotropic hormone), which shows how the level of hormones varies in response to stress. If, in normal tests or in this test, high levels of cortisol are indicated, then the patient does not have Addison's disease.
- A low level of cortisol, which does not increase after the administration of ACTH, suggests a lack of adrenal function.
- By the level of ACTH in the blood prior to the introduction of artificial ACTH, it is judged that the diagnosis is adequate: Addison's disease or secondary failure of the adrenal function, due to inadequate development of ACTH, leading to a low level of cortisol. Secondary insufficiency may be associated with disorders in the functioning of the pituitary gland, which controls the development of all hormones in the body.
X-rays, CT, and MRI are also used to examine the condition and the detection of adrenal damage.
If you have been diagnosed with Addison's disease, the doctor should also find out the level of thyroid hormones (hyper- and hypothyroidism) and the level of PTH, which causes a decrease in calcium in the blood. It is also necessary to find out whether the patient has type 2 diabetes, pernicious anemia, a failure of the reproductive system.
One or more of these diseases are found in about half of the patients with Addison's disease. It is especially important to know if a patient has tireosis. With hypothyroidism cortisol stays longer in the blood. Treatment of hypothyroidism can lead to a low level of cortisol and addisonic crises.