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  • Is hyperpigmentation is Addison's disease reversible?

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    Old 12-05-2009, 12:33 AM   #1
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    Is hyperpigmentation is Addison's disease reversible?

    Hi all,

    Hoping someone on this board can perhaps help me with a question.

    First off, I've never been tested for Addison's disease, and from my recent googling, I see that it is quite rare, so I'm not jumping to any conclusions that this is actually what's going on with me.

    I have very noticeable hyperpigmentation that started to develop about two years ago. This is at least when friends of mine began commenting on how tan I was. In the past 6 months the skin darkening has become very noticeable and honestly weird looking... I look tanorexic! At least a couple times a week someone will ask me if I've been on vacation. Basically, I have what looks like an overall deep and uneven tan. There are areas on my neck, lower back, chest and elbows that look more dirty than tan, and I have some scars with severe hyperpigmentation surrounding the scars, and several scars on my lower legs that have become almost black.

    Basically in the past two years my skin has changed from looking healthily, though unseasonably, tanned, to absurdly tanned, to looking like I have a skin disease. Make-up helps a lot, but I've become almost debilitatiingly self-conscious. My point is that is that I am very distressed about this from a cosmetic perspective and am desperate to find out what is causing it and if it can be treated.

    My bigger question is (finally...sorry for being so long-winded), when hyperpigmentation is caused by Addison's disease, is it reversible when the disease is treated? When the lacking hormones are replaced with medication, do the skin symptoms resolve?

    I have been waiting to see a dermatologist for 6 weeks now and have another two weeks to wait (my insurance is pretty bad and I can only see drs. at certain patient centers.) I am hoping that the dermatologist will refer me to an endocrinolgist for testing. From my obsessive googling on hyperpigmentation I have found another fairly rare disease called hemochromatosis that causes generalized hyperpigmentation. Are there any other explanations that people know of?? alternate diagnoses that a dr. would consider when they see skin darkening like this?

    I also have some of the other physical signs that present with Addison's, though I'm totally aware that these are all very general things, and not specific to Addison's. None of these are severe enough alone that I would seek medical help, but I guess they're worth mentioning to the dermatologist in light of the hyperpigmentation problem:

    - very low blood pressure (this could just mean I'm healthy!)
    - frequent dizzy spells when standing up (have always had this)
    - unintentional weight loss- i'm 5'2", about 103lbs (could be stress)

    - history of thyroiditis/hyperthyroidism (I no longer have this)
    - tachycardia

    Sorry for writing such a long post!! I doubt anyone's going to actually read this now. hehee. But seriously, anyone's experiences/feedback will be immensely appreciated. I've never posted a question like this online, but I'm just feeling devastated by how I am looking and am desperate for some answers.

    Many, many thanks

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    Old 12-06-2009, 10:13 AM   #2
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    Re: Is hyperpigmentation is Addison's disease reversible?

    I have addison's and had all the symptoms you have mentioned plus some others- the most notable were extreme fatigue, balace issues from very low blood pressure with a few falls, intolerance to heat and cold, and no tolerance for stress. Anything that stresses the body needs the body to produce cortisone and I wasn't producing enough to handle normal body stressors. I would ask to be referred to an endocrinologist for testing, but may need a referral from your primary doc. The symptoms tend to get worse as time goes on if treatment is needed and not started. My daughter also has adrenal insufficiency/most likely the beginning of addison's and is seeing an endo for frequent monitoring but has not started hydrocortisone yet. We both have hashimoto's throiditis and take thyroid repacement medication. This was also picked up by the endo.
    My iron levels have recently been high so I was tested for hemochromatosis but have one gene and apparently need two.
    A third thing which can cause a tanning effect is too much vitamin A or betacarotene.
    Last year I was drinking a lot of carrot juice and my overall increased tanning was very noticable. People were asking if I had gone on a winter vacation to a southern climate. This type of tan has an orange, reddish tint.
    My betacarotene levels were three times the normal range but vitamin A levels were normal. The high betacarotene levels won't hurt you, but docs told me to stop drinking the carrot juice. I was told by my endo that vitamin A/betacarotene is not metabolized as it should be if you have thyroid issues so it will accumulate at a more rapid rate and that I need to watch the amount of foods and vitamins that I take containing vitamin A and betacarotene. She also said she wishes her intern had been with her the day she saw me, as she doesn't see the beta carotene tan very often. I already had my test results when I saw her so she knew the increased tanning was beta carotene.
    In answer to your question, the tan from addison's did fade after I was on hydrocortisone, fludrocortisone, and DHEA for a while. It got worse with the carrot juice but for a different reason and now has faded again but I still look very lightly tanned, a very natural look and close to my original skin tone.
    I do wear sunscreen and a hat with visor or rim and don't stay out in the sun very long as I still tan from the sun very easily as I always have.
    Hope this helps.

    Old 12-06-2009, 07:25 PM   #3
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    Re: Is hyperpigmentation is Addison's disease reversible?

    Thank you, it really does help. Whatever is doing this to my skin, I just hope it's something that can be diagnosed and treated. I'm getting really sick of the accusatory: have you been going to a tanning salon? Silly for me to need reassurance of this when, again, I have yet to even consult a dr. in person.

    In retrospect I definitely should have asked my primary care dr. to refer me to an endo rather than a dermatologist, and in light of my thyroid history he probably would have been happy to over the phone. That will be by next step...My current insurance stinks and it seems to be a two month+ wait to see any kind of specialist.

    My thyroid function is normal as of the last time I had it tested-- I had a partial thyroidectomy when I was 27 (4 yrs ago) and it actually did the trick. It didn't make me hypothyroid either, so I was lucky in that respect. The way I've been physically feeling for the past 6 mos. FEELS like Graves disease though.. wiped out, heart pounding and losing weight. The only difference now is that a rarely have an appetite, where as with Graves I was eating every morsel that crossed my path! I'm also finding myself crouching and grabbing onto the furniture a few times a day because I'm so dang lightheaded/dizzy.

    I can't even remember the last time I ate a carrot (errr...) so I don't think it's a beta carotene tan. But I guess I won't know anything until I go see a dr other than just speculating on my own. And I am rambling now.

    Old 12-06-2009, 10:12 PM   #4
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    Re: Is hyperpigmentation is Addison's disease reversible?

    Originally Posted by robine27 View Post
    .... and no tolerance for stress. Anything that stresses the body needs the body to produce cortisone and I wasn't producing enough to handle normal body stressors.
    Hi Robine,

    Also, I'm really curious, can you explain a little what the "no tolerance" for stress in Addison's disease feels like? Sorry.. hope that isn't too abstract of a question.

    It's just so depressing... with the weight loss and the dark skin I look like I've aged a decade. I look like a female, mildly anorexic version of George Hamilton. Between my distress about my skin and with the long wait to see a dr. I've taken up the new hobby in the past two weeks of trying to diagnosis myself. I'm sure that's apparent from my rambling.

    My new theory, as of 5 minutes ago, is that I may just be hyperthyroid again, and just did a search for hyperthyroidism and hyperpigmentation and found that skin darkening can in fact be a symptom of thyroid issues. I'd never heard of that before. Two possible contradictions with my new theory are that it seems unlikely that I could be hyperthyroid with half of my thyroid removed, and the fact that I have little appetite. who knows.

    Thank you again for your 1st response. What I really need is to just take a deep breath and try really to handle this like a responsible, non-melodramatic, patient adult.

    Old 04-07-2010, 04:27 PM   #5
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    Re: Is hyperpigmentation is Addison's disease reversible?

    I was very tan when I was first diagnosed with Addisons Dz, all over tan, and the creases in my hands were dark also,,,but after I got on medication it went away,,,so don't worry, IF you have Addisons and get treated, it will probably fade,,,then you'll look pale and washed out like I do now,,,

    Old 04-14-2010, 02:33 PM   #6
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    Re: Is hyperpigmentation is Addison's disease reversible?

    I had all of your symptoms and then some. I got so sick of people asking me if I had been on vacation or my friends insisting that I must be using a tanning booth that I blurted out "well, maybe I have some weird disease that makes you tan" and then she said "and skinny". I never thought that such a thing existed. A couple of weeks later I was near death and, thankfully, diagnosed. It turns out you can be too tan and too thin. I am now neither one though I would say my skin is a nice tan color. I don't use self tanner anymore (no need) and my foundation is at least two shades deeper than it was when I was healthy, pre Addisons. I have heard that thyroid can cause you to look orange. I was definatley the George Hamilton brown. I think that going to see a derm is good but I'd get an appt with an endo or good primary care doc who can order a panel of tests for you. I wouldn't be surprised if you were on the right track with all your research. Good luck.

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