Diagnosis

Your health care provider will talk to you about your medical history and your symptoms. You might have some of the following tests:

  • Blood test. This test can measure blood levels of sodium, potassium, cortisol and adrenocorticotropic hormone (ACTH). A blood test also can measure antibodies related to autoimmune Addison's disease.
  • ACTH stimulation test. ACTH tells the adrenal glands to make cortisol. This test measures the level of cortisol in the blood before and after a shot of human-made ACTH.
  • Insulin-induced hypoglycemia test. This test is done to find out if the pituitary gland is causing secondary adrenal insufficiency. The test involves checking blood sugar and cortisol levels after a shot of insulin.
  • Imaging tests. A CT scan of the stomach area checks the size of the adrenal glands and looks for other issues. An MRI of the pituitary gland can test for secondary adrenal insufficiency.

Treatment

Medicines are used to treat Addison's disease. Hormone replacement therapy corrects the levels of steroid hormones the body isn't making enough of. Some treatments include oral corticosteroids such as:

  • Hydrocortisone (Cortef), prednisone (Rayos) or methylprednisolone (Medrol) to replace cortisol. These hormones are given on a schedule to act like the changes in cortisol levels the body goes through over 24 hours.
  • Fludrocortisone acetate to replace aldosterone.

You likely need plenty of salt in your diet. This is especially true during heavy exercise, when the weather is hot or if you have digestive upsets, such as diarrhea.

Your health care provider may increase your medicine for a short time if your body is stressed. Such stress can come from having surgery, an infection or a minor illness. If you're vomiting and can't keep down your medicine, you may need shots of corticosteroids.

Other treatment recommendations include:

  • Carry a medical alert card and bracelet at all times. A steroid emergency card and medical alert identification let emergency care providers know what kind of care you need. Also have a written action plan.
  • Keep extra medicine handy. It can be dangerous to miss even one day of medicine. So keep a small supply at work and with you when you travel.
  • Carry a glucocorticoid injection kit. The kit contains a needle, a syringe and an injectable form of corticosteroids to use in case of emergency.
  • Stay in contact with your care provider. Your care provider can monitor your hormone levels. If you have problems with your medicine, your provider might need to change the doses or when you take them.
  • Have yearly checkups. At least once a year, see your care provider or a doctor who treats hormone problems. Your provider may recommend yearly screening for autoimmune diseases.

An addisonian crisis is a medical emergency. Treatment typically includes IV:

  • Corticosteroids
  • Saline solution
  • Sugar

Potential future treatments

Researchers are working to develop delayed-release corticosteroids, which act more like the hormones made by the human body. They also are studying the use of pumps placed under the skin that can deliver steroids in more-accurate doses.

Preparing for your appointment

You're likely to start by seeing your primary care provider. However, you might be referred to an endocrinologist, a doctor who treats conditions of the endocrine glands.

Here's information to help you get ready for your appointment.

What you can do

Take a family member or friend with you to help you remember the information you get.

Make a list of:

  • Your symptoms and when they began.
  • Key personal information, including major stresses or recent life changes.
  • All medicines, vitamins or other supplements you take, including doses.
  • Questions to ask your provider.

For Addison's disease, questions might include:

  • What is likely causing my symptoms or condition?
  • What tests do I need?
  • Is my condition likely temporary or long-lasting?
  • What is the best course of action?
  • I have other health conditions. How can I best manage them together?
  • Are there restrictions I need to follow?
  • Are there brochures or other printed material I can have? What websites do you recommend?

Don't hesitate to ask other questions as well.

What to expect from your doctor

Your provider may ask:

  • Do you have symptoms all the time or only sometimes?
  • How bad are your symptoms?
  • What, if anything, makes your symptoms better?
  • What, if anything, makes your symptoms worse?
By Mayo Clinic Staff