Treatment of Addison’s disease generally involves corticosteroid replacement therapy. The medications are taken for life. The corticosteroid medication, which is usually taken orally (by mouth), replaces the cortisol and aldosterone the body is not producing.
Treatment options for Addison’s disease include many medications, usually in the form of tablets, depending on the specific hormones that the body is missing.
The outlook is positive if the corticosteroid replacement therapy is maintained – it is vital that patients follow the doctor’s instructions.
Fast facts on Addison’s disease treatment
Here are some key points about the treatment of Addison’s disease. More detail and supporting information is in the main article.
- Treatment focuses on corticosteroid replacement therapy, usually in the form of tablets once or twice daily.
- Home treatments, including injectable corticosteroids, may be required for emergencies.
- Treatment lasts for the rest of a patient’s life and focuses on managing symptoms.
- Prognosis is good, so long as medications are taken as directed, but regular doctor consultations are required.
The drugs required to effectively treat Addison’s depends on the hormones that are no longer being effectively produced in the adrenal glands.
Some potential medications include the following:
- Hydrocortisone – these tablets replace the missing cortisol. Prednisolone or dexamethasone are prescribed less commonly.
- Fludrocortisone – might be prescribed for missing aldosterone.
- Dehydroepiandrosterone (DHEA) – these pills may be prescribed if there is an androgen (the male sex hormone) deficiency.
Medication side effects
Side effects of hydrocortisone and fludrocortisone: include sleep problems, acne, slow wound healing, dizziness, nausea, and increased sweating.
Side effects of DHEA in women: similar to above but may also include changes in menstrual cycle, developing a deeper voice, and facial hair growth.
The frequency a patient has to take medication depends on their level of hormone deficiency and the severity of their symptoms. As a result, patients will have their treatment program tweaked by a healthcare professional over time.
Because the condition is treated with medications that need to be taken for the rest of a patient’s life, there are several risk factors that need to be considered.
Caution must be exercised when the person with Addison’s disease experiences the following:
- Illness – if the patient becomes unwell, their hormonal levels may be impacted, meaning that their medications may be less effective in alleviating symptoms.
- Surgery – a dysfunction of the adrenal gland is an important consideration during surgery; patients will need to be carefully monitored and have their treatment adjusted during and when recovering from surgery.
- Pregnancy – if a patient becomes pregnant, hormone levels change. During pregnancy, medications may have to be adjusted regularly to be effective.
During times of stress, injury, or infection medication may need to be increased. If the patient suffers from vomiting, the medications might need to be injected.
The patient may also have to add extra salt to their daily diet.
Adrenal crisis is a life-threatening situation where blood pressure and blood glucose levels are dangerously low, and potassium levels are too high.
The patient will require emergency medical treatment, which usually involves intravenous injections of:
- saline solution
- sugar (dextrose)
Adrenal crisis is an emergency and should be treated immediately.
Medical alert bracelet/necklace
Many doctors advise patients to wear a medical alert bracelet or necklace that informs healthcare professionals that they have Addison’s disease; this is especially important for older patients who may be more likely to fall or injure themselves.
Addison’s disease patients do not produce enough cortisol, so when they have an accident or serious injury, medical staff need to know what medication the individual immediately requires (cortisol) to prevent any complications.
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