Which of the following is a symptom of Addison's disease?

• A. Weight gain
• B. Hyperpigmentation
• C. High blood pressure
• D. Increased appetite

Answer: (B)

Hyperpigmentation is a classic sign of Addison’s disease because the adrenal glands aren’t producing enough cortisol, which causes higher levels of ACTH. In primary adrenal insufficiency, the pituitary kicks up ACTH to stimulate the adrenals, but since the problem is in the adrenal glands themselves, ACTH stays elevated. ACTH is derived from the same precursor as melanocyte-stimulating hormone, so the excess ACTH stimulates melanocytes and increases melanin production. That leads to darkening of the skin, especially in sun-exposed areas, folds, scars, and mucous membranes.

Other options don’t fit because weight gain, high blood pressure, and increased appetite aren’t typical for Addison’s; in fact, Addison’s often includes weight loss and low blood pressure due to salt-w wasting and cortisol deficiency.