Addison's Disease - Treatments

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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.

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Comment from: Tracey, 45-54 Female (Patient) Published: January 14

I was diagnosed with Addison's disease 3 months ago after being unwell for months. I was not eating or drinking very much or sleeping. I couldn't think properly, lacked concentration and became very grey looking. My mother died in July and my doctor diagnosed depression as the cause for all my symptoms. When my symptoms worsened I could not even keep a sip of water down or stay sitting up or holding my head up. My whole body ached and I told my doctor I felt I was dying. I was admitted to the hospital where it took 10 days to diagnose Addison's. I had many blood tests and scans during the 3 weeks I was there and began to improve when I was given hydrocortisone and fludrocortisone along with high doses of vitamin D. I have not been able to return to work yet due to extreme fatigue. Over the last two weeks I've been fighting a stomach bug and a very sore throat so they doubled my hydrocortisone which has helped. I'm hoping I will improve and be as well as the text books say Addisonians get after treatment! Either way it's good to know I am not suffering from depression and I am feeling better than I was prior to diagnosis.

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Comment from: Kathy, 25-34 Male (Caregiver) Published: April 23

My son is 34 now, but was 20 when he was diagnosed Addison's disease. The symptoms that stand out the most were fatigue, and a very short temper. That went on for about a year. He had had surgery for a pilonidal cyst about a month before diagnosis, so we both assumed the fatigue, dizziness, lack of appetite, were due to the surgery. But, he wasn"t getting better. I made an appointment with the doctor and my son was put through many tests, to rule out anything else. So, that was almost 15 years ago. He takes cortisone acetate 25 mg twice a day, Eltroxin 50 mcg once a day, and Florinef 0.1 mg once a day. (Cortisone and Synthroid in the morning, and cortisone and Florinef around lunch). Obviously, the medications do their job very well, but, he still suffers from depression, about a 6 on a 1-10 scale. One more rather peculiar, yet interesting thing about his diet is, he likes drinking pickle juice/water, from a jar of pickles. And he can"t get enough Clamato Juice! Perhaps he needs his Florinef dosage adjusted.

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