Doctors warn that extreme cravings for everything salty, from pickles to potato chips, could signal a rare – and fatal – health disorder.
A 15-year-old Toronto girl was hospitalized after months of unexplained symptoms, including severe dizziness, fatigue, dehydration and insatiable craving for salty snacks.
It wasn’t until the girl’s doctor noticed her unusually brown skin color and dark spots under her tongue that it became clear that her adrenal glands had stopped working, a potentially fatal health crisis.
She was eventually diagnosed with Addison’s disease, a condition that affects one in 100,000 in which the adrenal glands do not produce enough hormones to regulate crucial minerals and hormones in the body, leading to nausea, abdominal pain, weight loss, salt cravings and dark hair. spots on the skin – hyperpigmentation.
The condition can be treated with hormone replacement therapy, but can lead to death if left untreated.
Addison’s disease causes a dip in the hormone that regulates sodium and potassium levels in the body, causing a person to experience extreme cravings for salty foods.
A 15-year-old patient with extreme sodium cravings also developed pigmentation under her tongue, consistent with Addison’s disease
Addison’s disease disrupts the body’s delicate balance of hormones, as well as sodium and potassium – two essential minerals that help regulate blood pressure, muscle and kidney function, and cell nutrients.
Upon arrival, the Canadian patient’s sodium level was approximately 130 millimoles per liter (mmol/l), despite eating jars of pickles at a time, a handful of chips and dousing her meals with salt.
Normal sodium levels range from 136 to 145 mmol/l, which is necessary to regulate the amount of water in and around cells and to generate electrical signals between nerves, allowing communication between the brain and the rest of the body.
A an estimated 80 percent of patients with Addison’s disease require salt because the disease causes them to lose an excessive amount of sodium through the urine.
Normal potassium levels range from 3.5 to 5.2 millimoles per liter (mmol/l), but the patient’s level reached the highest point in this range, at 5 mmol/l.
Excess potassium in the blood disrupts crucial electrical impulses that regulate the heart rate. This predisposes the heart to abnormal electrical activity, increasing the risk of a life-threatening irregular heart rhythm
At the same time, she had an unquenchable thirst, despite drinking three liters of water every day. Increased thirst can be an early sign of Addison’s disease because the disease interferes with the way the body regulates water levels.
The internal medicine specialist who treated the girl also noticed that she was tan despite the fall, prompting the doctor to conduct a more thorough physical examination, during which the doctor noted the hyperpigmentation on the underside of the patient’s tongue, a characteristic Addison’s sign.
Patients also experience loss of appetite, decreased blood pressure, dizziness upon standing, unexplained weight loss, muscle pain, and nausea.
Addison’s disease occurs when the adrenal glands do not function properly. These multi-layered glands sit on top of the kidneys, and each layer produces a different crucial hormone.
The upper layers produce aldosterone, a hormone that signals the kidneys to retain sodium while signaling the release of potassium through the urine.
When the adrenal glands don’t produce enough aldosterone, the sodium that enters the body through salty snacks leaves just as quickly in the form of urine, leaving a person dehydrated, extremely dizzy, thirsty, and craving even more sodium.
The second layer produces cortisol, also called the stress hormone. It helps regulate blood sugar levels and blood pressure and helps the body deal with stress. Not enough can cause nausea, abdominal pain, weight loss and hyperpigmentation.
Addison’s disease also affects the third layer, which normally produces DHEA and androgenic steroids, precursor hormones that are converted into female hormones in the ovaries and into male hormones in the testes.
Addison’s disease can be fatal if left undetected or untreated, but can be treated with hormone replacement therapy to normalize aldosterone and cortisol levels.
Without treatment, symptoms can progress to dangerous electrolyte imbalances, including a spike in potassium levels and eventually organ failure.
The condition usually stems from an autoimmune disease, which occurs when the body turns its own immune system against itself. Particularly in Addison’s disease, the body attacks the outer part of its own adrenal glands.
In developed countries, autoimmune disease causes eight to nine in 10 cases of Addison’s disease.
Tuberculosis is the most common cause of Addison’s disease worldwide, but tuberculosis is generally rare in the US.
Other less common causes of Addison’s disease include a history of infections, especially HIV and fungal infections, heavy bleeding in the adrenal glands, cancer cells migrating to the adrenal glands from other parts of the body, surgical removal of the adrenal glands and certain genetic mutations. .
The condition is rare, affecting about one in 100,000 people in the US, and occurs most often in middle-aged women.
Autoimmune diseases are generally more common in women.