Addison’s disease

Diagnosis

During a medical evaluation, your doctor will inquire about your medical history and current symptoms. They may also conduct the following tests:

• Blood test. The blood levels of sodium, potassium, cortisol, and adrenocorticotropic hormone (ACTH) can all be determined by this test. Antibodies linked to the autoimmune Addison’s disease can also be measured through a blood test.
• ACTH stimulation test. The adrenal glands are told to produce cortisol by ACTH. This test compares the blood’s cortisol levels before and after receiving an injection of synthetic ACTH.
• Insulin-induced hypoglycemia test. To determine whether the pituitary gland is the root of secondary adrenal insufficiency, this test is carried out. After an insulin injection, the blood sugar and cortisol levels are measured as part of the test.
• Imaging tests. To evaluate the adrenal glands’ dimensions and detect potential problems, a CT scan is performed on the abdominal region. Meanwhile, an MRI is utilized to examine the pituitary gland and diagnose secondary adrenal insufficiency.

Treatment

Addison’s disease is treated with medications. Hormone replacement therapy restores the body’s inadequate production of steroid hormones. Oral corticosteroids are used in some treatments, such as:

• Fludrocortisone acetate to replace aldosterone.
• Hydrocortisone, prednisone or methylprednisolone to replace cortisol. These hormones are administered on a timetable to mimic the variations in cortisol levels the body experiences over the course of a day.

If you have been experiencing symptoms such as diarrhea, participating in intense exercise, or are in a hot environment, your diet may require an increased intake of salt. Additionally, if your body is under stress due to an infection, minor illness, or surgery, your healthcare provider may temporarily increase your medication. In cases where you are experiencing vomiting or have difficulty swallowing medication, you may require corticosteroid injections.

Additional suggestions for therapy include:

• Always bring a medical alert card and bracelet. Emergency personnel can determine the type of care you require by looking at your steroid emergency card and medical alert identification. Have a written action plan as well.
• Always keep spare medications. Even one day without taking your medication can be harmful. Therefore, carry a small supply with you when you travel and at work.
• Bring a glucocorticoid injection kit. In case of emergency, the package includes an injectable form of corticosteroids, a needle, and a syringe.
• Keep in touch with your doctor. Your doctor can keep an eye on your hormone levels. Your doctor may need to alter your medication’s dosage or timing if you’re experiencing side effects.
• Annual health checkups. Consult with your doctor or a hormone-related doctor at least once every year. Annual testing for autoimmune illnesses may be advised by your doctor.

In cases of an Addisonian crisis, it is considered a medical emergency. Typically, intravenous (IV) therapy involves a combination of sugar, saline solution, and corticosteroids.