How is adrenal insufficiency treated?

Treatment of adrenal insufficiency involves replacing, or substituting, hormones that the adrenal glands are not making. Cortisol is replaced with a synthetic glucocorticoid such as hydrocortisone, prednisone, or dexamethasone, which are taken orally one to three times each day, depending on which medication is chosen. If aldosterone is also deficient, it is replaced with oral doses of a mineralocorticoid, called fludrocortisone, which is taken once or twice a day. Because adrenal hormones help the body retain sodium, those with adrenal insufficiency may have to increase their salt intake. The doses of each medication are adjusted to meet the needs of an individual.

During an Addisonian crisis, low blood pressure (BP), low blood glucose, and high levels of potassium can be life threatening. Standard therapy involves intravenous injections of glucocorticoids and large volumes of intravenous saline solution with dextrose, a type of sugar. This therapy usually brings rapid improvement. When the patient can take fluids and medications by mouth, the amount of glucocorticoids is decreased until a maintenance dose is reached. If aldosterone is deficient, maintenance therapy also includes oral doses of fludrocortisone acetate.

This answer is based on source information from the National Institute of Diabetes and Digestive and Kidney Diseases.

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