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Addison's Disease Message Board

Addison's Disease Board Index

CORTISOL. Low cortisol is a major clue. All you need now is to determine if it is primary or secondary adrenal failure. Primary adrenal failure means that your adrenals are defective. Secondary adrenal failure means that your pituitary in not sending ACTH, which drives the adrenals to make cortisol. Low cortisol is best detected with a "24-Hour Urinary Free Cortisol" test.

If an ACTH test determines the adrenals are functioning, then the problem is either your hypothalamus, which drives the pituitary, or your pituitary, which drives the adrenals. The treatment is the same for both problems: take hydrocortisone daily, usually 25-30 mg, although some of us need higher doses (55 mg). Alternates to hydrocortisone (Cortef) are Decadron or Prednisone. The literature I've read claims that hydrocortisone is the drug of choice.

For either problem you need an MRI, without and with dye, to detect tumors of the hypothalamus-pituitary region.

THYROID. My doctors always ordered a TSH test (Thyroid Stimulating Hormone). Once the adrenals are involved the conventional tests, including TSH, are no longer valid. Free-T and Free-T4 are best.

CRAZY. If you have adrenal insufficiency, then your doctors are right: you are crazy. But given proper medication (hydrocortisone) then you will be normal again.

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