Addison’s Disease: A Patient’s Story

Lita Newdick has long been defying convention.

The 84-year-old Cambridge, Massachusetts resident and native New Yorker worked as a copywriter for a number of Madison Avenue ad agencies during the “Mad Men” era, working for clients in women’s categories such as fashion and home furnishings before her award-winning skills led to assignments alongside male counterparts on mainstream consumer brand accounts. “It was a rather ‘segregated’ work environment, but the only place where a woman could make decent money and get recognized,” she said.

Newdick continued to ply her trade at international powerhouse ad agency BBDO after a move to Boston with her husband in 1966, even continuing to work part-time during pregnancy, until she discovered – quite by chance (and long before HGTV) – her next occupation: real estate developer.

Inspired by the old, bow-front brownstones in the upperclass Manhattan neighborhood of Murray Hill “that we couldn’t afford at that time,” Newdick and her husband purchased a fixer-upper in Boston’s distressed South End and got to work restoring not only the family home, but the neighborhood buildings around it. “We had to work like dogs to restore that home and improve other properties around it that were in a state of decline, but it was a wise move and revived the neighborhood,” Newdick said.

Given that type of backstory, it’s no surprise a sudden change in her health in 1995 didn’t follow an ordinary path.

“I began to feel bad, like a flower that needing watering,” Newdick recalled. “I was fatigued, had no energy, had lost all of my appetite and slowly just kept getting worse and worse.” Down to 95 pounds after several months and suffering from debilitating depression, she was urged on by concerned friends to seek help. Newdick visited several doctors and underwent a number of medical tests, but results were inconclusive. And while the illness mystified her doctors, “I was going down the drain, and fast,” she said. It was only when she was waiting to be checked into an inpatient psychiatric facility for her depression that the facility’s intake healthcare personnel noted Newdick’s darkened skin (called hyperpigmentation) and alarmingly low sodium on her most recent blood test.

She was immediately transported to the emergency room of a nearby hospital where, after a workup, doctors diagnosed her on the spot with Addison’s disease. Rare and potentially life-threatening, Addison’s is most often caused by an autoimmune disorder and occurs when the body produces insufficient amounts of certain hormones produced by the adrenal glands, such as life-sustaining cortisol. Cortisol affects many different body systems and plays a role in blood pressure control, nervous system function, metabolism of fats, carbohydrates and protein, stress response and immune system function.

It already had been discovered in 1989 that she had pernicious anemia, an autoimmune disorder in which the body fails to make enough healthy red blood cells because it doesn’t have enough B-12. Plus, in 1993, she had been diagnosed with an underactive thyroid gland (hypothyroidism) caused by Hashimoto’s thyroiditis (see related article on page 4), meaning she was suffering from three distinct autoimmune diseases, a condition called polyglandular autoimmune (PGA) syndrome type II. PGA is a rare autoimmune disorder in which there is a steep drop in production of several of the body’s hormones by the glands that secrete these hormones. Since the combination of affected glands differs from patient to patient, the signs of this disorder are diverse.

Newdick was admitted to the hospital and stayed there for two weeks while doctors stabilized her condition with the administration of hydrocortisone to replace the normal levels of cortisol the body should have been producing. “There was a team of doctors that would come around to see me while I was there, because it’s a very rare disease and one that’s so often misdiagnosed,” Newdick noted.

The good news? Her conditions were all treatable.

Newdick takes daily thyroid hormone replacement medication plus hydrocortisone to help mobilize nutrients and stimulate her liver to raise her blood sugar. She also takes fludrocortisone, which enables her to retain salt and water levels that affect blood pressure and volume, and gets a B-12 shots once a month to battle the anemia. Although she admits her energy level has diminished somewhat over the years, this fit-as-a-fiddle octogenarian says she puts a lot of work into staying healthy, eating a healthy diet, doing resistance training at her apartment community’s 24-hour fitness center, playing tennis as often as possible and “being at peace with myself and others.”

“Even though the illness doesn’t affect me much, I know that my medication is keeping me alive,” Newdick said. “I am really very, very fortunate to have led and to be able to lead the life I have.”

More About Addison's Disease and Adrenal Insufficiency

Exceedingly uncommon, Addison’s disease affects only 110 to 144 of every one million people in developing countries according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

The symptoms of Addison’s disease develop gradually and may have become established before the condition is recognized and diagnosed. The most common ones are:

  • Muscle weakness and fatigue
  • Lightheadedness upon standing or difficulty standing
  • Muscle weakness
  • Fever
  • Weight loss/decreased appetite
  • Anxiety
  • Depression
  • Nausea/vomiting/diarrhea
  • Headache
  • Sweating
  • Changes in mood or personality
  • Joint and muscle pains

Some patients have cravings for salt or salty foods due to the loss of sodium through their urine. Hyperpigmentation, or darkening of the skin, also can occur in Addison’s disease, particularly when the patient lives in a sunny area.

In most cases, symptoms of adrenal insufficiency become serious enough that people seek medical treatment before the problem becomes life-threatening. However, under certain circumstances, the condition may progress to acute adrenal failure or Addisonian crisis, a severe illness which may include very low blood pressure, coma and even death. The signs and symptoms of an Addisonian crisis may include:

  • Pain in the lower back, abdomen or legs
  • Severe vomiting and diarrhea, leading to dehydration
  • Low blood pressure
  • Loss of consciousness
  • High potassium (hyperkalemia)

What you must know if you are at risk for adrenal failure:

  • Always carry identification that describes your condition in the event of an emergency. This should alert emergency medical personnel about the need to inject cortisol if you are found severely injured or in a condition where you are unable to answer questions. A medic alert bracelet or neck
  • A person with adrenal insufficiency should carry a corticosteroid injection at all times and make sure that others know how and when to administer the injection, in case the person becomes unconscious.
  • Physical stress, such as an injury, infection or illness, or emotional stress can worsen the condition of a person with Addison’s disease since their bodies lack the natural stress response hormones. Because of this, they should increase medication during periods of stress or infection to mimic the kind of hormonal response that the adrenal glands would normally have.
  • Immediate medical attention is needed when severe infections or vomiting or diarrhea occur. These conditions are a stress on the adrenals. Normally functioning adrenals can put out the needed extra hormones to keep the body going – abnormal glands cannot. You may require injections of hydrocortisone.