Addison’s disease and stress.

Addison’s disease occurs due to failure of the adrenal glands to produce sufficient amounts of the hormones, cortisol and aldosterone. … Cortisol affects how the body responds to stress and is released in greater quantities when a person is under stress.

Signs & Symptoms

The symptoms of Addison’s disease can vary from one individual to another. Symptoms usually develop slowly over time and are usually vague and common to many conditions (nonspecific). This often leads to delays in the proper diagnosis of Addison’s disease. In rare cases, the symptoms of Addison’s disease can develop rapidly causing a condition called acute adrenal failure.
Fatigue is the most common symptom of Addison’s disease. Another common initial symptom of Addison’s disease is the development of patches of skin that are darker than the surrounding skin (hyperpigmentation). This discoloration most commonly occurs near scars, by skin creases such as the knuckles, and on the mucous membranes such as the gums. Skin abnormalities can precede the development of other symptoms by months or years, but do not occur in every person.
Some individuals with Addison’s disease may also develop a condition called vitiligo in which white patches may appear on different areas of the body. This may vary from one or two small spots on the skin or multiple, larger affected areas. Black freckles may develop on the forehead, face or shoulders in some cases.
A variety of gastrointestinal symptoms may be present including nausea, vomiting, and abdominal pain. Diarrhea is less common, but may also occur. Affected individuals may have a poor appetite and unintentional weight loss and may develop progressive fatigue and muscle weakness. Muscle pain (myalgia), muscle spasms and joint pain may also occur. Dehydration can also affect individuals with Addison’s disease.
An additional symptom that may occur is low blood pressure (hypotension), which can cause lightheadedness or dizziness upon standing. Temporary loss of consciousness (syncope) can occur in some cases. Addison’s disease can also lead to changes in emotion and behavior. The disorder has been associated with irritability, depression, and poor concentration.
Individuals with Addison’s disease may have cravings for salt or salty foods and low blood sugar (glucose) levels. Women with Addison’s disease may have irregular menstrual periods, lose body hair and have a decreased sexual drive.
In some cases, symptoms of Addison’s disease may appear suddenly, a condition called acute adrenal failure or an addisonian crisis. During an addisonian crisis, affected individuals may develop a sudden loss of strength; severe pain in the lower back, abdomen or legs; vomiting and diarrhea potentially causing dehydration; and low blood pressure and loss of consciousness. An addisonian crisis is a medical emergency that can cause life-threatening complications such as shock or kidney failure if not treated. A crisis is usually set off when affected individuals are under stress such as during an accident, trauma, surgery or severe infection.

Musculoskeletal conditions.

There are about 200 different musculoskeletal conditions, which fall into five main groups:

Inflammatory arthritis
Arthritis literally means inflammation within the joint itself. Inflammation is part of your body’s healing process. It normally occurs as a defence against viruses and bacteria or as a reaction to injuries such as a burn.
But in people with this type of arthritis, inflammation often occurs for no obvious reason. This is referred to as an autoimmune condition and means that the immune system is attacking your joints. Instead of helping to repair the body, inflammation can cause damage to the affected joint and cause pain and stiffness.
Inflammation may also affect the tendons and ligaments surrounding the joint.
Inflammatory types of arthritis often affect several joints. Rheumatoid arthritis, which is a common example, is a systemic illness that mainly affects the joints. As well as joint pain and swelling, other symptoms of rheumatoid arthritis can include:
•tiredness
•depression

•irritability

•flu-like symptoms.

There are about 200 different musculoskeletal conditions, which fall into five main groups:

Inflammatory arthritis

Arthritis literally means inflammation within the joint itself. Inflammation is part of your body’s healing process. It normally occurs as a defence against viruses and bacteria or as a reaction to injuries such as a burn.

But in people with this type of arthritis, inflammation often occurs for no obvious reason. This is referred to as an autoimmune condition and means that the immune system is attacking your joints. Instead of helping to repair the body, inflammation can cause damage to the affected joint and cause pain and stiffness.

Inflammation may also affect the tendons and ligaments surrounding the joint.
Inflammatory types of arthritis often affect several joints. Rheumatoid arthritis, which is a common example, is a systemic illness that mainly affects the joints. As well as joint pain and swelling, other symptoms of rheumatoid arthritis can include:

•tiredness
•depression

•irritability

•flu-like symptoms.

A joint badly affected by rheumatoid arthritis

There are many other forms of inflammatory arthritis, including:
•ankylosing spondylitis
•psoriatic arthritis

•reactive arthritis.

Degenerative or mechanical arthritis

Degenerative arthritis is a group of conditions where the main problem is damage to the cartilage which covers the ends of the bones.
Normally the smooth, slippery cartilage helps the joints to move smoothly. In this type of arthritis the cartilage becomes thinner and rougher, and the bone underneath then tries to repair this damage but sometimes overgrows, altering the shape of the joint. This is known as osteoarthritis.
Osteoarthritis is more common in older people and particularly affects the joints that get heavy use, like hips and knees. It also often affects the base of the thumb and big toe joint.
Osteoarthritis can result from damage to the joint, for example a fracture or previous inflammation in that joint.
A joint that has been deformed by severe osteoarthritis
Soft tissue musculoskeletal pain
Soft tissue musculoskeletal pain is often felt in tissues other than your bones and joints. Typically it will come from the muscles or soft tissues supporting the joints, including the bursa, which can sometimes become inflamed.
You may find this type of pain is localised to one particular part of the body following an injury or overuse. You might find that the pain is more widespread and, if associated with other symptoms, a diagnosis of fibromyalgia may be made. Often the causes of these symptoms are not fully understood.
Back pain
Back pain is a very common problem that has a number of different causes. Pain can come from:
•muscles
•discs

•ligaments

•bones

•joints.

It may even be caused by problems with other organs inside your body. This is known as ‘referred pain’. 

Sometimes there’s a specific cause, such as the degenerative condition osteoarthritis. This is often known as spondylosis when it happens in the spine.

Sometimes back pain may be caused by a ‘slipped’ disc. The disc itself doesn’t really slip but the central part of the disc bulges through the outer ring. This more commonly causes pain in a limb, though.
Osteoporosis (thinning of the bones) can cause sudden back pain if one of the bones in the spine crunches down.
In most cases it isn’t possible to identify the exact cause of the pain, and doctors often describe this as non-specific or simple back pain.

Connective tissue diseases (CTD)
Connective tissues support, bind together or separate other body tissues and organs. They include:

•tendons
•ligaments

•cartilage.

Joints are usually involved in CTD, but there may also be inflammation in other tissues such as the:

•skin
•muscles

•lungs

•kidneys.

You may therefore feel a range of other symptoms besides painful joints. 

Examples of CTD include lupus (SLE), scleroderma (systemic sclerosis) and dermatomyositis.

Your healthcare team will often include different specialists along with your GP because these diseases often affect many organs.

What PTSD is.

Post Traumatic Stress Disorder (PTSD) is an anxiety disorder which may develop following exposure to any one of a variety of traumatic events that involve actual or threatened death, or serious injury.

The event may be witnessed rather than directly experienced, and even learning about it may be sufficient if the persons involved are family members or close friends. Sufferers may experience flashbacks, panic attacks and heightened awareness. PTSD is sometimes found in ex-military personnel who have been involved in conflict situations.

Chest infection.

The main symptoms of a chest infection can include:

•a persistent cough.

•coughing up yellow or green phlegm (thick mucus), or coughing up blood.

•breathlessness or rapid and shallow breathing.

•wheezing.

•a high temperature (fever)

•a rapid heartbeat.

•chest pain or tightness.

•feeling confused and disorientated.

Anyone can have a chest infection, and they are common after having a cold or flu, especially in the autumn and winter.

The two main types of chest infection in adults are acute bronchitis and pneumonia.
A chest infection is often mild and will clear up on its own, but in some adults it may be serious enough to require urgent medical treatment.

Causes of avascular Necrosis.

Symptoms

Many people have no symptoms in the early stages of avascular necrosis. As the condition worsens, your affected joint may hurt only when you put weight on it. Eventually, the joint may hurt even when you’re lying down.

Pain can be mild or severe and usually develops gradually. Pain associated with avascular necrosis of the hip may be focused in the groin, thigh or buttock. In addition to the hip, the areas likely to be affected are the shoulder, knee, hand and foot.
Some people develop avascular necrosis bilaterally — for example, in both hips or in both knees.

When to see a doctor
See your doctor if you have persistent pain in any joint. Seek immediate medical attention if you believe you have a broken bone.
Causes

Avascular necrosis occurs when blood flow to a bone is interrupted or reduced. Reduced blood supply can be caused by:

Joint or bone trauma. An injury, such as a dislocated joint, might damage nearby blood vessels. Cancer treatments involving radiation also can weaken bone and harm blood vessels.
Fatty deposits in blood vessels. The fat (lipids) can block small blood vessels, reducing the blood flow that feeds bones.

Certain diseases. Medical conditions, such as sickle cell anemia and Gaucher’s disease, also can cause diminished blood flow.

Diet and anemia.

Diets high in red meat, dark leafy vegetables, dried fruits and nuts, iron-fortified cereals, or bread can help treat or prevent iron deficiency. Foods high in iron include: meat, such as lamb, pork, chicken, and beef. beans, including soybeans.

Sources of iron in the diet

The amount of iron we need depends on our age and sex. The best sources of iron come from animal products – mainly red meat. However, we get a good proportion of iron from non-animal sources too.

Iron sources include:
Red meat and offal – eg, beef, lamb, pork, kidneys, liver, heart, black pudding (note pregnant woment should avoid liver).
Fish and shellfish – eg, sardines, pilchards, crab, anchovies, shrimps, mussels.

Eggs.

Cereal and cereal products – eg, bread, Rice Krispies corn flakes, Weetabix, Ready Brek, Special K Shreddies, bran flakes, Cheerios, oatcakes, rye crispreads.

Nuts and seeds – eg, hazelnuts, macadamia nuts, peanuts, pecans, walnuts, sesame seeds, sunflower seeds, pine nuts.

Green leafy vegetables – eg, broccoli, spinach, watercress, kale.

Beans and pulses – eg, baked beans, peas, lentils, chickpeas, black-eyed beans, kidney beans.

Dried fruit – eg, raisins, apricots, prunes, currants, figs.

Miscellaneous – eg, plain (dark) chocolate, cocoa powder, mango chutney, cherries in syrup, gingernut biscuits, pastry, curry powder.

Small amounts of haem iron are found in game and poultry – eg, pheasant, venison, rabbit, chicken, turkey.

Having vitamin C with iron-rich foods will help to absorb the iron more easily. Serve up meals with plenty of vegetables and fruit or have glass of orange juice with your meal.

Eating meat at meal times can also help to absorb the iron from non-animal sources. 
Avoid drinking tea with meals as this can actually reduce the amount of iron that is absorbed. Raw wheat bran can also interfere with the absorption of iron so this should be avoided.

Stress.

Stress is the feeling of being under too much mental or emotional pressure, and pressure turns into stress when you feel unable to cope.

What is stress?

We all know what it’s like to feel stressed, but it’s not easy to pin down exactly what stress means. When we say things like “this is stressful” or “I’m stressed”, we might be talking about:

Situations or events that put pressure on us – for example, times where we have lots to do and think about, or don’t have much control over what happens.
Our reaction to being placed under pressure – the feelings we get when we have demands placed on us that we find difficult to cope with.

There’s no medical definition of stress, and health care professionals often disagree over whether stress is the cause of problems or the result of them. This can make it difficult for you to work out what causes your feelings of stress, or how to deal with them. But whatever your personal definition of stress is, it’s likely that you can learn to manage your stress better by:

managing external pressures, so stressful situations don’t seem to happen to you quite so often
developing your emotional resilience, so you’re better at coping with tough situations when they do happen and don’t feel quite so stressed

You might find that your first clues about being stressed are physical signs, like tiredness, headaches or an upset stomach.

This could be because when we feel stressed emotionally, our bodies release hormones called cortisol and adrenaline. This is the body’s automatic way of preparing to respond to a threat (sometimes called the ‘fight or flight’ response). If you’re often stressed then you’re probably producing high levels of these hormones, which can make you feel physically unwell and could affect your health in the longer term.

Anxiety attack symptoms.

Anxiety Attack Symptoms
Symptoms of an anxiety attack:
Anxiety attacks can feel awful, intense, and frightening. Because they can be powerful experiences, it can seem like anxiety attacks are out of our control.
Those who experience anxiety attacks quickly learn that they can be highly unpleasant experiences. Even so, anxiety attacks and their symptoms can be successfully addressed with the right information, help, and support. No one needs to suffer needlessly. More on this in a moment.

What do anxiety attack symptoms feel like?
Symptoms of an anxiety attack can include:
•A feeling of overwhelming fear
•Feeling of going crazy or losing control

•Feeling you are in grave danger

•Feeling you might pass out

•A surge of doom and gloom

•An urgency to escape

•Dizziness

•Heart Palpitations

•Trembling

•Sweating

•Shortness of breath

•Chest pressure or pain

•Turning pale

•Feeling detached from reality

•Weak in the knees

•Burning skin

•Pins and needles

•Hot and cold flushes

•Numbness and tingling sensations

The above anxiety attack symptoms can be accompanied by:

•Choking sensation, tightening throat, it feels like your throat is closing, it feels like something is stuck in your throat
•Confusion

•Depersonalization (feeling detached from reality, separate from one-self, separate from normal emotions)

•Derealization (feeling unreal, in a dream-like state)

•Dizziness, lightheadedness, unsteadiness

•Emotional distress

•Emotional upset

•Inability to calm yourself down

•Knot in the stomach, tight stomach

•Nausea

•Panicky feeling

•Pounding, racing heart

•Butterflies in the stomach

•Sudden urge to go to the bathroom (urinate, defecate)

•Vomiting

•Feel like crying

This list is not exhaustive. As you can see, there are many physical, psychological, and emotional signs and symptoms of anxiety attacks. For a more comprehensive list of anxiety symptoms and descriptions of what they feel like, visit our anxiety symptoms list..

There is a long list of signs and symptoms of an anxiety attack. But because each body is somewhat chemically unique, anxiety attacks can affect each person differently. Consequently, anxiety attack symptoms can vary from person to person in type or kind, number, intensity, duration, and frequency. If your symptoms don’t exactly match this list, that doesn’t mean you don’t have anxiety attacks. It simply means that your body is responding to them slightly differently.
For example, one person may experience only a few minor signs and symptoms of an anxiety attack, while another person may experience all of them and to great severity. All combinations and variations are common.
Because there are many medical conditions that can cause anxiety attack signs and symptoms, such as the strong sensations and feelings associated with anxiety attacks, it’s wise to discuss them with your doctor. If your doctor has attributed your anxiety attacks to stress and anxiety, you can feel confident that your doctor’s diagnosis is correct. Anxiety attacks and their signs and symptoms are relatively easy to diagnose and aren’t easily confused with other medical conditions.

Anxiety headaches.

Anxiety headache description:

You have headaches or frequent headaches that feel like a tension, pressure, tight band around your head, shooting pain(s) in your head and/or face, and/or stabbing pain in the head. It also may feel like your head is ‘frozen,’ ‘thick,’ ‘numb,’ and/or many other odd aches, pains, feelings, and sensations.
Some people describe anxiety headaches as feeling like they have an odd pressure in their head or that their head feels like it is about to explode.

Anxiety headaches and migraines may occur as a response to feeling anxious or stressed, or may occur for no apparent reason.
Anxiety headaches can be mildly noticeable, moderately bothersome, or greatly problematic. They can occur rarely, frequently, or persistently, and may change from day to day and even moment to moment.
Anxiety headaches are also associated with migraine headaches.
All combinations and variations of the above are common.
What causes anxiety headaches?
There are four types of headache: vascular, muscle contraction (tension), traction, and inflammatory. 
Behaving in an anxious manner activates the body’s stress response. The stress response stresses the body. Muscle contraction headaches are commonly caused by stress, including the stress caused by being overly anxious.
Stress causes muscles to contract, and therefore, tighten. This can include the many muscle groups in the head, face, neck, and shoulders. Chronic stress can cause persistent muscle tension, and even muscle spasms (involuntary sudden muscle contractions).
When muscles remain tense, they can become painful, which is a common reason for stress-related headaches, head “pressures,” and feeling like you have a “tight band around your head.”
Tight muscles can also spasm, which is a common cause of stabbing and shooting pains in the head and face.
A common type of vascular headache is a migraine. While there are many causes for migraine headaches, stress, including the stress caused by being anxious, can also cause them.

Because there are many medical conditions that can cause anxiety and anxiety-like sensations and symptoms, including this one, we recommend that all new, changing, persistent, and returning symptoms be discussed with your doctor. If your doctor concludes that your sensations and symptoms are solely stress related (including anxiety-caused stress), you can be confident that there isn’t another medical reason for them. Generally, most doctors can easily tell the difference between stress- and anxiety-caused sensations and symptoms from those caused by other medical conditions.

If you are uncertain about your doctor’s diagnosis, however, you may want to seek a second and even third opinion. But if all three opinions concur, you can be assured that stress (including the stress that being overly anxious can cause) is the cause of your sensations and symptom, including this one, and not some other medical or biological problem.
How to get rid of anxiety caused headaches?
Because anxiety headaches are caused by the stress of behaving in an overly apprehensive manner, you can eliminate them by changing your behavior to a less anxious approach and reducing your body’s stress overall. As your body’s stress diminishes, so should your anxiety headaches. Keep in mind that it can take up to 20 minutes or more for the body to recover from a major stress response. But this is normal and shouldn’t be a cause for concern.
When your headaches are caused by persistently elevated stress, it may take a lot more time for your body to calm down and to the point where your headaches are eliminated.
Nevertheless, when your body’s stress has been sufficiently reduced, anxiety headaches, including anxiety-caused migraine headaches, should completely disappear.
You can speed up recovery time by reducing your stress, practicing relaxed breathing, increasing your rest and relaxation, and not worrying about your headaches.

Iron infusions.

The side effects of IV iron are usually minimal, but may include the following: bloating or swelling of the face, arms, hands, lower legs, or feet. dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position. gastrointestinal pains, including nausea and cramps.

What is intravenous iron supplementation?

Intravenous (IV) iron supplementation is a method of delivering iron by infusion with a needle into a vein. (Medication that is given intravenously is called parenteral therapy.)
Who receives intravenous iron supplementation?
Patients who receive IV iron usually do so because they cannot take oral iron. These include the following:
•patients who are bleeding in the gastrointestinal (GI) tract (the gut) and need to replace iron quickly (IV iron is absorbed by the body more rapidly than oral iron.);
•patients who have inflammatory bowel disease (diseases of the intestines that cause pain, diarrhea, and weight loss), and cannot take oral iron because it upsets their GI tract;

•patients who are on kidney dialysis, who often lose blood during dialysis. In addition, these patients are usually taking an ESA and may need extra iron.

•patients with iron-deficiency anemia who are having high blood loss surgery (> 500 ml) within the next 2 months and need to replace iron quickly (IV iron is absorbed by the body more rapidly than oral iron.);

•patients with celiac disease (gluten intolerance);

•cancer patients who have anemia and are taking an ESA.

How is intravenous iron given?

Intravenous iron is delivered into the patient’s vein through a needle. The procedure takes place in a doctor’s office or a clinic and may take up to several hours, depending on which treatment the physician has prescribed. The patient usually receives iron injections over the course of several visits until his or her iron levels are correct.
What are the side effects of intravenous iron?
The side effects of IV iron are usually minimal, but may include the following:
•bloating or swelling of the face, arms, hands, lower legs, or feet
•dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position

•gastrointestinal pains, including nausea and cramps

•problems with breathing

•skin problems, including rash

•chest pain

•low blood pressure

•anaphylaxis (a severe reaction that can include difficulty breathing, itching, or a rash over the entire body)