Question

Addison's disease develops when the adrenal cortex doesn't secrete enough mineralocorticoids and glucocorticoids. President John F. Kennedy was diagnosed with the disease when he was a young man. Before he started treatment with hormone replacement therapy, he was hypoglycemic and lost weight. Which missing hormone was responsible for his weight loss? How might Addison's disease have affected his blood pressure?

Answer 1

Addison’s disease is a rare hormonal disorder or endocrine disease. The symptoms of this disease include weight loss, weakness in muscles, alarmingly low blood pressure, fatigue, low blood pressure, skin darkening, etc. Occurrence of Addison’s disease is observed upon insufficient production of cortisol class of hormones. Cortisol has been found to have multiple effects on human body. Response to stress, maintenance of blood pressure as well as heart functioning, regulation of immune system, balancing insulin levels according to energy requirements, regulation of carbohydrate, protein as well as fat metabolism, etc. are some of the vital functions of cortisol.

Before performing hormone replacement therapy, President John F. Kennedy still had a condition of corticosteroid deficiency. Corticosteroids are known to regulate gluconeogenesis. In case of low energy levels, it will activate gluconeogenesis thus producing glucose so as to meet the energy requirements. In case of corticosteroid deficiency sensitivity to insulin increases which result in breakdown of carbohydrates causing low energy levels. However, gluconeogenesis is not triggered even though energy levels are low because of absence of corticosteroids. This causes hypoglycemia.

Corticosteroids maintain a balance between leptins which are responsible for regulating energy levels by controlling storage of fat tissues and ghrelins which are responsible for stimulate appetite thus increasing food intake as well as storage of fats. There is no control over the levels of leptin and ghrelin due to absence of corticosteroids. Moreover, cortisol deficiency leads to hypoglycemia which further leads to increase in breakdown of proteins and fats ultimately resulting in pronounced weight loss.   

Aldosterone is a hormone belonging to the class of mineralocorticoids, which are also produced by the adrenal gland. Aldosterone helps in maintaining water and salt balance in the body by retaining sodium and flushing out potassium from the kidney. In this way, it helps in regulation of blood volume as well as blood pressure. In case of Addison’s disease, where aldosterone levels are too low, kidneys are unable to maintain salt as well as water levels in balance. This results in low blood volume as well as blood pressure.