Treating Adrenal Insufficiency: Replacing What's Missing
Treating Adrenal Insufficiency: Replacing What's Missing
The Basics
Treating adrenal insufficiency involves replacing the hormones your body can't produce. While it's not a cure, proper treatment allows most people to lead normal, healthy lives.
Contents
- Cortisol Replacement: The Main Treatment
- Mineralocorticoid Replacement: For Some Patients
- Adjusting Treatment During Stress
- Monitoring and Adjusting Treatment
Cortisol Replacement: The Main Treatment
The primary treatment for adrenal insufficiency is replacing cortisol with hydrocortisone pills. Most people take these 2-3 times a day to mimic the body's natural cortisol rhythm. Your doctor will work with you to find the lowest dose that relieves your symptoms. It's crucial to take these medications as prescribed and never skip doses.
Mineralocorticoid Replacement: For Some Patients
If you have primary adrenal insufficiency (Addison's disease), you'll also need to replace aldosterone. This is typically done with a medication called fludrocortisone, taken once daily. This helps regulate your body's salt and water balance. People with central adrenal insufficiency usually don't need this medication.
Adjusting Treatment During Stress
Your body normally produces extra cortisol during times of stress or illness. Since you can't do this naturally, you'll need to increase your medication. This might mean doubling or tripling your usual dose during minor illnesses or injuries. For major stresses like surgery, you may need IV steroids. Your doctor will provide specific instructions for these 'stress doses'.
Monitoring and Adjusting Treatment
Regular check-ups are essential to ensure your treatment is working well. Your doctor will ask about your symptoms and energy levels, and may check your blood pressure and weight. Blood tests aren't usually needed for routine monitoring. If you're having persistent symptoms or side effects, your medication doses may need adjustment.
FAQs
How long will I need treatment?
Adrenal insufficiency requires lifelong hormone replacement therapy.
Are there side effects to these medications?
Possible, but minimized by using the lowest effective dose.
What if I forget a dose?
Take it as soon as you remember, unless it's almost time for your next dose.
Can I drink alcohol?
In moderation, but it may affect how your body processes the medication.
Will I need to adjust my treatment during pregnancy?
Yes, your doctor will help you make necessary adjustments.
The Bottom Line
While managing adrenal insufficiency requires ongoing care, most people achieve excellent quality of life with proper treatment.
Additional References
- Bornstein SR, et al. J Clin Endocrinol Metab. 2016;101:364-389.
- Husebye ES, et al. Lancet. 2021;397:613-629.
This article has been reviewed for accuracy by one of the licensed medical doctors working for Doctronic.