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Old 10-31-2006, 03:20 PM   #1
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Ivoryz00 HB User
QUESTION: Can someone explain the different types of Addison's Disease?

I'm having a hard time understanding the different types of Addison's Disease. Can someone please explain it?

I've been ill over a year now with an unknown cause. Although it hasn't been proven yet, I believe I have Addison's Disease. The symptoms I've been experiencing are pretty identical to adrenal deficiency (weight loss, low blood pressure, poor appetite, extreme fatigue; NO hyperpigmentation). Trust me, I've tested for everything and Addison's Disease is by far the closet explanation. Even the stories I've read on this website sound just like me. My hormones were tested while I was hospitalized earlier this year and it revealed that my aldosterone levels were low, while my cortisol levels were normal.

I'm going to see my primary doctor in a couple of days for a follow up appointment. I've been reading a lot about the different treatments for Addison's Disease. I want to ask him if he can perscribe me whatever treatment there is for Addison's Disease. I just want to see if it helps me feel better, and to also see how it affects me. I'm pretty desperate at this point because I've been suffering for so long with this and I need something to help me. I won't be able see my endo doctor for another month. I feel it's worth a try, but I also feel unsure about it because of possible risks involved in taking unecessary treatment. What treatment should I ask for?

 
Old 10-31-2006, 04:39 PM   #2
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Re: QUESTION: Can someone explain the different types of Addison's Disease?

You should not ask for treatment or accept any cortisol replacement before you have been diagnosed. There is secondary & primary addisons. Both mentioned in the testing below. Bug the endo's office to get you in sooner & to call you if there is a cancellation. Make sure they know how ill you are.

Both are treated with a cortisol replacement & primary is also treated with florinef. Some with secondary addisons eventually need florinef.

You could try drinking bouillon (salt cubes disolved in hot water), maybe 3 times a day, add plenty of salt to your food & eat salty foods to see if it makes you feel even a bit better. Drink allot of water.

Testing your electolytes would be informative.


Diagnostic Testing for Addison's Disease

TEST 1: Electrolyte profile:

OBJECT: To determine if the patient exhibits a normal serum (blood) sodium and potassium levels.

THE TEST: A blood draw followed by automated determination of sodium and potassium levels as well as other standard blood markers.

NORMAL RESULT (will vary somewhat from lab to lab): Sodium 135-150 mEq/L; Potassium 3.5-5.2 mEq/L

PRIMARY ADDISONIAN: Will show significantly below normal values of sodium and a elevated (above normal) levels of potassium.

REASON FOR ABNORMALITY: Low or no production of aldosterone from the adrenal cortex. This steroidal hormone regulates our mineral balance and is called a mineralocorticoid. Primary Addisonians lose sodium and retain potassium. Abnormal values here, in additon to physical signs and symptoms, require the next test.




TEST 2: The ACTH stimulation test:

OBJECT: To determine if the patient's adrenal glands can respond to the ACTH message from the pituitary to increase cortisol production in the adrenal cortex.

THE TEST: The test is usually given first thing in the morning when normal cortisol levels are highest. Blood is withdrawn from the patient to establish a baseline (No instructions regarding necessity for fasting). The patient is given 250 micrograms (ug) of ACTH (Cortrosyn, Cosyntropin, or Synacthen) by injection in saline at one time. Blood is drawn at 30 minutes and/or 60 minutes and the serum cortisol level is determined.

NORMAL RESULTS: Normal pre-injection levels of cortisol are 5-25 ug/dL (138-690 nmol/L). The value should double at 30-60 minutes with a minimum of 20 ug/dL (552 nmol/L). PRIMARY ADDISONIAN: There will be no or little increase in cortisol levels upon ACTH injection. Notes: It is stated in several places that a single test of cortisol levels, or even 24 h urinary levels of cortisol and its metabolites, are NOT DIAGNOSTIC! In the normal individual cortisol levels are seen to pulse. Low cortisol production in either the serum or the urine after ACTH stimulation is diagnostic of Addisons disease.

SECONDARY ADDISONIAN (Pituitary malfunction): Low cortisol production can be seen if the patient has "functional adrenal cortical atrophy" due to prolonged absence of normal ACTH secretion. This type of patient would not show the typical hyper-pigmentation of primary Addisons.

REASON FOR ABNORMALITY: Due to autoimmune, or other destruction of enzymatic (biocatalytic) machinery of the adrenal gland, there is no response to ACTH and no production of cortisol and other adrenal steroids necessary for life. If this test gives normal results and the patient has other signs and symptoms then one of the following tests is required.

 
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