Addison's Disease

---

Addison’s disease is a rare endocrine disorder that occurs in all age groups and is characterised by the reduction in the production of a hormone known as cortisol and aldosterone[1]. Interestingly, Addison’s disease affects predominantly males during childhood and females during adulthood[2]. 

There are two main categories of Addison’s disease: 

1) Primary adrenal insufficiency

2) Secondary adrenal insufficiency. 

In a primary adrenal insufficiency, the adrenal glands do not produce enough cortisol and aldosterone whereas in the secondary adrenal insufficiency type, there is a lack of hormone produced by the brain to stimulate the adrenal glands to release cortisol[3]. 

Affecting approximately 10 in 100,000 individuals, common symptoms include:

• muscle weakness
• salt cravings
• dehydration
• chronic fatigue
• nausea
• loss of appetite and weight
• low blood sugar and 
• irregular or no menstrual periods in women[4]. 

Conventional western medical treatment for treatment of Addison’s disease is replacing the hormones the body is not making by taking medicines. In these cases it is important to ensure plenty of calcium and vitamin D are consumed[5]. 

References

[1] Australian Addison’s Disease Association

[2] The Royal Australian College of General Practitioners (RACGP)

[3] Healthdirect.gov.au

[4] Betterhealth.vic.gov.au

[5} National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

In order for day-to-day functioning, our bodies are required to convert a type of sugar known as glucose from food into energy. This process is facilitated by a hormone known as insulin. Broadly, diabetes is a chronic condition whereby there is an insufficiency of insulin leading to a build up of glucose in the blood[1]. 

There are three main types of diabetes: 

1. Type 1 diabetes

2. Type 2 diabetes, and 

3. Gestational diabetes[2]

Type 1 diabetes is thought to be caused by a combination of genetic and environmental factors and usually has an onset during childhood. Of the three types, type 2 diabetes is the most common form. This type of diabetes is attributed to poor lifestyle factors including poor diet, smoking, lack of exercise and being overweight/obese. Gestational diabetes is first recognised during pregnancy and usually resolves after the baby is born. Most mothers who have had gestational diabetes will have no long term diabetes.

Currently there is no cure for diabetes but there are effective management strategies to control blood glucose level. These include regulating weight management, diet, physical activity, self-management and if blood glucose levels are recalcitrant to these, then medications may be considered[3]. These are usually in the form of oral tablets, and/or insulin injections if more severe. It is vital to ensure a balanced blood glucose level as high blood glucose levels can result in serious complications such as nerve damage, heart disease, infections, kidney damage and eye damage[4].

Dietary Advice

Balanced diet, low in carbohydrates and low GI (glycaemic index). Foods where starch is reduced and the amount of carbohydrate is known and standardized. Sugar should avoided.

Foods to be Avoided

The total amount of carbohydrate which may be taken daily is fixed by your doctor. The chief carbohydrate foods are sugar, bread, biscuits, flour, jam, dried fruits, some sweet fruits, potatoes and other root vegetables. Glucose and sugar being practically pure carbohydrates are to be reduced, as are foods rich in sugar or starch. Keep away from sweets, pastries, cakes, sauces and gravies thickened with flour.

References

[1] The Department of Health – Australian Government (2016, November) Diabetes. health.gov.au/internet/main/publishing.nsf/Content/chronic-diabetes

[2] Australian Institute of Health and Welfare (2019, October). Diabetes. aihw.gov.au/reports-data/health-conditions-disability-deaths/diabetes/overview

[3] Diabetes Victoria. About Diabetes. diabetesaustralia.com.au/about-diabetes

[4] Better Health Channel (2015, March) Diabetes. betterhealth.vic.gov.au/health/conditionsandtreatments/diabetes

The average age of Menopause in Australia is 51 years old. Some women are affected much earlier than this, while others a number of years after. You may have one or more symptoms consistent with the hormonal changes in your body, such as:

• hot flushes (no matter what the temperature outside is)
• excessive sweating (often requiring changes of bed clothes or pyjamas several times a day)
• headache
• sleeping disturbance (often secondary to hot flushes)
• loss of libido

Regular western medicine may involve prescription HRT (Hormone Replacement Therapy), however it is important to understand potential risks with these. Please discuss with your GP prior to commencing these.

The thyroid is a gland found in the neck and throat region and is important in the production of hormones that help control bodily function. When the thyroid is defective in its function and or structure, it can lead to abnormalities in metabolism, heart rate, blood pressure and weight[1]. 

Thyroid problems can thus be broadly categorised into two categories thyroid dysfunction and structural disease.

In thyroid dysfunction, there are two main types: 

1. Hyperthyroidism and

2. Hypothyroidism

Hyperthyroidism is defined as an overactive thyroid whereby the thyroid is overproducing hormones. In these cases individuals affected by hyperthyroidism tend to exhibit symptoms of: 

• accelerated heart rate
• muscle weakness and trembling
• sleeping difficulties
• unexplained weight loss
• sensitivity to heat and 
• changes in menstruation. 

There are multiple factors which can cause hyperthyroidism but the most common is from an immune system abnormality condition known as Graves’ disease. There are no cures for hyperthyroidism, but there are effective medications and treatments to stabilise thyroid function[2]. It is important to note, individuals who are affected from hyperthyroidism to get regularly checked as it is common for affected individuals to develop hypothyroidism as treatment for hyperthyroidism causes the thyroid to become underactive.  

When the thyroid gland becomes underactive and hence cannot produce enough hormones, this is termed as hypothyroidism. This condition mainly affects women over 40 and like hyperthyroidism is caused by a multitude of factors such as a diet low in iodine or an autoimmune disease called Hashimoto disease[3]. Symptoms of hypothyroidism include:

• weight gain
• slow heart rate
• heavier than normal menstruation
• muscle pain and 
• increased sensitivity to the cold[4].

Treatments for hypothyroidism aim to replace the thyroid hormone. 

Thyroid problems can also be a consequence from structural change in the thyroid glands. For example, lumps known as nodules can form in the thyroid and can cause pain in the throat area, difficulty breathing and swallowing, and swelling[5]. In approximately 1 in 10 cases, benign thyroid nodules can become malignant (cancerous) and can cause hyper function of the thyroid gland[6].

References

[1] Health Direct (2018,November) Thyroid problems healthdirect.gov.au/thyroid-problems 

[2] Better Health Victoria (2011, December) Thyroid – hyperthyroidism betterhealth.vic.gov.au/health/conditionsandtreatments/thyroid-hyperthyroidism

[3] Health Direct (2018, November) Hypothyroidism healthdirect.gov.au/hypothyroidism 

[4] Healthy WA – Department of Health. Hypothyroidism (underactive thyroid) healthywa.wa.gov.au/Articles/F_I/Hypothyroidism-underactive-thyroid

[5] Thyroid Foundation Australia. Thyroid Nodules thyroidfoundation.org.au/Thyroid-Nodules

[6] Mackenzie and Mortimer (2004) Thyroid nodules and thyroid cancer doi: 10.5694/j.1326-5377.2004.tb05894.x