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Addison's disease

Introduction

Evidence of infection

The adrenal crisis had been precipitated by influenza virus type B infection.1)

hyperkalemia

Those with a tendency to high potassium levels would be helped by our home made 'Jigsaw water'. Read the details in sodium bicarbonate

delay in Diagnosis

Addison's Disease: A Diagnostic Dilemma. 2)

Addison's disease is a rare endocrinal disorder, with several oral and systemic manifestations. A variety of pathological processes may cause Addison's disease.3)

A LONG FOLLOW-UP STUDY ON 143 PATIENTS.4)

In addition to the common “classical” causes of PAI like autoimmune, infectious, neoplastic and genetic disorders, other iatrogenic conditions - mostly pharmacological side effects (e. g., adrenal haemorrhage associated with anticoagulants, drugs affecting glucocorticoid synthesis, action or metabolism and some of the novel anti-cancer checkpoint inhibitors) are contributing factors to this phenomenon.

PAI is frequently not considered resulting in a delayed diagnosis. Successful therapy is mainly based on adequate patient education as a cornerstone in the prevention and management of adrenal crisis. 5)

Recent research

Even though efficient and safe pharmaceutical preparations for the substitution of endogenous gluco- and mineralocorticoids are established in therapy, the mortality in patients with primary adrenal insufficiency (PAI) is still increased and the health-related quality of life (HRQoL) is often reduced. PAI is a rare disease but recent data report an increasing prevalence. In addition to the common “classical” causes of PAI like autoimmune, infectious, neoplastic and genetic disorders, other iatrogenic conditions - mostly pharmacological side effects (e. g., adrenal haemorrhage associated with anticoagulants, drugs affecting glucocorticoid synthesis, action or metabolism and some of the novel anti-cancer checkpoint inhibitors) are contributing factors to this phenomenon. Due to the rarity of the disease and often non-specific symptoms at least in the early stages, PAI is frequently not considered resulting in a delayed diagnosis. 6)

Acute adrenal crisis is a life-threatening condition that requires immediate treatment. Standard replacement therapy consists of multiple daily doses of hydrocortisone or cortisone acetate combined with fludrocortisone. Annual follow-up by an endocrinologist is recommended with the focus on optimization of replacement therapy and detection of new autoimmune diseases. 7)

The most common causes of PAI are autoimmune adrenalitis (Addison's disease), infectious diseases, adrenalectomy, neoplasia, medications, and various rare genetic syndromes and inborn errors of metabolism that typically present in childhood although late-onset presentations are becoming increasingly recognized. 8) Fady Hannah-Shmouni and Constantine A. Stratakis : An overview of inborn errors of metabolism manifesting with primary adrenal insufficiency

Main presenting symptoms of Addison's disease such as fatigue, anorexia, vomiting and convulsion often mimics central nervous system (CNS) infections. 9)

New-onset autoimmune Addison's disease should be considered as a potentially reversible condition in some patients. Future studies of immunomodulation in autoimmune Addison's disease may be warranted. 10)

The prevalence of the metabolic syndrome in patients with AM was 35.71% after a period of treatment longer than 15 years. 11)

Patient's reports

Amelia

I decreased my Benicar back to every 6 hours for Monday and the nausea came back and my muscles were so sore like I exercised, which I didn't. I increased Benicar back to every 4 hours and am much better. Previously, when ever I had increased Benicar for more than a week, it made me nauseous and this time I am nauseated on the lower dose. I am going through a Lyme flair and my body must need the extra? I am a little sad about one thing though, My one year mark on the MP is later this month and my goal was to be off of the Cortef completely. I did go from 20mg to less than 5mg and with the Addison's, I didn't think even that was possible.

Bob

Recovering from surgery on the HPA axis, it seems as if my pituitary is not signalling my kidneys resulting in hypocortolism. This is different from Addison's (adrenal failure originating in the kidneys) or the other typical reasons MPers end up on Cortef (e.g., use as a steroid).

Toby

Anything to do with language, but especially writing (even while wearing Noirs) causes even more fatigue, plus the sensation as if fireworks are being set off within my brain, which can last for several days, and take up to several weeks to recover from. Just writing a few sentences can be enough to set this off! This leads to (additional) sleep disturbances, quite severe brain fogThe loss of intellectual functions such as reasoning; memory loss; and other neurological abilities that is severe enough to interfere with daily functioning., (again) worsening language skills, and other temporary neurological setbacks.

This is probably the result of the nerve damage I sustained due to very late treatment of my vitamin B12-deficiency, in my case caused by the autoimmune disease Pernicious Anemia. (Or better, to avoid the mistakes this often mis-used term can lead to: Addison-Biermer's Disease.) The B12-deficiency caused Subacute Combined Degeneration of my spinal cord and brain, and it's only since start of treatment with (frequent) B12-injections (May 2009), that this has very gradually been reversing. (So, before I started Olmesartan, in 2012.) Over time, among a great many other symptoms, B12-deficiency had made me lose most of my ability to read, write and speak, and had caused quite advanced dementia. I am now way better than at the start of B12-injections, and many neurological and other symptoms have greatly improved since, including the symptoms listed above.

Notes and comments

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look in https://www.marshallprotocol.com/search.php?s=1&q=+Addison%27s+disease&forum_id=35

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===== Symptoms =====
===== Management =====
===== Other treatments =====
===== Tests ===== 
===== Diagnosis =====
===== Types =====
===== Evidence of infectious cause=====
===== Politics =====
===== Patient interviews =====
===== Presentations and publications=====

References

1)
Addison's disease in a patient with hypothyroidism: autoimmune polyglandular syndrome type 2.
Bain A, Stewart M, Mwamure P, Nirmalaraj K
BMJ Case Rep2015p(2015 Aug 3)
2) , 9)
Addison's Disease: A Diagnostic Dilemma.
Afroz S, Bain S
Mymensingh Med J26p671-675(2017 Jul)
3)
Addison's disease.
Sarkar SB, Sarkar S, Ghosh S, Bandyopadhyay S
Contemp Clin Dent3p484-6(2012 Oct)
4)
THE NATURAL HISTORY OF AUTOIMMUNE ADDISON'S DISEASE FROM THE DETECTION OF AUTOANTIBODIES TO DEVELOPMENT OF THE DISEASE: A LONG FOLLOW-UP STUDY ON 143 PATIENTS.
Naletto L, Frigo A, Ceccato F, Sabbadin C, Scarpa R, Presotto F, Dalla Costa M, Faggian D, Plebani M, Censi S, Manso J, Furmaniak J, Chen S, Rees Smith B, Masiero S, Pigliaru F, Boscaro M, Scaroni C, Betterle C
Eur J Endocrinolp(2019 Jan 1)
5) , 6)
An Update on Addison's Disease.
Barthel A, Benker G, Berens K, Diederich S, Manfras B, Gruber M, Kanczkowski W, Kline G, Kamvissi-Lorenz V, Hahner S, Beuschlein F, Brennand A, Boehm BO, Torpy DJ, Bornstein SR
Exp Clin Endocrinol Diabetesp(2018 Dec 18)
7)
Ionic conductances related to GABA action on secretory and biosynthetic activity of pars intermedia cells.
Taleb O, Loeffler JP, Trouslard J, Demeneix BA, Kley N, Hollt V, Feltz P
Brain Res Bull17p725-30(1986 Nov)
8)
PMID: 29956047 was not found.
10)
Adrenal steroidogenesis after B lymphocyte depletion therapy in new-onset Addison's disease.
Pearce SH, Mitchell AL, Bennett S, King P, Chandran S, Nag S, Chen S, Smith BR, Isaacs JD, Vaidya B
J Clin Endocrinol Metab97pE1927-32(2012 Oct)
11)
[Cardiovascular and metabolic impact of glucocorticoid substitution therapy in patients with Addison's disease].
Salah DB, Charfi N, Elleuch M, Kacem FH, Rekik N, Mnif M, Mnif F, Abid M
Pan Afr Med J30p251(2018)
home/diseases/addisons.txt · Last modified: 02.11.2019 by sallieq
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