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Celiac Disease and Primary Adrenal Insufficiency (Addison’s Disease)

What is Primary Adrenal Insufficiency (Addison’s Disease)?

Primary adrenal insufficiency is a rare condition where the adrenal glands (located just above the kidneys) don’t produce enough cortisol, which is a hormone that regulates stress and stress reactions. The adrenal glands may also not produce enough aldosterone, which regulates sodium absorption. Primary adrenal insufficiency is also known as Addison’s disease and hypocortisolism.

Symptoms tend to develop gradually, and include but are not limited to:

  • Fatigue
  • Fainting
  • Low blood pressure
  • Low blood sugar
  • Weight loss
  • Decreased appetite
  • Salt cravings
  • Darkening of the skin
  • Gastrointestinal stress (pain, nausea, diarrhea or vomiting)
  • Joint pain
  • Irritability or depression
  • Loss of body hair in women

Sometimes symptoms can appear suddenly, in a life-threatening complication called acute adrenal failure (also known as an addisonian crisis).

Get emergency care immediately if you suspect Addison’s disease and experience:

  • Confusion or delirium
  • Weakness
  • Pain in lower back and/or legs
  • Severe GI distress (pain, vomiting and diarrhea)

What is the Connection Between Celiac Disease and Primary Adrenal Insufficiency?

People with primary adrenal insufficiency often have autoimmune conditions too, including celiac disease. Multiple studies show an increased risk of celiac disease among patients with primary adrenal insufficiency. One study also showed that patients with celiac disease were at an increased risk of developing primary adrenal insufficiency.

A small study from 2002 found 12.2% of patients with Addison’s disease also had celiac disease. The study authors recommended screening patients with AD for CD.

A study from 2003 found 7.9% of patients with autoimmune Addison’s disease also had celiac disease. The study authors recommended that patients be screened for celiac disease.

A study from 2007 found that “subjects who developed Addison’s disease were at an eight-fold increased risk of subsequent celiac disease.” They also found an increased risk of AD in those with CD. They recommended that patients with AD be screened for celiac disease.

How is Primary Adrenal Insufficiency Diagnosed?

Your doctor may have you undergo blood tests, a CT scan of your abdomen, and/or an ACTH stimulation test. If you are concerned that you may have Addison’s disease, speak with your doctor about getting tested. Your primary care physician may refer you to an endocrinologist (a doctor who specializes in hormones).

How is Primary Adrenal Insufficiency Treated?

Primary adrenal insufficiency is treated with lifelong hormone replacement therapy. Patients take tablets (usually hydrocortisone, prednisone or methylprednisolone) two or three times a day. Patients are also encouraged to get plenty of sodium (salt) in their diet.

Where Can I Learn More?

Think you may have celiac disease?

Symptoms Checklist