Treating Addison’s disease: Medications, side effects, and prognosis

In general, Addison’s disease treatment requires corticosteroid replacement therapy. The medications are taken for life. Corticosteroid treatment typically taken by mouth orally, replaces cortisol and aldosterone, which the body does not produce.

Some drugs, usually in the form of tablets, provide treatment options for Addison’s disease, depending on the particular hormones that are lacking from the body.

If the corticosteroid replacement treatment is retained, the outlook is positive-it is vital that patients obey the orders of the doctor.

Fast facts on Addison’s disease treatment

Here are some key points about Addison’s disease treatment. The main article provides more comprehensive and supporting material.

  • 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.

What medications are available for Addison’s disease?

Addison’s disease affects the adrenal glands.
Addison’s disease affects the adrenal glands.

Addison’s relies on the hormones that in the adrenal glands are no longer developed effectively.

The following are some possible medications:

  • 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 issues with sleep, acne, slow healing of wounds, dizziness, nausea, and increased perspiration.

Side effects of DHEA in women: similar to the above, but may also include menstrual cycle modifications, deeper voice development, and growth of facial hair.

The frequency of medication a patient needs to take depends on their hormone deficiency level and the severity of their symptoms. As a consequence, over time patients will have their treatment programme tweaked by a healthcare professional.

Complications during treatment

Because the disease is treated with drugs that must be used for the remainder of the life of a patient, there are many risk factors that need to be taken into account.

When a person with Addison’s disease experiences the following, caution must be exercised:

  • 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.

The dosage may need to be increased during periods of stress, injury, or infection. The drugs might need to be injected if the patient suffers from vomiting.

The patient may have to add additional salt to their daily diet as well.

Adrenal crisis (Addisonian crisis) treatment

The adrenal crisis is a life-threatening condition where there is a dangerously low level of blood pressure and blood glucose and too high a level of potassium.

The patient will need medical emergency therapy, typically requiring intravenous injections of:

  • hydrocortisone
  • saline solution
  • sugar (dextrose)

The adrenal crisis is an emergency and should be urgently handled.

Medical alert bracelet/necklace

Many physicians encourage patients to wear a bracelet or necklace that informs healthcare providers that they have the disease of Addison; this is particularly important for elderly patients who may be more likely to fall or harm themselves.

Patients with Addison’s disease do not produce enough cortisol, so medical personnel need to know what drug the person urgently needs (cortisol) to avoid any complications when they have an accident or serious injury.

Read more about Addison’s disease:

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