Addison’s Disease, A Simple Guide To The Condition, Treatment And Related Conditions
By Kenneth Kee
()
About this ebook
Addison Disease is a disease that is caused by the deficiency of circulating glucocorticosteroids and mineral corticoids (aldosterone) hormones as a result of disease of the adrenal glands.
The causes of Addison Disease are:
1. Auto-immune disease (Type 1 PGA – Poly-glandular Autoimmune Syndrome) of the adrenals with destruction of the adrenal parenchyma
2. Tuberculosis of the adrenal glands
3. Adrenal tumors that may be benign or malignant
4. Rare causes are hemorrhage, infarction, and infiltrative diseases
The increased pigmentation especially in areas not exposed to the sun (such as buccal mucosa and palmar creases) and loss of weight can suggest the diagnosis of Addison Disease
This is due to excess pituitary production of ACTH which has melanocytes producing properties.
There is also sparse growth of axillary and pubic hairs.
Electrolytes especially sodium is low, potassium and urea nitrogen is high
ACTH stimulation test with impaired corticoid response is required to confirm diagnosis
Plasma cortisol is low (< 3mcg/dL) and do not rise with ACTH stimulation
Addison crisis is treated by intravenous normal saline and hydrocortisone 100mg every eight hours
Treatment must be done before laboratory confirmation of diagnosis because of the danger of coma
Chronic Addison disease requires replacement of glucocorticosteroids:
Hydrocortisone 30mg daily (two thirds in the morning, one third in the evening)
Cortisone acetate 37.5 mg daily or
Fludrocortisones 0.05 to 0.2 mg daily
DHEA 50mg orally in the morning
Adequate salt intake is important for normal fluid and electrolyte balance.
Addison crisis patients have excellent recovery with appropriate treatment
Chronic Addison disease patients also recovered well with replacement therapy.
Care is needed when there is trauma, infection and surgery
TABLE OF CONTENT
Introduction
Chapter 1 Addison Disease
Chapter 2 Interesting Facts about Adrenal Fatigue
Chapter 3 Treatment of Adrenal Fatigue
Chapter 4 Adrenal Fatigue
Chapter 5 Adrenal Tumors
Chapter 6 Adrenal Crisis
Chapter 7 Cushing Syndrome
Epilogue
Kenneth Kee
Medical doctor since 1972.Started Kee Clinic in 1974 at 15 Holland Dr #03-102, relocated to 36 Holland Dr #01-10 in 2009.Did my M.Sc (Health Management ) in 1991 and Ph.D (Healthcare Administration) in 1993.Dr Kenneth Kee is still working as a family doctor at the age of 74However he has reduced his consultation hours to 3 hours in the morning and 2 hours inthe afternoon.He first started writing free blogs on medical disorders seen in the clinic in 2007 on http://kennethkee.blogspot.com.His purpose in writing these simple guides was for the health education of his patients which is also his dissertation for his Ph.D (Healthcare Administration). He then wrote an autobiography account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.comThis autobiography account “A Family Doctor’s Tale” was combined with his early “A Simple Guide to Medical Disorders” into a new Wordpress Blog “A Family Doctor’s Tale” on http://ken-med.com.From which many free articles from the blog was taken and put together into 1000 eBooks.He apologized for typos and spelling mistakes in his earlier books.He will endeavor to improve the writing in futures.Some people have complained that the simple guides are too simple.For their information they are made simple in order to educate the patients.The later books go into more details of medical disorders.He has published 1000 eBooks on various subjects on health, 1 autobiography of his medical journey, another on the autobiography of a Cancer survivor, 2 children stories and one how to study for his nephew and grand-daughter.The purpose of these simple guides is to educate patient on health disorders and not meant as textbooks.He does not do any night duty since 2000 ever since Dr Tan had his second stroke.His clinic is now relocated to the Buona Vista Community Centre.The 2 units of his original clinic are being demolished to make way for a new Shopping Mall.He is now doing some blogging and internet surfing (bulletin boards since the 1980's) startingwith the Apple computer and going to PC.The entire PC is upgraded by himself from XT to the present Pentium duo core.The present Intel i7 CPU is out of reach at the moment because the CPU is still expensive.He is also into DIY changing his own toilet cistern and other electric appliance.His hunger for knowledge has not abated and he is a lifelong learner.The children have all grown up and there are 2 grandchildren who are even more technically advanced than the grandfather where mobile phones are concerned.This book is taken from some of the many articles in his blog (now with 740 posts) A Family Doctor’s Tale.Dr Kee is the author of:"A Family Doctor's Tale""Life Lessons Learned From The Study And Practice Of Medicine""Case Notes From A Family Doctor"
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Addison’s Disease, A Simple Guide To The Condition, Treatment And Related Conditions - Kenneth Kee
Addison’s Disease,
A
Simple
Guide
To
The Condition,
Treatment
And
Related Conditions
By
Dr Kenneth Kee
M.B., B.S. (Singapore)
Ph.D (Healthcare Administration)
Copyright Kenneth Kee 2014 Smashwords Edition
Published By Kenneth Kee at Smashwords.com
Dedication
This book is dedicated
To my wife Dorothy
And my children
Carolyn, Grace
and Kelvin
This book describes the Addison Disease, its Treatment and Related Diseases such as Adrenal Fatigue, Adrenal tumors, Adrenal Crisis and Cushing Syndrome.
This eBook is licensed for your personal enjoyment only. This eBook may not be re-sold or given away to other people. If you would like to share this book with another person, please purchase an additional copy for each reader.
If you’re reading this book and did not purchase it, or it was not purchased for your use only, then please return to Smashwords.com and purchase your own copy.
Thank you for respecting the hard work of this author.
Introduction
Ode to Addison Disease
Addison Disease is a disease caused by the deficiency of steroids
The main cause is autoimmune disease with reduced cortisol
Tuberculosis of the adrenal glands in developing countries
Rare causes are lymphoma, metastasis and amyloidosis
Symptoms are fatigue, abdominal pain and vomiting
Loss of weight and appetite, also salt craving
Irregular menses, hyperpigmentation of the skin
Some patients have dizziness that occurs upon standing
Plasma cortisol is low that will not rise with ACTH stimulation
This test will confirm the diagnosis together with hyperpigmentation
Chest X-ray will exclude pulmonary Tuberculosis
A Bone scan will also exclude osteoporosis
Treatment is intravenous normal saline and hydrocortisone
Followed by oral hydrocortisone in morning and later in the evening
DHEA 50mg is given in the morning orally
Adequate salt to balance the electrolyte daily
-An original poem by Kenneth Kee
Interesting Tips about the Addison Disease
A Healthy Lifestyle
1. Take a well Balanced Diet
2. Treatment of Addison Disease
a. Addison crisis is treated by intravenous normal saline and hydrocortisone 100mg every eight hours
Treatment must be done before laboratory confirmation of diagnosis because of the danger of coma
b. Chronic Addison disease requires replacement of glucocorticosteroids:
i. Hydrocortisone 30mg daily (two thirds in the morning, one third in the evening)
ii. Cortisone acetate 37.5 mg daily or
iii. Fludrocortisones 0.05 to 0.2 mg daily
c. DHEA 50mg orally in the morning
d. Adequate salt intake is important for normal fluid and electrolyte balance.
3. Keep bones and body strong
Bone marrow produces our blood
Eat foods rich in calcium like yogurt, cheese, milk, and dark green vegetables.
Eat foods rich in Vitamin D, like eggs, fatty fish, cereal, and fortified milk.
Eat food rich in Vitamins B and C such as green vegetables and fruits
Zinc and other minerals are important to the body
4. Get enough rest and Sleep
Avoid stress and tension
5. Exercise and stay active.
It is best to do weight-bearing exercise such as walking, jogging, stair climbing, dancing, or lifting weights for 2½ hours a week.
One way to do this is to be active 30 minutes a day at least 5 days a week.
Begin slowly especially if a person has not been active.
6. Do not drink more than 2 alcohol drinks a day for a man or 1 alcohol drink a