Addison’s Disease: Therapy

General measures

  • Aim to maintain normal weight!Determine BMI (body mass index, body mass index) or body composition using electrical impedance analysis.
    • Falling below the BMI lower limit (from the age of 45: 22; from the age of 55: 23; from the age of 65: 24) → Participation in a medically supervised program for the underweight.
  • Review of permanent medication due topossible effect on the existing disease.

Vaccinations

The following vaccinations are advised, as infection can often lead to worsening of the present disease:

  • Flu vaccination
  • Pneumococcal vaccination

Regular checkups

  • Regular medical checkups

Nutritional medicine

  • Nutritional counseling based on nutritional analysis
  • Nutritional recommendations according to a mixed diet taking into account the disease at hand. This means, among other things:
    • Daily total of 5 servings of fresh vegetables and fruits (≥ 400 g; 3 servings of vegetables and 2 servings of fruits).
    • Once or twice a week fresh sea fish, i.e. fatty marine fish (omega-3 fatty acids) such as salmon, herring, mackerel.
    • High-fiber diet (whole grains, vegetables).
  • Selection of appropriate food based on the nutritional analysis
  • See also under “Therapy with micronutrients (vital substances)” – if necessary, taking a suitable dietary supplement.
  • Detailed information on nutritional medicine you will receive from us.

Training

  • Patients with Addison’s disease receive an emergency ID card and must be trained and informed that there is an increased need for glucocortocoids in stressful situations.Common precipitating factors in adrenal crises include:
    • Gastrointestinal infections (gastrointestinal infections; 22-33%).
    • Other febrile infections (17-24%).
    • Operations (7-16 %)
    • Intensive physical labor (7-8%)
    • Psychological stress (4-6%)
  • The following facts are trained:
    • Symptoms of acute adrenal insufficiency.
    • Dose adjustment in stressful situations (see above).
    • Diarrhea (diarrhea) and vomiting as an urgent indication for parenteral (“bypassing the intestine,” i.e., injection) glucocorticoid administration
  • “Emergency equipment” includes the prescription of, for example: 100 mg hydrocortisone-21-hydrogensuccinate as an ampoule and glucocorticoid suppositories/suppositories (e.g., 100 mg prednisolone suppositories)
  • Training the patient in self-injection of hydrocortisone.