When You Have Addison Disease

Medicine instructions

• Take all medicines for this disease exactly as directed. You will need to take replacement hormones for the rest of your life. Cortisol is replaced by the drug hydrocortisone. Aldosterone is replaced by the drug fludrocortisone. Your health care provider will adjust the dose of each of these medicines based on your needs.

• As Addison disease affects your body’s ability to respond to stress, you’ll need higher doses during times of physical stress like infection, trauma, and surgery to prevent an Addisonian crisis. So your medicine dose may need to be doubled or tripled if you are injured or become seriously ill. After you recover, your provider will adjust your dose back to your regular, pre-illness level. Ask your provider to explain when and why you might need to increase your steroid dose. 

• You may need an emergency shot if you are in an accident or if you can't keep your hormone pill down because of vomiting. Carry a steroid injection kit for emergencies as directed by your provider. 

• Before you have any type of surgery, tell your provider or surgeon that you have Addison disease. Your steroid dose may need to be increased. If you’re having surgery that uses general anesthesia, you’ll need treatment with I.V. corticosteroids and saline.

• Get a medical ID bracelet that says, “Addison disease: needs steroid medicine daily.” Wear it at all times, in case of emergency. Always carry an emergency medical information card, a list of your medicines and dosages, along with the name and telephone number of the provider who treats your Addison disease on your phone or inside your wallet.

Preventing dehydration

It's very important to not get dehydrated. To do this:

• Increase your salt intake if your health care provider advises you to. Examples of salty foods are canned soups and potato chips. Use table salt where needed. If you are taking a mineralocorticoid pill, your provider may need to increase your dose during warmer months of the year if you are sweating more.

• Treat minor flare-ups by drinking more fluids and eating more salty foods.

• High doses of corticosteroids are linked with osteoporosis. It's a condition in which the bones become less dense and are more likely to fracture. Check with your provider if you need dietary or nutritional supplements for calcium and vitamin D.

• Work with a registered dietitian nutritionist to create a personalized meal plan and:

  • Select the best sodium sources and find out how much sodium you should have each day.

  • Recommend food items that are either rich in or fortified with calcium and vitamin D.

Preventing Addisonian crisis

Addisonian crisis can occur if you don’t have enough steroid hormones during stress or you are dehydrated. Major causes include:

• Viral or bacterial infections. (This is the most common cause.)

• Physical stress, such as a surgical procedure or trauma.

• Forgetting or suddenly stopping glucocorticoid therapy.

• Physical overexertion and dehydration.

• Psychological stress.

To prevent an Addisonian crisis:

• Take your medicine regularly. You may need to increase your hormone medicine at times. Your health care provider should explain when you will need to do this. 

• Don't get dehydrated. Don't overexert yourself in hot and humid conditions. Drink plenty of fluids.

• Stay healthy. Stay away from crowds during cold and flu season.

• Practice good hygiene. Wash your hands often. Don't touch surfaces in public places. Wear a mask if needed.

• Ask your provider about vaccines to help keep you healthy. Always get the yearly flu vaccine, unless you are allergic to it.

• If you are ill, take extra medicine doses as directed by your health care team.

• If you can't keep the medicine down because of vomiting, take the medicine by injection, as directed by your care team. Learn how to inject the right dose of your medicine.

• Make sure that a close family member or friend is educated about your Addison disease. This person should know how you treat it and where you keep your medicines. They should understand the danger signs that mean you need medical care right away. Make sure that your partner or spouse and close family members also know how to inject the right dosage of your medicine, in case you aren't able to do so.

Alerting your health care providers

Tell all of your health care providers that you have Addison disease. This includes your dentists, surgeons, and any specialists.

Follow-up care

Make a follow-up appointment as directed by your health care provider. Go to your regular follow-up appointments with your provider. Always contact your provider if you have questions about managing your disease.

When to get medical advice

Contact your health care provider right away if you have:

• Tiredness or weakness.

• A loss of appetite or you lose weight.

• Dizziness or you feel like you might faint when you stand up.

• Muscle aches.

• Nausea, vomiting, or diarrhea.

• Sharp pain in your lower back, belly (abdomen), or legs.

• An infection of any kind.

• Depression.

• Confusion.

• Severe emotional stress.

• A serious injury.

• A fever of 100.4°F ( 38°C) or higher, or as advised by your provider.

• Darkening of your skin.