Treatment

All treatment for Addison's disease involves medication. You will be given hormone replacement therapy to correct the levels of steroid hormones your body isn't producing. Some options for treatment include oral corticosteroids such as:

• Hydrocortisone (Cortef), prednisone or methylprednisolone to replace cortisol. These hormones are given on a schedule to mimic the normal 24-hour fluctuation of cortisol levels.
• Fludrocortisone acetate to replace aldosterone.

You will need to get plenty of salt (sodium) in your diet, especially during heavy exercise, when the weather is hot or if you have gastrointestinal upsets, such as diarrhea.

Your doctor will also suggest a temporary increase in your medication dosage if your body is stressed, such as from an operation, an infection or a minor illness. If you're ill with vomiting and can't keep down oral medications, you may need injections of corticosteroids.

Other treatment recommendations include:

• Carry a medical alert card and bracelet at all times. A steroid emergency card and medical alert identification will let emergency medical personnel know what kind of care you need. Also have a written action plan.
• Keep extra medication handy. Missing even one day of medication may be dangerous, so keep a small supply of medication at work and with you whenever you travel.
• Carry a glucocorticoid injection kit. The kit contains a needle, syringe and injectable form of corticosteroids to use in case of emergency.
• Stay in contact with your doctor. Keep an ongoing relationship with your doctor to make sure that the doses of replacement hormones are adequate, but not excessive. If you're having ongoing problems with your medications, you may need adjustments in the doses or timing of the medications.
• Have annual checkups. See your doctor or an endocrinology specialist at least once a year. Your doctor may recommend annual screening for a number of autoimmune diseases.

Treatment for an addisonian crisis, which is a medical emergency, typically includes intravenous injections of:

• Corticosteroids
• Saline solution
• Sugar (dextrose)

Potential future treatments

Researchers are working to develop delayed-release corticosteroids, which act more like the human body. They are also working on pumps implanted under the skin that can deliver steroids in more-accurate doses.

Future treatment may eventually involve using adrenocortical stem cells combined with immunomodulatory treatment — modifying the immune response or the immune system — as well as gene therapy.