National Adrenal Diseases Foundation

Information for Health Care Practitioners

Recent Publications On Addison's Disease?

  1. Best Practice Guidelines Dr. Susan S. Braithwaite in 2014 research a number of recent articles in Europe and the US and created slides summarizing this information.
  2. Adrenal insufficiency (Lancet 2014) - Lancet article evaluating cause, diagnosis, treatement and management of Addison’s disease. Feb 2014
  3. "Consensus statement on the diagnosis, treatment and follow-up of patients with primary adrenal insufficiency (Journal_of_Internal_Medicine-2013)" - Consensus evaluation of 16 European physicians on the diagnosis, treatment, and management of Addison’s disease.
  4. What is Addison’s disease (England 2002) - Overview of Addison’s by Addison's Disease Self Help Group in England.
  5. Replication of cortisol circadian rhythm: new advances in hydrocortisone replacement therapy (Ther Adv Endocrinol Metab. 2010 Jun; 1(3): 129–138) .> This article also has a good section relating cortisol and sleep patterns.
  6. Adrenal crisis in treated Addison's disease: a predictable but under-managed event . This article suggest that 8% of Addisonian patients will need crisis injections each year. Therefore crisis kits must be prescribed.

What Are The Symptoms?

  1. Spotting Signs and Diagnosis 2002 Overview from Addison's Disease Self Help Group in England.
  2. Survey of Individuals with Addison's Disease 1997 Survey compiled in 2000 of Demographic and medical data of Addison’s patients in US – 700 responses.

How Is It Diagnosed?

  1. ACTH (Cortrosyn) Stimulation Test Protocol
  2. The Approach to the Adult with Newly Diagnosed Adrenal Insufficiency- this articles describes the steps to be taken when diagnosing and prescribing for a newly diagnosed adult patient.
  3. Safely clearing cortisol-type hormone replacement or supraphysiological dosing using dexamethasone for accurate ACTH (Cortrosyn) stimulation test (NADF)
  4. Diagnosing Addisons: a guide fpr GPs (Addisons Self Hlep group England) - a good overview for primary care physicians.
  5. ADRENAL ANTIBODY TEST (NADF) - anti-21 hydroxylase test instructions

What Medication Is Prescribed?

  1. Circadian patterns of cortisol relaease Understanding Diurnal Cortisol production > (Slide Presentation by Dr. Susan S. Braithwaite) - Understanding need to duplicate Natural Cicadian cycle
  2. Usual Adrenal Hormone Replacement Protocols NADF - This is a good guideline for basic non stress hormone replacement.
  3. Beware when switching medications - When a different type of of steroid is used patient must learn to retitrate the quantity they need.

Dosing For Stress Situations.

  1. Illness Stress Dosing - Illness guidelines from NADF
  2. Surgical Guidelines for Stress Dosing - Excellent guidelines for patient with surgical or dental procedures
  3. Corticosteroid Comparison Chart - Equivalent potency, half-life, and time required to be effective (NADA)
  4. Change in Solu-cortef - Pfizer changed formulation and Inventory number for Solu Cortef
  5. Flu Shot recommendations
  6. Dosage when under Cancer Treatment

What Causes It?

  1. NADF overview of Addison's disease.
  2. Adrenal Insufficiency and Addison's Disease HIH overview of Addison's disease
  3. What causes adrenal gland disorders?

Follow up exam Requirements

  1. Follow up Exam Requirements

Where is future research headed?


Special instructions for Patients.

  1. Understanding of the necessity of hydrocortisone intake determine patients attitude toward illness. - Patient education is essential for full life.
  2. Addison's Disease Owner's Manual from English Self Help Group - This is one of the mose complete manuals for the Addisonian available.
  3. Special consideration for Children and Teenagers- Section from Self-Help group in England
  4. Special advice to Athletes
  5. Special instructions on Hydration - Addisonian waste salt and water and need to adapt.
  6. Information for Women only
  7. WHAT SHOULD WE ASK TO HAVE ENGRAVED ON OUR MEDIC ALERT EMBLEM? This is minimum. Most engrave physician information and phone numbers on it.
  8. Special Instruction for Addison stress kits
  9. COLONOSCOPY dosage