Addison's disease

Diagnosis

Diagnosis involves the steps that your healthcare team takes to find out if you have Addison's disease. Your healthcare professional talks with you about your medical history and your symptoms. You might have some of the following tests that check for Addison's disease or for secondary adrenal insufficiency:

• Blood test. This test can measure blood levels of sodium, potassium, cortisol and adrenocorticotropic hormone (ACTH). A blood test also can measure proteins called antibodies related to Addison's disease caused by an autoimmune 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 lab-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 spot damage that may cause secondary adrenal insufficiency.

Treatment

Addison's disease treatment involves taking medicines to correct the levels of steroid hormones that the body isn't making enough of. Some treatments include corticosteroid medicines taken by mouth such as:

• Hydrocortisone (Cortef), prednisone (Rayos, Prednisone Intensol) or methylprednisolone (Medrol) to replace cortisol. You take these medicines on a schedule. This helps mimic the changes in cortisol levels the body typically goes through over 24 hours.
• Fludrocortisone acetate to replace aldosterone.

You'll likely need plenty of sodium in your diet. This is especially true during heavy exercise and when the weather is hot. It's also true if you have digestive troubles such as diarrhea.

Your healthcare professional may tell you to raise the dose of 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.

Follow these treatment recommendations as well:

• Carry a medical alert card and bracelet at all times. A steroid emergency card and medical alert bracelet or tag let emergency care professionals 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 take extra medicine with you when you travel.
• Carry a corticosteroid medicine 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 healthcare professional. Your healthcare team can monitor your hormone levels. If you have trouble with your medicine, your healthcare professional may need to change the doses or when you take them.
• Have yearly checkups. At least once a year, see your healthcare professional or a doctor who treats hormone conditions. Your healthcare professional may recommend yearly screening tests for autoimmune diseases.

Addisonian crisis is a medical emergency. Treatment typically includes medicines or solutions given through a vein. These include:

• Corticosteroids.
• Saline solution.
• Sugar.

Clinical trials

Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this condition.

Preparing for your appointment

You're likely to start by seeing your primary healthcare professional. Then, you might be referred to a doctor called an endocrinologist who treats conditions related to hormones.

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

What you can do

Take a family member or friend with you if you can. This person can 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 healthcare professional.

For Addison's disease, questions might include:

• What is likely causing my symptoms or condition?
• What tests do I need?
• Is my condition likely short-term 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?

Feel free to ask other questions as well.

What to expect from your doctor

Your healthcare professional 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?