The symptoms of Addison's
Disease usually begin gradually.
Characteristics of the disease are
- chronic, worsening fatigue
- muscle weakness
- loss of appetite
- weight loss
About 50 percent of the time, one will
notice
Other symptoms include
- low blood pressure that falls further
when standing, causing dizziness or fainting
- skin changes in Addison's disease,
with areas of hyperpigmentation, or dark tanning, covering exposed and
nonexposed parts of the body; this darkening of the skin is most visible
on scars; skin folds; pressure points such as the elbows, knees,
knuckles, and toes; lips; and mucous membranes
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.
Source: NHI |
