Living with Addison's disease
People with Addison's disease need to take daily steroid medication to replace the lost hormones. Most are then able to live an active life, although many people find they still need to manage their fatigue.
In some cases, the underlying causes of Addison's disease can be treated. For example, tuberculosis (TB) is treated with a course of antibiotics over a period of at least 6 months.
However, most cases are caused by an immune system problem that cannot be cured.
Medication for Addison's disease
Treatment usually involves corticosteroid replacement therapy for life. Corticosteroid medication is used to replace the cortisol and aldosterone that the adrenals no longer produce. It's usually taken in tablet form 2 or 3 times a day.
In most cases, hydrocortisone is used to replace the cortisol. Other possible medicines are prednisolone or dexamethasone, although these are less commonly used.
Aldosterone is replaced with a medication called fludrocortisone. Sometimes extra salt is recommended in the daily diet. If a patient feels the urge to eat something salty, then they should eat it.
In general, the medications used for Addison's disease don't have side effects, unless the dose is too high. Overdose for a long time risks osteoporosis, mood swings and insomnia.
Living with Addison's disease
Many people with Addison's disease find that taking their medication enables them to continue with their normal diet and exercise routines.
However, bouts of fatigue are also common, and it can take some time to learn how to manage these periods of low energy.
Some people find that needing to take regular doses of medication is restrictive and affects their daily life or emotional health. Missing a dose of medication, or taking it late, can also lead to exhaustion or insomnia.
Some people can develop associated health conditions, such as diabetes or hypothyroidism, which require extra treatment and management.
- keep spare medication as necessary – for example, in the car or at work, and to always carry some spare medication
- take the medication every day at the right time
- pack extra medication if they are going away – usually double what they would normally need, plus the emergency injection kit
- carry medication in hand luggage if travelling by plane, with a note from the doctor explaining why it is necessary
- wear a medical alert bracelet
After a serious accident, such as a car crash, a healthy person produces more cortisol. This helps cope with the stressful situation and additional strain on the body that results from serious injury. If body cannot produce cortisol, an emergency hydrocortisone injection is needed to replace it and prevent an adrenal crisis.
At certain times, the medication may need to be temporarily increased. For example:
- an operation, dental or medical procedure
- an illness or infection – particularly if there is a high temperature of 38C or above
- an accident, such as a car crash
- strenuous exercise that's not usually part of daily life
Over time, patients get used to the condition and learn what can trigger the symptoms, and how to adjust the medication themselves. An experienced patient can often advise a dentist on their best dose adjustments. Remember that extractions and major dental surgery should be done in secondary care, under IV or IM hydrocortisone injection.
Contains public sector information licensed under the Open Government Licence v3.0.