How is Adrenal Insufficiency treated

What is the treatment of Adrenal Insufficiency?

The treatment for adrenal insufficiency revolves around replacing or substituting the hormones that the adrenal glands are unable to produce. Cortisol is typically replaced with synthetic glucocorticoids such as hydrocortisone, prednisone, or dexamethasone, administered orally once to three times daily, depending on the chosen medication. If aldosterone is also deficient, it is supplemented with oral doses of a mineralocorticoid like fludrocortisone acetate (Florinef), taken once or twice daily. Patients undergoing aldosterone replacement therapy are often advised to increase their salt intake. Secondary adrenal insufficiency patients, who usually maintain aldosterone production, typically do not require aldosterone replacement therapy. Dosages of each medication are adjusted based on individual needs.

During an Addisonian crisis, characterized by life-threatening low blood pressure, low blood glucose, and high potassium levels, immediate treatment is crucial. Standard therapy involves intravenous administration of glucocorticoids and large volumes of saline solution with dextrose to rapidly stabilize the patient. Once the patient can tolerate oral intake, glucocorticoid doses are gradually reduced to reach a maintenance level. Maintenance therapy may also include oral fludrocortisone acetate if aldosterone deficiency is present.