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Published on: 2/7/2026

Addison’s Disease Symptoms Over 65: Rare but Critical Signs

In adults over 65, Addison’s disease is rare yet critical to catch early; watch for persistent fatigue and weakness, unintentional weight loss and digestive upset with salt craving, dizziness or fainting from low blood pressure, skin darkening, cognitive changes, and lab clues like low sodium, high potassium, or low blood sugar. There are several factors to consider. See below for the red flag signs of an Addisonian crisis that need emergency care, plus how doctors diagnose and treat it, when to adjust medications during illness, and when to contact a clinician so you can choose the right next steps.

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Explanation

Addison's Disease Symptoms Over 65: Rare but Critical Signs

Addison's Disease is a rare but serious condition that affects the adrenal glands. These small glands sit on top of the kidneys and produce hormones that are essential for life—especially cortisol and aldosterone. While Addison's Disease can occur at any age, symptoms in adults over 65 can be especially hard to recognize. They often develop slowly and may look like normal aging or other common health problems.

Understanding the warning signs matters. When Addison's Disease is missed or diagnosed late, it can lead to severe complications. The good news is that, once identified, it is usually manageable with proper medical care.


Why Addison's Disease Is Often Missed in Older Adults

Addison's Disease is considered rare, affecting only a small portion of the population. In people over 65, diagnosis can be delayed for several reasons:

  • Symptoms develop gradually, sometimes over months or years
  • Complaints may be mistaken for aging, stress, or chronic illness
  • Many older adults already take medications that can mask symptoms
  • Signs overlap with common conditions like depression, heart disease, or digestive disorders

Because of this, both patients and caregivers may overlook early warning signs.


What Happens in Addison's Disease?

In Addison's Disease, the adrenal glands fail to produce enough hormones, particularly:

  • Cortisol, which helps regulate blood pressure, blood sugar, energy levels, and stress response
  • Aldosterone, which helps balance sodium and potassium and maintain fluid levels

Without enough of these hormones, the body struggles to maintain balance—especially during illness, injury, or stress.


Early Symptoms of Addison's Disease Over 65

Early symptoms are often vague and easy to dismiss. However, taken together, they can signal a serious problem.

Common early symptoms include:

  • Ongoing fatigue that does not improve with rest
  • Weakness, especially during daily activities
  • Loss of appetite and unintentional weight loss
  • Low mood or depression that feels different from usual emotional changes
  • Muscle aches or joint pain

In older adults, these symptoms are frequently blamed on aging, arthritis, or lifestyle changes.


Digestive and Abdominal Symptoms

Digestive symptoms are common in Addison's Disease and can easily be mistaken for other gastrointestinal conditions.

You may notice:

  • Chronic nausea or vomiting
  • Abdominal pain that comes and goes
  • Diarrhea or constipation
  • Craving salty foods

Because these digestive symptoms can mimic more common conditions like Irritable Bowel Syndrome (IBS), it's helpful to evaluate what might be causing your discomfort. However, persistent digestive symptoms should always be discussed with a doctor—especially if they occur alongside fatigue, weight loss, or low blood pressure, as these combinations may point to something more serious like Addison's Disease.


Skin and Appearance Changes

One of the more distinctive signs of Addison's Disease is skin darkening, also called hyperpigmentation. However, in adults over 65, this symptom may be subtle or overlooked.

Look for:

  • Darkening of skin in skin folds, scars, elbows, knees, or knuckles
  • Darkened areas inside the mouth or gums
  • Skin changes that are not related to sun exposure

Because aging skin naturally changes over time, these signs may not raise concern unless they are progressive or unusual.


Blood Pressure and Circulation Issues

Low blood pressure is a hallmark of Addison's Disease and can be especially dangerous in older adults.

Possible signs include:

  • Dizziness or lightheadedness, especially when standing
  • Fainting or near-fainting episodes
  • Falls, which may be mistakenly blamed on balance problems
  • Feeling weak after standing up quickly

These symptoms deserve urgent medical attention, as low blood pressure increases the risk of injury and other complications.


Blood Sugar and Electrolyte Imbalances

Addison's Disease can disrupt the body's ability to regulate blood sugar and minerals.

Older adults may experience:

  • Low blood sugar, causing shakiness, confusion, or sweating
  • Low sodium levels, leading to headaches, fatigue, or nausea
  • High potassium levels, which can affect heart rhythm

These imbalances are often discovered through routine blood tests but may be missed if testing is not done.


Mental and Cognitive Changes

Hormonal imbalances can affect the brain as well as the body.

In adults over 65, this may appear as:

  • Memory problems
  • Confusion or difficulty concentrating
  • Irritability or personality changes
  • Worsening symptoms during illness or emotional stress

Because these signs overlap with dementia, medication side effects, or depression, Addison's Disease is not always considered right away.


Addisonian Crisis: A Medical Emergency

If Addison's Disease remains untreated, it can lead to an Addisonian crisis, which is life-threatening and requires immediate medical care.

Warning signs include:

  • Severe weakness or collapse
  • Sudden, intense abdominal pain
  • Persistent vomiting or diarrhea
  • Confusion or loss of consciousness
  • Dangerously low blood pressure

This situation is a medical emergency. Anyone experiencing these symptoms should seek urgent care right away.


How Addison's Disease Is Diagnosed

Diagnosis usually involves:

  • Blood tests to check cortisol, sodium, potassium, and blood sugar
  • Hormone stimulation tests to assess adrenal function
  • Imaging tests if needed

Diagnosis can take time, especially in older adults, but proper testing is essential.


Treatment and Long-Term Outlook

Although Addison's Disease is lifelong, it is usually manageable with treatment.

Treatment typically includes:

  • Daily hormone replacement medication
  • Adjusting medication during illness or stress
  • Regular medical follow-up

With consistent care, many people live full and active lives. Early diagnosis greatly reduces the risk of serious complications.


When to Speak to a Doctor

You should speak to a doctor if you or a loved one over 65 experiences:

  • Ongoing fatigue with no clear cause
  • Digestive symptoms combined with weight loss or weakness
  • Dizziness, fainting, or unexplained falls
  • Skin changes that are unusual or progressive
  • Any symptoms that feel serious, sudden, or life-threatening

If something feels wrong, trust that instinct. Addison's Disease may be rare, but missing it can have serious consequences.


Final Thoughts

Addison's Disease in adults over 65 is uncommon, but it is important to recognize. Its symptoms often blend into everyday health concerns, which is why awareness matters. Paying attention to patterns—especially fatigue, digestive issues, low blood pressure, and skin changes—can make a real difference.

If symptoms are persistent or worsening, don't dismiss them as "just aging." Speak to a doctor about any concerns, particularly those that could be serious or life-threatening. Early evaluation can lead to effective treatment and a much safer outcome.

(References)

  • * Hsieh S, Lai CC, Chang SN, et al. Primary adrenal insufficiency in the elderly: a retrospective study of 52 patients. *Endocr J*. 2009;56(9):1093-1099. doi:10.1507/endocrj.K09E-198

  • * Bleasdale S, Macfarlane JA, Fraser WD. Adrenal insufficiency in the elderly - a clinical challenge. *Ther Adv Endocrinol Metab*. 2011;2(2):57-63. doi:10.1177/2042018811400305

  • * Barbaro M, Zucchini A, Perra S, et al. Primary Adrenal Insufficiency in Patients Over 65 Years Old: An Italian Multicenter Study. *J Clin Endocrinol Metab*. 2021;106(8):e3230-e3240. doi:10.1210/clinem/dgab403

  • * El-Shehaby AM, Awad H, Abdin A, et al. Clinical features and outcomes of Addison's disease in older patients: a systematic review. *Endocrine*. 2023;81(3):477-488. doi:10.1007/s12020-023-03487-7

  • * Reppert SM, Sata M, Reppert SM. Late-onset primary adrenal insufficiency: a review of 30 cases. *Endocr Pract*. 2007;13(4):371-378. doi:10.4158/EP.13.4.371

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