Understanding the root causes of Addison’s disease can help in early detection and better management.
Autoimmune Disease: The Most Common Cause
In many developed countries, most cases of Addison’s disease are autoimmune in nature. This means the body’s immune system mistakenly attacks the adrenal glands, damaging the outer layer (adrenal cortex) responsible for hormone production. This type of Addison’s disease is called autoimmune adrenalitis.
The exact reason why this immune response occurs isn’t fully understood, but it’s often seen alongside other autoimmune conditions like type 1 diabetes, thyroid disorders, or vitiligo. This collection of conditions is sometimes referred to as autoimmune polyendocrine syndrome.
Infections
In some regions, particularly in developing countries, infections are a leading cause. Tuberculosis (TB) used to be the most common culprit worldwide and still is in areas where TB is prevalent. The infection can spread to the adrenal glands, causing lasting damage.
Other infections that may affect the adrenal glands include:
- Fungal infections
- HIV/AIDS
- Cytomegalovirus (CMV)
- Genetic and Inherited Conditions
Rare genetic disorders can also lead to Addison’s disease. For example, congenital adrenal hyperplasia (CAH) is a group of inherited conditions that affect hormone production from birth. In some cases, adrenoleukodystrophy (ALD) — a condition that affects the nervous system and adrenal glands — is responsible, particularly in boys and young men.
Other Possible Causes
- Cancer: Metastatic cancers can sometimes spread to the adrenal glands and interfere with their function.
- Bleeding into the adrenal glands: This can happen in very rare cases due to sepsis or blood clotting disorders.
- Surgical removal: If both adrenal glands are surgically removed due to a tumour or other health condition, Addison’s disease will result.
When the Cause Is Unknown
Sometimes, no clear cause is identified. In these cases, further testing and monitoring may help uncover underlying issues or rule out other conditions.
👉 Next: How is Addison’s Disease Diagnosed?
Reviewed April 2025. Always consult a professional for individual guidance.
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