Addison's disease natural history, complications and prognosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Natural History

The symptoms of Addison's disease subside with treatment. Patients whose Addison's disease is due to treatable causes recover well once the cause is treated. The rest of the patients require glucocorticoid and mineralocorticoid replacement for life. Patients on steroid replacement therapy need to be closely monitored by an endocrinologist.

Complications

Complications of Addison's disease include:

• Hypoglycemia
• Addisonian crisis
• Hypoxia
• Hypovolemic shock
• Cardiac arrest
• Stroke

Prognosis

While treatment solutions for Addison's disease are far from precise, overall long-term prognosis is typically good. Because of individual physiological differences, each person with Addison's must work closely with their physician to adjust their medication dosage and schedule to find the most effective routine. Once this is accomplished (and occasional adjustments must be made from time to time, especially during periods of travel, stress, or other medical conditions), symptomology is usually greatly reduced or occasionally eliminated so long as the person continues their dosage schedule.

If untreated Addison's disease can be fatal. Hormone pills should be taken for the rest of the patient's life.

As long as the proper dose of replacement medication is taken every day, an Addisonian can have a normal crisis-free life. There are no specific physical or occupational restrictions. Routine care includes regular physician visits, avoidance of dehydration, and the use of extra medication during illness. Pregnancy is possible, but will require extra monitoring of the replacement medication. Every Addisonian should wear an identification bracelet or preferably a necklace stating that he or she has the disease, in order to ensure proper emergency treatment. An identification card outlining treatment is also suggested.