In this Article

• What is Addison's disease?
• How does Addison's disease occur?
• What is cortisol?
• How is cortisol regulated?
• What is aldosterone?
• What causes Addison's disease?
• Primary adrenal insufficiency
• Polyendocrine deficiency syndrome
• Tuberculosis
• Other causes
• Secondary adrenal insufficiency
• What are the signs and symptoms of Addison's disease?
• How is Addison's disease diagnosed?
• How is Addison's disease treated?
• Surgery
• Pregnancy?
• Patient education
• For more information
• Patient Discussions: Addison's Disease - Symptoms At Onset Of Disease
• Addison Disease Glossary
• Addison Disease Index

How is Addison's disease treated?

Treatment of Addison's disease involves replacing, or substituting, the hormones that the adrenal glands are not making. Cortisol is replaced orally with hydrocortisone tablets, a synthetic glucocorticoid, taken once or twice a day. If aldosterone is also deficient, it is replaced with oral doses of a mineralocorticoid called fludrocortisone acetate (Florinef), which is taken once a day. Patients receiving aldosterone replacement therapy are usually advised by a doctor to increase their salt intake. Because patients with secondary adrenal insufficiency normally maintain aldosterone production, they do not require aldosterone replacement therapy. The doses of each of these medications are adjusted to meet the needs of individual patients.

During an addisonian crisis, low blood pressure, low blood glucose, and high levels of potassium can be life threatening. Standard therapy involves intravenous injections of hydrocortisone, saline (salt water), and dextrose (sugar). This treatment usually brings rapid improvement. When the patient can take fluids and medications by mouth, the amount of hydrocortisone is decreased until a maintenance dose is achieved. If aldosterone is deficient, maintenance therapy also includes oral doses of fludrocortisone acetate.

Surgery

Patients with chronic adrenal insufficiency who need surgery with general anesthesia are treated with injections of hydrocortisone and saline. Injections begin on the evening before surgery and continue until the patient is fully awake and able to take medication by mouth. The dosage is adjusted until the maintenance dosage given before surgery is reached.

Pregnancy

Women with primary adrenal insufficiency who become pregnant are treated with standard replacement therapy. If nausea and vomiting in early pregnancy interfere with oral medication, injections of the hormone may be necessary. During delivery, treatment is similar to that of patients needing surgery; following delivery, the dose is gradually tapered and the usual maintenance doses of hydrocortisone and fludrocortisone acetate by mouth are reached by about 10 days after childbirth.

Addison's Disease - Symptoms At Onset Of Disease

The MedicineNet physician editors ask:

The symptoms of addison's disease can vary greatly from patient to patient. What were your symptoms at the onset of your disease?

Anonymously share your comment to help others.
See 12 Viewer Comments

Submit Your Comment

From the Doctors at MedicineNet.com

Antinuclear Antibody Test - Read about antinuclear antibodies (ANAs), unusual antibodies that can bind to certain structures within the nucleus of the cells, are found in patients whose immune system may be predisposed to cause inflammation against their own body tissues. ANAs are indicative of the potential presence of an autoimmune illness. Source:MedicineNet Low Blood Pressure - Learn about low blood pressure (hypotension). Low blood pressure is blood pressure below normal and symptoms may include: lightheadedness, dizziness, fainting upon standing (orthostatic hypotension). There are many causes of low blood pressure, and treatment is dependant upon the cause. Source:MedicineNet Hyperkalemia - Learn about hyperkalemia, a condition caused by abnormally high levels of potassium in the blood. Symptoms include nausea, fatigue, muscle weakness, and tingling sensations. Causes, diagnosis, and treatment options are also included in the information. Source:MedicineNet Read 30 more Addison Disease related articles ... So Much to Do, So Little Sleep Head Injuries All Too Common in Summer Play Health Tip: The Word on Wisdom Teeth Health Tip: Make Exercise a Daily Habit New Source of Heart Stem Cells Found Health Highlights: June 23, 2008 Poorer Patients Have Poorer Survival After Cancer Diagnosis One Gene May Be Key to Myeloma Crocodile Babies Cry Out for Hatching Immune Molecule Key to Preventing Organ Rejection