From the Guidelines
Addison's disease symptoms include fatigue, muscle weakness, weight loss, low blood pressure, darkening of the skin, salt cravings, nausea, diarrhea, abdominal pain, and mood changes, and treatment involves hormone replacement therapy with glucocorticoids and mineralocorticoids, as well as emergency measures for adrenal crisis situations. The symptoms of Addison's disease can vary, but common signs include:
- Fatigue and muscle weakness
- Weight loss and loss of appetite
- Low blood pressure and dizziness
- Darkening of the skin, especially on the hands, feet, and face
- Salt cravings and increased thirst
- Nausea, diarrhea, and abdominal pain
- Mood changes, such as irritability and depression Treatment for Addison's disease typically involves hormone replacement therapy with glucocorticoids like hydrocortisone (typically 15-25 mg daily divided into 2-3 doses) or prednisone (5-7.5 mg daily), and mineralocorticoids such as fludrocortisone (0.05-0.2 mg daily) 1. Patients with Addison's disease must take these medications for life and increase glucocorticoid doses during illness, surgery, or significant stress, such as major surgery, where 100 mg hydrocortisone im is given just before anesthesia, and continued every 6 hours until able to eat and drink, then doubling the oral dose for 48 hours, and tapering to the normal dose 1. An emergency injection kit with 100 mg hydrocortisone should be available for adrenal crisis situations, which can be precipitated by events such as vomiting, diarrhea, infections, surgical procedures, and severe allergic reactions 1. Regular medical follow-up is essential to monitor symptoms and adjust medication doses, and patients should wear a medical alert bracelet and educate family members about emergency management 1.
From the FDA Drug Label
INDICATIONS & USAGE Fludrocortisone acetate tablets, 0.1 mg are indicated as partial replacement therapy for primary and secondary adrenocortical insufficiency in Addison’s disease and for the treatment of salt-losing adrenogenital syndrome. DOSAGE & ADMINISTRATION ... Addison's Disease ... Patients should be continually monitored for signs that indicate dosage adjustment is necessary, such as remission or exacerbations of the disease and stress (surgery, infection, trauma)
The symptoms of Addison's disease are not explicitly listed in the provided drug labels. However, the labels mention adrenocortical insufficiency and the need to monitor for remission or exacerbations of the disease and stress.
- The treatment for Addison's disease involves partial replacement therapy with fludrocortisone acetate tablets, often in combination with a glucocorticoid such as hydrocortisone or cortisone, as stated in 2 and 2.
- The usual dose of fludrocortisone acetate tablets is 0.1 mg daily, although this may vary depending on the severity of the disease and the patient's response.
From the Research
Symptoms of Addison's Disease
- The symptoms of Addison's disease can be acute or chronic, and may include:
- Orthostatic hypotension, fever, and hypoglycemia in acute cases 3
- Malaise, anorexia, diarrhea, weight loss, joint and back pain in chronic cases 3
- Darkening of the skin, especially in sun-exposed areas, and hyperpigmentation of the palmar creases, frictional surfaces, vermilion border, recent scars, genital skin, and oral mucosa 3, 4, 5
- Fatigue, weariness, and reduced stress tolerance 6
- Generalized weakness, dizziness, loss of appetite, and vomiting 4
Treatment of Addison's Disease
- The treatment of Addison's disease involves replacement of the deficient hormones, including:
- Glucocorticoids, such as hydrocortisone, which can be administered orally or through continuous subcutaneous infusion 7, 6
- Mineralocorticoids, such as fludrocortisone, which can be administered orally 7, 6
- Dehydroepiandrosterone replacement has been advocated in some cases, but the evidence for benefit is weak 6
- The goal of treatment is to restore normal hormone levels and alleviate symptoms, allowing patients to resume normal daily activities with a highly functional status 5
- Treatment may also involve addressing underlying causes of the disease, such as tuberculosis, which can cause adrenal insufficiency 4