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Addison's disease: Adrenal Insufficiency
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Addison's disease: Adrenal Insufficiency

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DIABETES AND ENDOCRINE SYSTEM

Endocrine System

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When to seek medical advice

If you have severe fatigue, have unintentionally lost weight, feel progressively weaker, experience abdominal pain, have fainting spells and your skin has become darker, see your doctor to determine whether Addison's disease or some other medical condition may be the cause.

Screening and diagnosis

Your doctor will talk to you first about your medical history and your signs and symptoms. If your doctor thinks that you may have Addison's disease, you may undergo some of the following tests:

  • Blood test. Measuring your blood levels of sodium, potassium, cortisol and ACTH gives your doctor an initial indication of whether adrenal insufficiency may be causing your signs and symptoms. A blood test also can measure antibodies associated with autoimmune Addison's disease.

  • ACTH stimulation test. This test involves measuring the level of cortisol in your blood or urine before and after an injection of synthetic ACTH. ACTH signals your adrenal glands to produce cortisol. If your adrenal glands are damaged, the ACTH stimulation test shows that your output of cortisol in response to synthetic ACTH is blunted or nonexistent.

  • Insulin-induced hypoglycemia test. Occasionally, doctors suggest this test if pituitary disease is a possible cause of adrenal insufficiency (secondary adrenal insufficiency). The test involves checking your blood sugar (blood glucose) and cortisol levels at various intervals after an injection of insulin. In healthy people, glucose levels fall and cortisol levels increase.

  • Imaging tests. Your doctor may have you undergo a computerized tomography (CT) scan of the abdomen to check the size of your adrenal glands and look for other abnormalities that may give insight to the cause of the adrenal insufficiency. Your doctor also may suggest a CT scan or magnetic resonance imaging scan of your pituitary gland if testing indicates you have secondary adrenal insufficiency.

Treatment

If you receive an early diagnosis of Addison's disease, treatment may involve taking prescription corticosteroids. Because your body isn't producing sufficient steroid hormones, your doctor may have you take one or more hormones to replace the deficiency. Cortisol is replaced using hydrocortisone (Cortef), prednisone (Deltasone) or cortisone. Fludrocortisone (Florinef) replaces aldosterone, which controls your body's sodium and potassium needs and keeps your blood pressure normal.

You take these hormones orally in daily doses that mimic the amount your body normally would make, thereby minimizing side effects. If you're facing a stressful situation such as an operation, an infection or a minor illness, your doctor may suggest a temporary increase in your dosages. If you're ill with vomiting and can't retain oral medications, you may need corticosteroid injections.

Addisonian crisis
An addisonian crisis is a life-threatening situation that results in low blood pressure, low blood levels of sugar and high blood levels of potassium. This situation requires immediate medical care. Treatment typically includes intravenous injections of:

  • Hydrocortisone

  • Saltwater solution

  • Sugar (dextrose)

 

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Disclaimer

This information is provided for general medical education purposes only and is not meant to substitute for the independent medical judgment of a physician relative to diagnostic and treatment options of a specific patient's medical condition.
In no event will The DrEddyClinic.com be liable for any decision made or action taken in reliance upon the information provided through this web site.

 


 



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Last Modified : 05/14/08 07:36 AM